LEVELS
OF MENARCHE ON GENERAL HEALTH AND PERSONAL HEALTH DEPRESSION AMONG ADOLESCENT
GIRLS
Dr.Chandrakanth
Jamadar
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
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
Anthropoligy 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 menustral 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 behavioural
changes that are expected of the girl after they attained menarche. In the
theoretical framework expected behavioural changes is elaborated in the form of
norms that are the rules and expectations by which a society guides the
behaviour 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 helath and
menarche in Rural and urban adolescent girls (N = 120)
|
GHQ
|
Area
|
Mean
|
SD
|
E-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
|
E-Value
|
|
Urban
|
5.43
|
4.05
|
2.42*
|
|
|
Rural
|
6.95
|
4.08
|
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
|
E-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
|
E-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
|
E-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
|
There is no significant
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
|
E-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.
No comments:
Post a Comment