Factors Related to Menstrual Disorders in Students of SMAN 12 City

of Depok in 2022

Julieta Vinka Wibowo, Ony Linda and Cornelis Novianus

Public Health Study Program Faculty of Health Sciences University of Muhammadiyah Prof. Dr. HAMKA

JL. Limau, South Jakarta, Indonesia

Keywords: Adolescents, Menstrual Disorders, Nutritional Status, Physical Activity, Stress.

Abstract: Ideally menstruation in one cycle time is 21--35 days, if there is <21 and >35 days, the occurrence of pain

during menstruation, until there is no menstruation, menstruation occurs, menstrual disorders occur. This

study aims to determine the factors related to menstrual disorders in students of SMAN 12 Depok City in

2022. This study is a quantitative study with a Cross-Sectional design and a sample of 168 respondents. Data

were obtained using nutritional status questionnaires with BMI/U, stress with watershed standard

questionnaires, physical activity with GPAQ questionnaires, carbohydrate intake, protein intake, fat intake

with 24-hour food recall, and menstrual disorders. Data analysis using the Chi-Square test. The results showed

that there was a relationship between stress (p = 0.009), physical activity (p = 0.035) and menstrual disorders.

However, there was no relationship between nutritional status, carbohydrate intake, protein intake, fat intake,

and menstrual disorders (p > 0.05).

INTRODUCTION

Adolescence is characterized by puberty, which will

be seen by changes physically, emotionally, and

socially. However, in women puberty is characterized

by the presence of menstruation (Manggul, 2016).

Menstruation is naturally occurring a process by

which the uterus (endometrium) is flowed to the

cervix through the vagina in the form of blood. From

puberty to menopause, women have menstruation

every month (Begum et al., 2016). The time span that

occurs between menstruation each month is called the

menstrual cycle. Usually, the menstruation cycle is

said to be ideal if it occurs between 21--35 days, with

an average number of cycles of 28 days (Purwati &

Muslikhah, 2020).

According to Novita (2018), WHO states that

menstrual disorders experienced by adolescents are as

much as 75%. Based on research as many as 60.20%

of respondents experience menstrual disorders. There

are several disorders in menstruation such as the

condition of not having menstruation for 3

consecutive months called amenorrhea, this disorder

is divided into primary amenorrhea, namely woman

who is 18 years old but has never had menstruation,

and secondary amenorrhea, which is having had

menstruation but not having menstruation for at least

3 consecutive months. Oligomenorrhea is a menstrual

cycle with a span of more than 35 days.

Polymenorrhea is a menstrual cycle with a span of

less than 21 days (Islamy, 2019). Dysmenorrhoea is

menstrual pain that is felt in the lower abdomen. This

pain is generally included cramps, nausea, and

headaches (Miraturrofi’ah, 2020). Menstrual

disorders that are not handled properly can result in a

decrease in the quality of life, especially in daily

activities (Santi, 2018).

In this study, researchers chose disorders such as

amenorrhea that is did not have menstruation for three

months in a row, polymenorrhea, which is a

menstrual cycle that is less than 21 days,

oligomenorrhoea, which is a menstrual cycle that is

more than 35 days, and dysmenorrhea, which is pain

in the lower abdomen during menstruation. The

results of the study by Cakir M et al (2015) found that

the largest prevalence of menstrual disorders was

dysmenorrhoea as much as 89.5%, then the

irregularity of the menstrual cycle by 31.2%, and the

length of the menstrual cycle was 5.3%. Based on the

results of research in India (2019) found that

menstrual disorders that occur in adolescents are as

much as 6.1% (Singh et al., 2019). Another study in

Iran (2020) stated that menstrual disorders in

adolescents were 28.4% (Shamloo et al., 2020). The

Wibowo, J., Linda, O. and Novianus, C.

Factors Related to Menstrual Disorders in Students of SMAN 12 City of Depok in 2022.

DOI: 10.5220/0011650600003608

In Proceedings of the 4th International Conference on Social Determinants of Health (ICSDH 2022), pages 94-98

ISBN: 978-989-758-621-7; ISSN: 2975-8297

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

results of another study in Bone (2019) found that

menstrual disorders in adolescents ranged from

75.7% (Indriasari et al., 2019).

Data according to RISKESDAS (2013) in Sari

(2019) states that Indonesian women aged 10--59

years have menstrual cycle irregularities of 13.7%.

Data from West Java, according to RISKESDAS

2018, there are 72.15% of women who have

experienced menstruation with an average age of the

first menstruation of 12.70 years. According to the

results of Cabral's research (2019) found menstrual

disorders in adolescents around 100%. Another study

by Fahira (2021) stated that menstrual disorders in

adolescents are around 82.6%. Based on the results of

Manggul's research (2016) found that menstrual

disorders in adolescents were 66.2%.

