CHAPTER – I

INTRODUCTION
 CHAPTER-I

INTRODUCTION

“LEADERS BLEED”

An amazing moment in the life of a female is menarche. It is the stage where it crowns

the female gender. A moment to cherish only turn to be a torment with the

commencement of periods start pain, mood swings at times inconvenience and

humiliation. Instead of feeling blessed, women only dread this experience crying out

The term adolescent is derived from the Latin word, “ADOLESCENT” meaning ‘TO

GROW UP’, ‘TO MATURE’; developmentally this allows achieving an identity. Adolescent

is a period extending from puberty to early adulthood and considered as a part and

extension of the teenage years in girls, menarche is a major event in the dramatic

process of pubertal changes. Several changes in the physiology as well as in the

personal and social world occur as the young grows. Adolescent stage is the golden

period of investment of health to build a healthy and wealthy India. It is estimated that fifty

percent of girls suffer from dysmenorrhea in the early adulthood life. The first menstrual

period is called menarche, It usually starts between the age 11 and 14years but it can

happen as early as in the age of 9 to 15years.

The term dysmenorrhea is derived from Greek word

Dys – Difficulty

Meno - Month

RrHeoe – flow

Normal menstruation requires integration of the hypothalamic pituitary ovarian axis with

functional uterus of patent lower genital outflow tract and a normal genetic karyotype of

46xx.

Primary: - From the beginning to life long, severe and frequent menstrual cramping

caused by severe and abnormal uterine contraction. It affects more than 50% of post

pubescent women in the age group of 18-25 years.

Secondary: - Due to some physical cause and usually of later onset, painful menstrual

period caused by other medical conditions in the body i.e. Pelvic inflammatory disease,

endometriosis, fibroids, adenomyosis. The pain begins with the onset of menstruation

and persists throughout the first one to three days. The physiological symptoms include

fatigue, malaise, nausea, vomiting, back pain, headache and diarrhea. Psychological

symptoms are depression, tension, anger, nervousness, irritability and loss of motivation.

Mint (Pudina) is one of the popular spices which widely used in Indian cooking

these days. Mint is derived from Latin word "Menthae". It is widely grown in the parts

West Africa, India and Indonesia.100gm of mint leaves gives 48Kcal energy, and it

contains 84.9g of moisture and Protein 4.8g, Fat 0.6g, Carbohydrate 0.8g, Crude fiber

2.0g, Iron 15.6mg, Calcium 200mg, Folic acid 114µg, Carotene 1620µg, Vitamin C 27mg,

other minerals 1.9g.

Mint contains plenty of vitamins and is rich in minerals. Mint contains calcium,

phosphorus, iron, carotene or vitamin A, vitamin B3, vitamin B12. It also contains vitamin

D and vitamin E. It is cultivated in most parts of Europe, Asia and Africa.(repeated)

Although there are different species of mint found all over the most common among them

are Peppermint, Spearmint, Wild mint, Pennyroyal and Berg mint. It was used as a

remedy for ailments related to digestive tract, oral, respiratory and skin disorders. It was

often used as an air freshener. During the middle ages powdered mint leaves were used

to whiten teeth. It find use in the Ayurveda as ‘Ark Pudina’, which is generally prescribed

after delivery as it is a possessor of the property of uterus retraction. Mint has been

considered valuable in spasmodic dysmenorrhea or painful menstruation, especially in

young girls. Tea made from mint when given four days earlier to expect menstruation

period aids treating pain during menstruation. It is much valued as a stimulant and as a

drug, which relieves flatulence. It is useful in strengthening the stomach and promoting its

action and also counteract in spasmodic disorders. It forms an ingredient of most drugs

prescribed for stomach ailments because of its digestive properties. It is good for liver

and helps dissolve gravel in kidneys and bladder.

There are 1.2 billion adolescents aged 10-19 in developing nations making up

1/5th to 1/4th of country’s populations. The total population of India is over 1081 million

and is the second most populous country in the world. Adolescents (10-19 years)

form a large section of population, about 22.5 percent that, is about 225 million. They

have diverse health needs as they are residence in diverse circumstances. The total

population of young people (10-24 years) is approximately 331 million comprising

nearly 30 percent of the total population of India.

