LEVELS OF MENARCHE ON GENERAL HEALTH AND PERSONAL HEALTH DEPRESSION AMONG ADOLESCENT GIRLS

LEVELS OF MENARCHE ON GENERAL HEALTH AND PERSONAL HEALTH DEPRESSION AMONG ADOLESCENT GIRLS *Chandrakant Jamadar **Bhanu B.M Abstract : Background : A growing number of studies suggest a link between levels of menarche an general health depression and personal health among school going girls. Aims To examine levels of menarche on personal health depression and general health among school going girls. Method : The study sample comprised 120, 60 private, 60 Government schools, Mysore Urban and Rural school going children. The association between Government and Private school children menarche and depressive symptoms at 5th std to 7th, 8th std to 10 and 11 to 12 std adolescent girls was examined within a structural equation model. Results : Girls with general health at .300 mere is no significant but in personal health depression .001 it is very highly significant in these depression government and private school Key Words: Menarche, Depression, Health and Adolescent. …………………………………………………………………………………… *Asst.Professor,P.G.Studies in Psychology,Maharani Arts & Commerce College ,MYSORE ** M.Sc Student, P.G.Studies in Psychology,Maharani Arts & Commerce College ,MYSORE Menarche : Menarche the first menstruation which occurs at puberty. The majority of girls (95%) reach menarche between 11 and 15 years of age, the average is said to be about 13 years. Ovulation can occur at the time of menarche but usually this does not happen for several months or even up to two years later. Thus the first few menstrual cycles are often anovulatory and hence infertile. The word menarche is derived from the Greek words men, month and arche - beginning. It is the term used to refer to the first menustral period. This first sign that menustration has begin is governed by a complex set of biological processes, genetic information and psychosocial factors. In the human female, the usual age for menarche is between ages eleven and twelve (Martini 1992) others studies however, report figures between twelve and thirteen (Boaz and Almgnist 1997) variables that influence the one set of menarche include body build or body mass critical weight, height / weight ratio, skeletal maturation and percentage of body fat. Other correlates are health history, protein intake, amount of daily exercise and familial trends. The biological Process At about age eight, the pituitary gland secretes hormones until the ovaries begin their own production of steroids. The chemicals that are responsible for initiating puberty. These hormones follicle stimulating hormone and lweinizing hormone allow for an increase in adipose tissue, and inhibit the growth hormone. They stimulate the overy to produce estrogen and progesterone, which results in breast development and public hair. View of Guyton (1976) at birth, the human female has approximately 750,000 primordial follicle (eggs). By puberty, 400.00 remain. At or soon after menarche, the first mature egg is released. Menstruation will recur each month until menapuse when few or no follicles remain. Differing ages of onset through history According to Tanner (1962) by age thirteen, most girls in industrialized societies have attained menarche. Interestingly this number has not been consistent through history. It appears that menustral age has been decreasing from between fifteen and sixteen in the last half of the eighteenth century, to twelve to thirteen in the present day at a rate of three months per decade. Vario7us reasons have been hypothesized. Alarmists decry this trend and blame it on a multiplicity of factors from hormones in food to mass media. Since nutrition and standard of living have improved in the last 200 years, one explanation is that the time for menarche has always been the same biologically, but was delayed because of the lack of essential nutrients for the chemical pathways to trigger hormone synthesis. Genetically, humans have always had the potential for certain biological phenomena to express themselves, but environmental conditions retarded both growth and development ages wise world. Reproduction and family Menarche is an abrupt signal that marks a change ins social status from child to adult. Cross - culturally, menarche has a variety of meanings that include adult responsibilities, freedoms, and expectations regarding reproductions. As with all cultural phenomena, there is a wide range of significance attached to menarche. Family life, reproductive health education are interrelated. While each one has specific focus they also overlap. Family life education is defined (IPPF) international planned parenthood federation. As an educational process designed. Young people in their physical, emotional and moral development as they prepare for adulthood marriage, parenthood and ageing, as well as their social relationships in the socio cultural context of the family and society (1985 IPPF). Reproductive health education is described by UNESCO/ UNFPA as