Research conducted by Sitoayu (2017) stated that

there are several factors that cause menstrual

disorders, such as nutritional status, namely body

condition which is measured from weight weighing

and measuring respondents' height in accordance with

anthropometric guidelines using BMI / U and

processed using WHO Antroplus. The nutritional

status needed by each person is different, but lack or

even overnutrition will have a bad impact on health,

especially in young women because it can affect FSH

and LH hormones which result in menstrual disorders

(Felicia et al., 2015). Stress is a sense of interfering

both physical and psychic experienced by

respondents that causes pressure, stress can affect the

imbalance of FSH and LH hormones so as to increase

crh and GnRH hormones which can cause menstrual

cycles to be longer or shorter (AlJadidi et al., 2016).

Physical activity is an activity carried out by

respondents with a mild, moderate, severe level. The

high physical activity carried out can cause menstrual

disorders, but if the activity carried out tends to be

normal, it can reduce the risk of menstrual disorders

(Anindita et al., 2016). Carbohydrate intake was

respondents consuming foods containing fructose

within 24 hours before the time the study was

conducted. Juveniles need carbohydrates as a source

of energy during the luteal phase. Low carbohydrate

intake can result in depressed work of the hormone

estrogen so that the menstrual cycle is disturbed

(Rachmawati & Murbawani, 2015). Protein intake,

namely respondents consumed foods such as

processed milk, and so on within 24 hours before the

study was conducted. Protein functions as an energy

reserve for the body that functions to respond to

infertility and affects the follicular cycle

(Rachmawati & Murbawani, 2015). Fat intake was

that respondents consumed food sources of energy

within 24 hours before the time the study was

conducted. In reproduction, fats are beneficial in the

production of the hormone estrogen (Hanapi, 2021) .

According to the results of the study, there was a

relationship between, adequacy of carbohydrate

intake, adequacy of protein intake, adequacy of fat

intake, nutritional status, and stress with menstrual

disorders (Sitoayu et al., 2017). Subsequent studies

found that there were research results related to

physical activity and menstrual disorders

(Kusumawati et al., 2021).

A preliminary study that has been conducted at

SMAN 12 Depok City obtained from 30 female

students taken randomly by 30 people showed results

that as many as 70% of female students experienced

a faster menstrual cycle, 53.3% of female students

had menstruation twice in one month, 76.7% of

female students experienced pain during menstruation,

70% of female students experienced pain in the lower

abdomen alone. Based on this background, researchers

are interested in conducting a study with the title

"Factors related to menstrual disorders in students of

SMAN 12 Depok City in 2022”.

2 METHOD

This study used a Cross-Sectional design, where

observing an object in the form of risk factors and

their effects using one or more variables by collecting

data and to observe the relationship between variables

at the same time. The advantage of this design is that

its simple implementation does not require

complicated preparation, does not require much cost,

is effective, and the time it takes is not too long so that

the results are known faster (Siyoto, 2015).

This study is a quantitative study taken using

primary data using questionnaires containing

questions related to menstrual disorders, direct

measurements for nutritional status, stress, physical

activity, carbohydrate intake, protein intake, and fat

intake.

This study uses probability sampling technique,

namely with Simple Random Sampling, which is

sampling that is carried out randomly without paying

attention to the level in the population. The advantage

of the Simple Random Sampling technique is that it

does not require additional information other than the

population list, the formula used is easier, and more

efficient (Novita, 2018).

The sample in this study was 168 people. The

selection of samples is in accordance with the

inclusion criteria, namely active students of SMAN

12 Depok City, respondents have signed an approval

sheet, have menstruation.

Factors Related to Menstrual Disorders in Students of SMAN 12 City of Depok in 2022

3 RESULT AND DISCUSSION

Table 1: Distribution of Respondents to Students of SMAN

12 Depok City in 2022.

Variable

Category

n %

Menstrual Disorders

Yes

128

91,4

8,6

Nutritional Status

Abormal

Normal

101

27,9

72,1

Stress

Not Stress

62,9

37,1

Physical Activity

High

Low

107

76,4

23,6

Carbohydrate Intake

Not Good

Good

126

Protein Intake

Not Good

Good

39,3

60,7

Fat Intake

Not Good

Goo

45,7

54,3

In table 1, it presents that the results of a univariate

analysis of menstrual disorder variables with the

answer category were yes as many as 128 respondents

(91.4%) and not as many as 12 respondents (8.6%).

In the nutritional status variable with abnormal

categories, there were 39 respondents (27.9%) and

normal as many as 101 respondents (72.1%). The

stress variable with the answer category of stress was

88 respondents (62.9%) and non-stress as many as 52

respondents (37.1%). The physical activity variable

with a high category was 107 respondents (76.4%),

and low as many as 33 respondents (23.6%). The

variable carbohydrate intake with the bad category

was 126 respondents (90%), and good as many as 14

respondents (10%). Protein intake variables with bad

categories were 55 respondents (39.3%), and good as

many as 85 respondents (60.7%). The variable fat

intake with the bad category was 64 respondents

(45.7%), and good as many as 76 respondents

(54.3%).

Table 2: Chi Square Test Results on Students of SMAN 12

Depok City in 2022.