(Piyush gupta, 2019)

 Adolescence is a transition period from childhood to adulthood and is

characterized by a spurt in physical, endocrinal, emotional and mental growth, with a

change from complete dependence to relative independence. The period of

adolescence for a girl is a period of physical and psychological preparation for safe

motherhood. As the direct reproducers of future generations, the health of adolescent

girls influences not only their own health, but also the health of the future population.

Almost a quarter of India’s population comprises of girls below 20 years.

One of the major physiological changes that take place in adolescent girls is

the onset of menarche, which is often associated with problems of irregular

menstruation, excessive bleeding, and dysmenorrhoea of these, dysmenorrhoea is

one of the common problems experienced by many adolescent girls.

A study done in Sweden showed that more than 50% of all menstruating

women experience some discomfort. It has also been reported by a senior

obstetrician that probably 5-10% of girls in their late teens suffer from severe

spasmodic dysmenorrhoea interrupting their educational and social life.

The true incidence and prevalence of dysmenorrhoea are not clearly

established in India. In recent times, George and Bhaduri concluded that

dysmenorrhoea (87.87%) is a common problem in India. In Sweden the prevalence

was >2 – 4%. Similar findings had been reported by Jayashree and Jayalakshmi, in

rural married women of Andhra Pradesh. Dysmenorrhoea has been estimated to be

the greatest cause of time lost from work and school in the United States.
 A study was conducted to assess the prevalence of

dysmenorrhoea among adolescent girls residing at Gwalior. 970 girls

were selected using multistage cluster sampling technique. A semi

structured dysmenorrhoea status questionnaire with a total of 14

items were used. It was found that 698(79.6%) of girls had

experienced dysmenorrhoea. Most of them, that is 37.96%

experienced dysmenorrhoea every month. The three most common

symptoms present on both days, that is day before and first day of

menstruation were lethargy and tiredness (first), depression (second)

and inability to concentrate in work (third), whereas the ranking of

these symptoms on the day after the stoppage of menstruation

showed depression as the first common symptoms. Negative

correlation had found between dysmenorrhoea and the General health

status as measured by the body surface area.

(Anil.K.Agarwal, Anju Agarwal, 2016)

Need for the Study

Dysmenorrhea is a common gynecological disorder affecting as many as 50% of menstruating

women. It usually appears one to two years after menarche, when ovulatory cycles are

established. This disorder affects younger women but may persist up to 40years of age. Three

are the main prostaglandin concerned with menstruation are PGF2, PGE2, PGI2 causing

dysmenorrhea.

Gulani. K.K., (2011) stated that Global adolescents account for one fifth of the population that is

more than one billion. Four out of five adolescents live in developing countries. According to

Population Bureau in 1996, 30% of the total population was that of adolescents (284.02

million).Due to gradual decrease in the growth rate of the over all population, there is little

increase in the number of adolescents in population projections till the year 2016 (Population

projection 1996-2016) census of India.

Chauduri.S., (2010) conducted a study, with the age group of 13-15years followed by 17-

18years ,respectively affected by dysmenorrhea 67.3% were the commonest problem in women

suffering from menstrual pain. Women with 63.3% had other symptoms of pre menstrual

symptoms. Daily routine 60% girls 24 were affected due to prolonged bed rest, missed social

activities, disturbed sleep and appetite.

In our country, the most young girls (75%) experience in painful menstruation, that is

Dysmenorrhoea; it is the leading cause of recurrent short term school or college absenteeism. It

affects their academic performance social and sports activities Dysmenorrhoea is a disorder

characterized by lower abdominal pain that occurs during menstruation, but the pain may start 2

or more days before menstruation. It is sometimes associated with headache, nausea, vomiting,

diffuse abdominal pain, and backache, general malaise, weakness, and other gastrointestinal

symptoms. Dysmenorrhea is often under treated because physicians are not fully aware of its
high prevalence and morbidity. Primary dysmenorrhea is generally believed to affect 50% of

menstruating women, and some degree of dysmenorrhea may be present in as many as 90%.