educational experience aimed at developing capacity of adolescents to understand their sexuality in the context of biological, psychological, socio-cultural and reproductive dimensions and to acquire skills in managing responsible decisions and actions with regard to sexual and reproductive health behaviour (UNESCO / UNFPA, 1998b). and population education is defined by UNFPA as “the process of helping. People understand the nature, causes and implications of population process as they affect, and are affected by individuals, families communities, and nations. It focuses on family and individual decisions influencing population change at the micro level as well as on broad demographic changes” (Sikes 1993), population growth and scarce resources as well as population decline in light of increasingly elderly population. In the cultural context of India, attainment of menarche by girls is considered a biological indicator that the girl is ready for the commencement of sexual relations. This is evident from the traditional practice of “Gauna” that was commonly followed in the olden days. In this system girl used to be married off at an early age but continued staying in the parental home without consummation of marriage. However, when a girl attained menarche the ceremony of Gauna would be performed and then the girl went to live at her husband’s house where she would begin her married life. The even of menarche is also a social indicator signifying the eligibility of the girl for marriage and the initiation of the search for suitable marriage partner. According Hutter et al (1998 - 2003) research findings illustrate tht the two events of menarche and marriage follow each other very closely in the rural area. Tribal in Karnataka, where fertility is crucial, menarche is celebrated by a rite of passage. Where fertility is at a premium, it is cause for elaborate ritual and public knowledge. Menarche is treated in different societies Anthropology is rich with descriptions of coming of age ceremonies for girls. The attitudes of societies toward menarche vary from delight and pride to fear and shame. Positive labels signify that the girl is an adult. Capable of contributing to the ongoing society. Menstrual pollution is the term anthropologists use to describe fears of menstrual blood and its dangerous powers. Since the time of Pliny (23-79) myths and taboos have surrounded menarche societies in India, British Colombia and North America built menstrual huts to segregate menstruating women. In Karnataka ‘gauna’ was held for each girl at Menarche. The girl informed older women that she has started to bleed and then their would take her to the fire to warm her seeds were cooked and the girl was made to extract and eat the cooked seeds which was hot and streaming she was made to stay in separate hut. Most girls in the rural areas unaware and unprepared for menarche. There matters did not discuss menstruation with them. They were traumatized by the experience and had now where to turn for information or support. As some part of the Karnataka blessing the daughter with a congratulatory statement such as “total you are a women” 10 to 15 days along ceremony is celebrated in honar of each girl who began her period in these 15 days include feasting dancing and singing each evening. In the last two day a private ceremony is held only among a relatives to show her that she is their passing into womanhood. Behavioral changes : The different categories of knowledge seem directly or indirectly to influence behavioral changes that are expected of the girl after they attained menarche. In the theoretical framework expected behavioral changes is elaborated in the form of norms that are the rules and expectations by which a society guides the behavior of its members. normal are age graded as well as status based, Age-graded norms refer to how women of particular ages should behave, whereas the status based norms refer to how a menstruating girl should behave in comparison to a non-menstruating girl. There are certain rules and restriction as well as role in society and family which is acceptable and unacceptable for the coming generation. Which could be seen in the consciousness of her look, way of dressing her responsibility as a women for cooking, conducting pooja’s helping her mother in the domestic work or kitchen varies as day passes. Depression and menarche There is much recent evidence that depression and anxiety became common during menarche prospective community studies have shown arise from low prevalence rates at the beginning of the second decade to adults. Respective studies of adults with psychiatric disorders have highlighted the frequency with which depression and other functional psychiatric disorders begin in the teens prospective studies of adolescents who present which psychiatric disorders have further emphasized continuity withy adult disorders finally, family studies have shown high rates of first onset of major depression in the early teens for female subjects with