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Prevalence of Pain Symptoms Suggestive of Endometriosis Among Finnish Adolescent Girls (TEENMAPS Study)

  • P.A. Suvitie
    Correspondence
    Address correspondence to: P.A. Suvitie, MD, Department of Obstetrics and Gynecology, Turku University Hospital, Kiinamyllynkatu 4-8, FI-20520 Turku, Finland; Phone: +358-2-3130917
    Affiliations
    Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland

    Department of Obstetrics and Gynecology, University of Turku, Turku, Finland

    Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland
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  • M.K. Hallamaa
    Affiliations
    Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland

    Department of Obstetrics and Gynecology, University of Turku, Turku, Finland
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  • J.M. Matomäki
    Affiliations
    Department of Pediatrics, Turku University Hospital, Turku, Finland
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  • J.I. Mäkinen
    Affiliations
    Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland

    Department of Obstetrics and Gynecology, University of Turku, Turku, Finland
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  • A.H. Perheentupa
    Affiliations
    Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland

    Department of Obstetrics and Gynecology, University of Turku, Turku, Finland

    Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland
    Search for articles by this author

      Abstract

      Study Objective

      To evaluate the prevalence of pain symptoms suggestive of endometriosis among adolescent girls aged 15-19 years.

      Design

      Cross-sectional study.

      Setting

      University hospital.

      Participants

      Adolescent girls aged 15-19 years attending elementary school, high school, or vocational institute at 3 cities in Southwest Finland in 2010-2011.

      Interventions

      The school nurses distributed a detailed questionnaire to 2582 girls who were attending school at the time of the study. Completion of the questionnaire was voluntary and anonymous.

      Main Outcome Measures

      Prevalence and severity of dysmenorrhea, acyclic abdominal pain, dyspareunia, dyschezia, and dysuria. Severity was evaluated with an 11-point numerical rating scale (NRS).

      Results

      A total of 1103 eligible answers were analyzed. The prevalence of dysmenorrhea was 68% (738/1092) with mean NRS of 7.0 (SD = 2.0). Acyclic abdominal pain, dyspareunia, dyschezia, and dysuria were less frequent (19% [207/1085], 12% [53/458], 8% [87/1088] and 5% [50/1084], respectively). The prevalence of severe dysmenorrhea (NRS 8-10) was 33% (355/1089). Severe dysmenorrhea was associated with increased risk of concurrent acyclic abdominal pain (odds ratio [OR] = 2.7; 95% confidence interval [CI], 2.0-3.6), dyschezia (OR = 2.5; 95% CI, 1.6-3.9), and regular absenteeism from school or hobbies (OR = 10.0; 95% CI, 4.2-23.6). Using different criteria, 2%-10% (21-106/1103) of all girls could be identified as having symptoms suggestive of endometriosis. Five percent of girls (n = 53/1103) had severe dysmenorrhea, used oral contraceptive pills, and reported inadequate relief from pain medication.

      Conclusion

      One-third (355/1089) of 15- to 19-year-old girls had severe menstrual pain and 14% (49/355) of them were regularly absent from school or hobbies. Five percent of all teenage girls (53/1103) were poor responders to conventional therapy for primary dysmenorrhea.

      Key Words

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