Some women could not have much botheration about it even it interferes with their daily activities

and some women are not taking any medications.

Cakir et all (2007) conducted a study to find out the prevalence of dysmenorrhea and its effect

on social activities and school attendance among 480 female students between the age group of

9-17 years. The study results show the prevalence of dysmenorrhea of 89.5%. 10% of

dysmenorrhea subjects had severe dysmenorrhea and school absentism and need to consult a

physician were more common in those subjects.

Schroeder 8. (2013) reported in dysmenorrhea and pelvic pain in adolescents as the incidence

of dysmenorrhea has been reported to be 92% of adolescents. For 1 5% of respondents reported

their clearly curtailed activity during dysmenorrhea. A correlation was found between severity of

dysmenorrhea, duration of menstruation, and the quantity of menstrual flow. This study also

noted that a total of 50.9% of the respondents had missed time from work or school as a result of

dysmenorrhea. Among all women, only 31% reported dysmenorrhea to their physicians.

Widholm and Kante (2016) observed that the frequency of dysmenorrhea among 13 to 20-

years old ranged from 36% to 56%, with an overall absence rate of 23.4%. This study noted that

a significant number of adolescents suffered from dysmenorrhea, and many did not seek help

from health care professionals for the problem.

In 2018 Teshager Aklilu Yesuf conducted a study to investigate impacts of

dysmenorrhea in China. The results were dysmenorrhea occurred on 37% of the

menstrual dates on average and was unrelated to irregularity of menstrual cycles.

The symptoms of primary dysmenorrhea begin a few hours before menstruation

begins and may peak during the heaviest flow during menstruation; the most
common symptoms are stomach cramp (78.0%), backache (58.9%), and mood

change (56.9%).

Younger age, low body mass index, smoking, early menarche, prolonged or

aberrant menstrual flow, premenstrual somatic complaints, pelvic infections,

psychological disturbance, genetic influence, and a history of sexual assault

influence the prevalence and severity of dysmenorrhea .

Zeinab Samadi et al., in 2013 conducted a quasi-experimental study conducted in

Iran with the objective the effects of 8 weeks of regular aerobic exercise on the

symptoms of premenstrual syndrome in non-athlete girls. Results showed that the

mean scores of PMS and symptoms declined after 8 weeks of training in the

experimental group. The comparison of the two groups showed that the mean

scores of PMS, for symptoms during and after exercise, were significantly different

(P ≤ 0.001) and the percentages of scores PMS changes, physical, and

psychological symptoms of experimental and control groups had a significant

difference (P ≤ 0.001) after 8 weeks of training.

According to study conducted in India among female medical students who reported

dysmenorrhea, 31.67% and 8.68% were frequently missing college and classes,

respectively. A study done in South India showed that ibuprofen was taken by

80.95% of students while a study done in Taiwan and Ghana showed that

paracetamol was the most effective strategies in relieving dysmenorrhea. According

to Egyptian study, fresh ginger was effective in relieving menstrual pain

Suresh K. Kumbhara et al (Associate Professor, Department of Community

Medicine, RIMS medical college, Kadapa, Andhra Pradesh) conducted a cross

sectional study conducted from Jan 2011 to May 2011 among 183 Undergraduate

students (14-19years) in Schools and colleges Kadapa town using a semi-

structured questionnaire. Out of 183 undergraduate students 119 (65%) are

dysmennorhic, 68.4% and 61.2% are from the urban and rural areas respectively.

Out of 81 undergraduate students with family history of dysmenorrhea 60 (74.1%)

undergraduate students are dysmennorhic. Sickness absenteeism is seen among

47.9% dysmennorhic girls. Quality of life is significantly reduced among

dysmennorhic girls. Almost 73.1% of rural girls rely on self-help technique to

manage the dysmenorrhea as compare to urban girls (55.2 %).

Hyun-Nam Ko et al (October 10, 2016) conducted a study on the evidence for the

effectiveness of yoga in the management of menstrual pain and the symptoms

associated with dysmenorrhea. A significant difference was observed between

experimental and control groups in pain intensity and pain duration (p<0.05).