a family history of depression. Literature Review Few studies analyzed depression and personal health related this problem CG paton and etal studied on menarche and the onset of depression and anxiety in Victoria, Australia. This study aimed at examine the associations between puberty and social circumstances and the adolescent rise in depression and anxiety. In this study they are selected 2525 large samples survey - an overall participation rate of 83% levels of depression and anxiety increased with the secondary school years and girls has significantly higher rates at each school year level. Overall menarche marks a transition in the risk of depression and anxiety in girls. Another important studies in this area is timing of menarche and depressive symptoms in adolescent girls from UK (The British Journal of Psychiatry 2011 pp 198). This study examine whether girls who experience earlier menarche than their peers have higher levels of depressive symptoms in adolescence. This study consists of 2184 girls from the Avon longitudinal study of parents and children. The association between timing of menarche and depressive symptoms at 10.5, 13 and 14 years was examined within a structural equation model. Result was girls with early menarche (< 11.5 years) has the highest level of depressive symptoms at 13 (P - 0.007) and 14 years (P < 0.001) compared with these with normative and late timing of menarche. Totally early maturing girls are at increased risk of depressive symptoms in adolescence and could be targeted by programmes aimed at early intervention and prevention. Methodology Statement of problems Levels of menarche on general health and personal health depression among adolescent girls. Objectives of the study 1. To assess and analyze the general health and personal health depression and menarche in adolescent girls. 2. To find out differences between rural and urban adolescent girls in menarche and general health and personal health depression. 3. To know the differences in different religion and menarche in general health and personal health depression. Hypothesis H1 : There will be a significant difference in general health and personal health depression in adolescent girls in H2 : There will be significant differences between rural and urban development adolescent girls in menarche and general health and personal health depression H3 : there is a significant impact in different standard adolescent girls in menarche and general health and personal health depression. H4 : There will be significant differences between different religion adolescent girls in menarche and general health and personal health depression. Sample The present study consists of 120 samples (60 govt. - 60 private) was a community based descriptive, cross-sectional study conducted among school going girls in the 5th to 7th (I Group) 8th - 190 (II Group), 11th to 12th (III Group) adolescent girls from of Mysore Urban and Rural area here two educational institute (private / govt) were selected in random sampling method. Measure The following standardized tools were selected for data collections 1. General health questionnaire (GHQ) by Gold berg and Hiller (1979). The GHQ consists of 28 items. The securing was done according to the respective manual 2. Personal health depression questionnaire (PHQ D-9) by seanford patient education research centre (2001). The scoring was done according to the respective manual it consists of 9 items the internal reliability is 88. Consecutive numbers are circled, score and higher (more distress), number. If the numbers are not consecutive, do not score the items. Score is the sum of the 9 items. Of more than 1 item missing set the value of the scale of missing. A score of 15 or greater is considered major depression, 20 or more is severe major depression. The internal reliability is 88. Statistical analysis Keeping the objectives of the study is view, the following statistical techniques were applied mean, SD were calculated F- test was used to assess the significant difference in menarche and general health and personal health depression. Result and discussion Table No. 1 general health and menarche in Rural and urban adolescent girls (N = 120) GHQ Area Mean SD F-Value Urban 6.20 4.12 .775 Rural 6.82 4.57 There is no significant Above table reflects the general health of rural and urban adolescent girls. The mean score of general health or urban and rural is 6.20 and 6.82 respectively. Where as the SD is 4.12 and 4.57 respectively. The calculated F- value is 440 it is not significant. It shows that there is no difference in general health and menarche of rural and urban adolescent girls. Table No. 2 Personal health depression and menarche in Rural and Urban adolescent girls (N - 120 ) PHD Area Mean SD F-Value Urban 5.43 4.05 2.42* Rural 6.95 4.08 *It is significant at 0.005 level Table No. 2 it shows that personal health depression and menarche in rural and urban adolescent girls. The mean score of personal health depression and menarche in rural