Variable Pvalue Description

Nutritional

Status

Abormal

Normal

1,000

Relationship

Stress

Not Stress

0,009 Relationship

Physical

Activit

High

Low

0,035 Relationship

Carbohydrat

e Intake

Not Good

Goo

0,610

Relationship

Protein

Intake

Not Good

Goo

1,000

Relationshi

Fat Intake

Not Good

Goo

0,229

Relationshi

Based on table 2, the results of bivariate analysis

using the Chi-Square test were obtained that the

nutritional status variable had a Pvalue of 1,000

which stated that there was no relationship between

the nutritional status variable and the menstrual

disorder variable (Pvalue >0.05), the stress variable

had a Pvalue of 0.009 which stated that there was a

relationship between the stress variable and the

menstrual disorder variable (Pvalue <0.05), the

physical activity variable had a Pvalue of 0.035 which

stated there was a relationship between the activity

variable physical with variable menstrual disorders

(Pvalue <0.05), carbohydrate intake variable has

pvalue 0.610 which states no relationship between

carbohydrate intake variable and menstrual disorder

variable (Pvalue >0.05), protein intake variable has

Pvalue 1.000 which states there is no relationship

between protein intake variable and menstrual

disorder variable (Pvalue >0.05), fat intake variable

has Pvalue 0.229 which states no relationship

between variable protein intake and menstrual

disorder variable (Pvalue >0.05).

Menstruation is a natural cycle in women that

shows hormonal maturity characterized by bloody

discharge from the uterus. This process is caused by

a decrease in the hormones estrogen and progesterone

so that menstruation occurs (Nuraini, 2018). This

study was conducted on students of SMAN 12 Depok

City, the results showed that as many as 128

respondents (91.4%) had menstrual disorders, while

as many as 12 respondents (8.6%) did not experience

menstrual disorders. The most respondents

experienced pain that occurred during menstruation

as many as 118 respondents (84.3%).

Based on research, it was found that stress has a

relationship with menstrual disorders. Stress is a

condition that puts a person under pressure and

requires a person to act (Suparji, 2019). If stress

persists continuously, it will have an impact on

immunity and hormone balance in the body which

results in disruption of the reproductive system

(Irwan, 2021). Univariate results of stress with a total

of 88 respondents (62.9%), while non-stress a total of

52 respondents (37.1%). The results of the bivariate

analysis obtained Pvalue (0.009) this shows that there

ICSDH 2022 - The International Conference on Social Determinants of Health

is a relationship with menstrual disorders. A similar

study conducted by Manggul (2016) stated that there

was a relationship between stress and menstrual

disorders Pvalue 0.003 (Pvalue < 0.05) in class xii

students of Karya Ruteng High School. Research

conducted by Nathalia (2019) showed that there is a

relationship between stress and menstrual disorders

Pvalue 0.000 (Pvalue < 0.05) in STIT Diniyyah Puteri

Students in Padang Panjang City.

Menstrual cycle irregularities are caused by heavy

physical exertion and are carried out continuously

(Loa et al., 2022). Excessive physical activity results

in fatigue and causes disturbed GnRH secretion,

resulting in menstrual disorders (Kusumawati et al.,

2021). Univariate results obtained high physical

activity with a total of 107 respondents (76.4%),

while low physical activity was 33 respondents

(23.6%). The results of the bivariate analysis obtained

Pvalue (0.035) this shows that there is a relationship

with menstrual disorders. Another study in line with

Rante (2021) stated that there was a relationship

between physical activity and menstrual disorders

Pvalue 0.048 (Pvalue < 0.05) in Pre-Clinical students

of the Faculty of Medicine, Nusa Cendana University

in 2020. The results of a study conducted by Sari

(2019) showed that there was a significant

relationship between physical activity and menstrual

disorders Pvalue 0.040 (Pvalue < 0.05) in Dharma

Husada Pekanbaru students in 2019.

4 CONCLUSION

Based on research that has been conducted at SMAN

12 Depok City, it was found that as many as (91.4%)

respondents experienced menstrual disorders,

(27.9%) respondents with abnormal nutritional status,

(62.9%) respondents experienced stress, (76.4%)

respondents with high activity, (90%) respondents

with poor carbohydrate intake, (39.3%) respondents

with bad protein intake, (45.7%) respondents with

bad fat intake.

Based on bivariate results, it can be concluded that

factors related to menstrualdisorders are found in

stress (Pvalue 0.009), and physical activity (Pvalue

0.035). Meanwhile, factors such as nutritional status

(Pvalue 1,000), carbohydrate intake (Pvalue 0.610),

protein intake (Pvalue 1,000), and fat intake (Pvalue

0.229) were not related to menstrual disorders.

ACKNOWLEDGEMENTS

I would like to thank all the female students who have

been involved and volunteered to be my respondents,

as well as the teachers and administrative staff of

SMAN 12 Depok City who have helped me a lot in

carrying out my research so that I was able to

complete this research well.

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