Thyroid stimulating hormone (p<0.002), follicle-stimulating hormone (p<0.02),

luteinizing hormone (p<0.001), and prolactin (p<0.02) were decreased significantly

in the intervention group, compared with the control group. Neither included trial

reported data on overall improvement in symptoms, adverse effects of treatment,

restriction of daily activities, or absence from work or school etc.

Rosenwaks Z. et.al. (2007) has identified uterine prostaglandins as substantially

contributing to the pathogenesis of primary dysmenorrhea. It is now known that at the end

of the menstrual cycle, prostaglandins increase myometrial contractions and cause

constriction of small endometrial blood vessels, with consequent tissue ischemia,

endometrial disintegration, bleeding and pain. Dysmenorrhea may be due to tissue

ischemia resulting from increased intrauterine pressure, vessel constriction and

decreased uterine blood flow. The most compelling evidence for the Prostaglandin theory’

is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea.

The pain relief can be achieved by the various treatments by suppression of the

prostaglandins level and decreasing the intrauterine pressure.

Jennifer S. et.al., (2004) reported that the treatment available in the present scenario is

not giving enough relief from dysmenorrhea. Estimates of the effectiveness of current

treatments including oral contraceptives and non-steroidal anti-inflammatory drugs

ranging from 64 to 90% of patients but some women have intolerable side effects like

upset and infertility. The available treatments decrease impairment but not to the non

menstruating level of productivity for all women. Some patients resort to surgical

treatment. The long-term and associated health risks of dysmenorrhea have not been

studied. Using of treatment with different mechanism of action for the treatment of

dysmenorrhea may benefit some women to have complete relief from dysmenorrhea. For

this commonly seen problem among the adolescents, there is a lot of research done on

the physiological and psychological aspects of the same. Many such solutions like
Adolescence is a transition period from childhood to adulthood and is characterized by a

spurt in physical, endocrinal, emotional, and mental growth, with a change from complete

dependence to relative independence. The period of adolescence for a girl is a period of

physical and psychological preparation for safe motherhood. As the direct reproducers of

future generations, the health of adolescent girls influences not only their own health, but

also the health of the future population. Almost a quarter of India's population comprises

of girls below 20 years.

One of the major physiological changes that take place in adolescent girls is the onset of

menarche, which is often associated with problems of irregular menstruation, excessive

bleeding, and dysmenorrhea. Of these, dysmenorrhea is one of the common problems

experienced by many adolescent girls.

Globally adolescents account for 1/5 th of the population that is more than 1 billion. 4 out of

5 adolescents live in developing countries. According to Population Bureau in 2014, 30%

of the total population was that of adolescents (284.02 million). Due to gradual decrease

in the growth rate of the overall population, there is little increase in the number of

adolescents in population projections till the year 2016(Population projection 2014-2016)

census of India.

The first menstrual period is called menarche. It usually starts between the ages 11 and

14. But it can happen as early as age 9 or as late as 15. Menarche is the sign of growing

up. In the days before the periods start, the adolescent may feel tense or emotional, gain

water weight and feel bloated, pain in the abdomen, back or legs that lasts few hours or

more.
Menstruation is a normal, healthy occurrence for many years in life. Yet many women,

across a range of different cultures, experiences menstrual problem that range from mild

discomfort to acute pain. Although most women have some physical or emotional

changes or discomfort linked to menstrual cycle, a small number of about 5% find that the

problems are more serious and may have to seek some kind of treatment.

The term dysmenorrhea is derived from the Greek words ‘dys’ meaning difficult/painful,

‘Meno’ meaning month and ‘rrhea’ meaning flow. Dysmenorrhea is defined as pain or

discomfort (cramps) during or just before a menstrual period. Two types of dysmenorrhea

are primary and secondary dysmenorrhea. When the menstrual cycle begins

prostaglandins are released by the endometrial cells as they are shed from the uterine

lining causing the uterine muscles to contract. If excessive prostaglandin is present, the

normal contraction response can become strong and painful spasm. Uterine muscles

deprive for oxygen and cause cramps.