and urban adolescent girls is 5.43 and 6.95 where is SD is 4.05 and 4.08 respectively. The calculated F - value is 2.42 which is significant at 0.05 level. It shows that there is significant difference in the personal health depression and menarche in rural and urban adolescent girls. Therefore, the hypothesis that, there is significant difference between personal health depression in rural and urban adolescent girls is accepted. Table No. 3 General health and menarche in three different class adolescent girls (N - 120) GHQ Class Mean SD F-Value 5th - 7th 6.68 3.39 2.43* 8th -10th 7.48 5.21 11th - 12th 5.38 4.08 Total 6.51 4.35 *Significant at 0.05 level Table No. 3 is reflected the general health and menarche in there different class of adolescent girls. The mean score of 5 to 7th standard, 8 to 10th standard and 11 to 12th standard adolescent girls mean is 6.68, 7.48 and 5.38 respectively and SD is 3.3, 5.21 and 4.08. the calculative F- value is 2.43. It is significant at 0.005 level. It shows that there is a significant difference in their general health and menarche in three different class adolescent girls. Therefore the hypothesis is accepted Table No. 4 Personal health depression and menarche is three different class adolescent girls (n = 120) PHD Class Mean SD F-Value 5th - 7th 6.85 3.47 7.65* 8th -10th 7.48 4.82 11th - 12th 4.25 3.24 Total 6.19 4.12 *Significant at .001 level. Above table reflects the personal health depression and menarche in three different class adolescent girls. The mean score of 5-7 , 8-10 and 11-12 class girls is 6.85, 7.48 and 4.25 and SD is 3.47 \, 4.82 and 3.24 is respectively. The calculative F- value is 7.65 which is significant at .001 level it shows that there is highly significant difference in their personal health depression and menarche in three different class adolescent girls. Therefore the hypothesis is accepted. Table No. 5 General health and menarche in different religion adolescent girls GHQ Religion N Mean SD F-Value Hindu 112 6.41 4.42 1.04 Muslim 05 9.20 2.58 Christian 03 5.67 2.88 Total 120 6.51 4.35 Table No. 5 it shows that the general health and menarche in different religion of adolescent girls mean score of Hindu, Muslim and Christian adolescent girls is 6.41, 9.20 and 5.67 respectively. Where SD is 4.42, 2.58 and 2.88. the calculated F- value is 1.04 It is not significant. It shows that there is no difference in their general health and menarche in different religion of adolescent girls. Table No. 6 Personal health and menarche in difference religion adolescent girls PHD Religion N Mean SD F-Value Hindu 112 5.87 3.95 5.67 Muslim 05 11..00 4.74 Christian 03 10.33 2.88 Total 120 6.19 4.12 *Significant at 0.05 level Table No. 6 reflects that the personal health depression in different religion adolescent girls. The mean score of Hindu, Muslim and Christian adolescent girls is 5.87, 11.00 and 10.33 and SD is 3.9, 4.74 and 2.88 is respectively. The calculative F- value is 5.68. Which is significant at 0.05 level. It shows that there is significant difference in their personal health depression in different religion adolescent girls. Therefore, the hypothesis that there is significant difference in different religion adolescent girls is accepted. Summary and Conclusion • There is significant difference in menarche and general health and personal health depression in adolescent girls. • There is significant differences between rural and urban adolescent girls in menarche and general health and personal health depression. • There is significant difference between different standard adolescent girls in general health and personal health depression. • There is significant differenced between different religion like Hindu, Muslim, and Christian adolescent girls in menarche and personal health and personal health depression. References • GC Patton et al (1996) Menarche and on set of depression and anxiety in Victoria, Journal of Epidemiology an community health pp 661. • Thomas et al (1998) Age variability menarche and menopause pp - 274-275. • Amrita Bagga and S. Kulkarni (2000) age at menarche and secular trend in Maharastrian Girls acts biological szegedenisis vol 44 (1-4) pp 55. • Bardhan A (1962) A short note on relationship between menarcheal age and certain anchropometric measurements. The anthropologists 9 : 25 - 30 • Indian council of medical research (ICMR) (1972) growth and physical and development of Indian infants and children technical report ser New Delhi pp - 18 • Veereshwar, P (1979), A study of mental health and adjustment of college girls, Meerat University NCERT Report (1991) (Ed) Pp 454. • Carol Joinson et al (2011) timing of menarche and depressive symptoms in adolescent girls from UK, British Journal of psychiatry (2011) p. 17-23. • Sharma J.C (1970) physical growth and development of the Maharastrian Ethnographic and folk culture society, Lucknow, India pp 45-47. • Bali R.S. Randhwa M.N (1978) Relationship between menarcheal age and body girls Indian Phys Antrop and Human General pp 71-74.