Dysmenorrhea is the most common gynecological problem in women in all ages. Most

adolescence experience dysmenorrhea in the first 3 years after menarche. Young adult

women ages 17 to 24 years are most likely to report painful menses between 50% and

80%of women report some level of discomfort associated with menses and 10 to 18%

report severe dysmenorrhea. It has been estimated that up to 10% of women have

severe pain which interfere with their functioning for 1-3 days a month.

Dysmenorrhea generally does not occur until ovulatory menstrual cycles are

established. Maturation of the hypothalamic-pituitary-ovarian axis leading to ovulation

occurs at different rates; approximately 18 to 45 % of teens have ovulatory cycles two

years post menarche, 45 to 70 percent by two to four years, and 80 percent by four to five
years. Dysmenorrhea occasionally accompanies anovulatory cycles, especially if heavy

bleeding and clots are present. The prevalence of dysmenorrhea among adolescent

females ranges from 60 to 93 %. Many adolescents report limitations on daily activities,

such as missing school, sporting events, and other social activities, because of

dysmenorrhea. However, only 15 % of females seek medical advice for menstrual pain,

signifying the importance of screening all adolescent females for dysmenorrheal.

Menstrual disorders are a common presentation by late adolescence, 75% of girls

experience some problems associated with menstruation. Dysmenorrhea is a common

problem in women of reproductive age. Primary dysmenorrhea is defined as painful

menses in women with normal pelvic anatomy, usually begins during adolescence. It is

unusual for symptoms to start within first six months after menarche. Affected women

experience sharp, intermittent spasm of pain usually concentrated in the supra pubic

area. Pain may radiate to the back of the legs or the lower back. Systemic symptoms of

nausea, vomiting, diarrhea, fatigue, mild fever and headache or light headedness are

fairly common. Pain usually develops usually develops within hours of the start of the

menstruation and peaks as the flow becomes heaviest during the first day or two of the

cycle. During the first two years after menarche, most cycles are an ovulatory. Despite

this, they are somewhat regular within a range of approximately 21 to 42 days, in contrast

to an adult woman, whose cycles typically range between 21 and 35 days. The mean

duration of menses is 4 to 7 days; 89% of cycles last 7 days, the average blood loss per

cycle is 30 - 35 ml.

A total of 1648 adolescent girls from six districts of Karnataka were surveyed to find out

the incidence of dysmenorrhea in Karnataka state. The survey showed that the incidence

of dysmenorrhea was 87.87 percent among the adolescent girls. 

 The treatment available in the present scenario is not giving enough relief from

dysmenorrheal estimates of the effectiveness of current treatments including oral

Contraceptives and non-steroidal anti-inflammatory drugs ranging from 64 to 90% of

patients but some women have intolerable side effects like upset and infertility. The

available treatments decrease impairment but not to the non-menstruating level of

productivity for all women. Some patients resort to surgical treatment. The long-term and

associated health risks of dysmenorrhea have not been studied. Using of treatment with

different mechanism of action for the treatment of dysmenorrhea may benefit some

women to have complete relief from dysmenorrhea.

Menstrual problem is one among the commonly found health disorders in women.

Irregularity of menstrual cycle in women may occur as temporary or as permanent.

Depending upon the cause and occurrence of problem, irregularity in menstrual cycle is

divided into versatile types like dysmenorrhea, endometriosis, oligomenorrhea and

amenorrhea. Symptoms shown by a person suffering from menstrual problem vary from

one person to another. Common symptoms shown as a result of menses problem include

irritability; back ache, bloating, acne and food cravings.

Herbal supplement is found to be very beneficial for the treatment of menstrual

problems. Prolonged result with zero adverse action on user is one among the main

advantage of using herbal cures. Some of the herbs like mint leaves, sesame seeds, and

bark extract of Asoka tree etc are best recommended cures for the treatment of

menstrual problems.

Mint is one of the herbs, which grows like a weed and is perfectly safe for use,

and is an excellent remedy for reducing symptoms related to digestion.  It is well known
for its properties related to indigestion, stomach cramps, menstrual cramps, flatulence,

upset stomach, nausea, vomiting, and colici pain in children. 

A pre experimental study was conducted to assess the effectiveness of the mint extract

upon dysmenorrhea among the students at Apollo school of Nursing, Chennai. Pre

experimental design was adopted and purposive sampling method was used and 35

students were selected as samples. Self administered questionnaire on dysmenorrhea

was administered. The levels of dysmenorrhea were assessed before and after mint

extract administration for consecutive days, 5 days before menstruation and 3 days after

menstruation. . The pre test level dysmenorrhea score of students wear high, M =6.46,

SD=2.57 in comparison with the score of post test were M=1.2, SD=1.26 the difference

between the experimental pretest and post test is found to be statistically proven to be

significant (p<0.001). There was no significant association between the selected

demographic variables and pretest post test level of dysmenorrhea score.

The result could be attributed to the effectiveness of the mint extract.

A study was conducted to assess the effectiveness of mint leaves paste on

dysmenorrhea among adolescent girls at selected schools Kanyakumari district, An

experimental design was adopted and purposive sampling method was used based on

the selection criteria 34 adolescent girls in experimental group and 16 adolescent girls in

control group. No intervention was given to control group, so the effective participants in

experimental group was 30, pre and post test were conducted after the mint leaves

administration. The data were collected using self administered questionnaire the

obtained mean difference between the pre test and post test regarding dysmenorrhea

score was 15.3, the obtained ‘t’ value t=9.89 (P<0.05) was significant. Data on post mean

dysmenorrhea score among adolescent girls in experimental on control group was 8.81.
The obtained ‘t’ value t=4.01 (P<0.01) was significant. Therefore it was inferred that

adolescent girls in experimental group had significant reduction in dysmenorrhea score

compare to control group and mint leaves paste was effective in reducing dysmenorrhea.

Dysmenorrhoea affects 40-90% of women. Despite of its high prevalence,

understanding of its path physiology and its relation to other pain syndromes in

women is still limited. Dysmenorrhoea has been historically categorized into two

distinct types- primary and secondary dysmenorrhoea. Primary dysmenorrhoea is the

menstrual pain without pelvic pathology and the onset is typically just before

menstruation. Secondary dysmenorrhoea occurs when underlying pathology is

identified. Its onset may be years after menarche. Pain may start 1 – 2 weeks before

menstruation and persists for several days. (Sophy Shay, 2017)

A Swedish study analyzing absenteeism due to dysmenorrhoea in young

women found that one third to one half missed school or work at least once,

and 5 14% were absent more frequently. A community- based survey of

women in the United Kingdom found dysmenorrhoea to be closely related to

chronic daily pain, with 80% of women with chronic pelvic pain reporting

dysmenorrhoea. (Frank, 2017)

The prevalence of dysmenorrhoea among adolescent females ranges from

60 to 93%. Many adolescent report limitations on daily activities, such as

missing school sporting events and other social activities, because of

dysmenorrhoea. However only 15% of females seek medical advice for

menstrual pain, signifying the importance of screening all adolescent females

for dysmenorrhoea. (Chanlay Banikarim, 2018)

Menstrual cramps experienced by a woman during her monthly menstrual

period are pains that occur in the abdomen and pelvic area. To some extent

50% of all women are affected by menstrual cramps and approximately 15%

of these women have severe cramps. 90% of girls still in their adolescence

have cramps. (Dr.Vijaya, 2016)

A Swedish study analyzing absenteeism due to dysmenorrhoea in young

women found that one third to one half missed school or work at least once,

and 5 14% were absent more frequently. A community- based survey of

women in the United Kingdom found dysmenorrhoea to be closely related to

chronic daily pain, with 80% of women with chronic pelvic pain reporting

dysmenorrhoea. (Frank, 2017)

The prevalence of dysmenorrhoea among adolescent females ranges from

60 to 93%. Many adolescent report limitations on daily activities, such as

missing school sporting events and other social activities, because of

dysmenorrhoea. However, only 15% of females seek medical advice for

menstrual pain, signifying the importance of screening all adolescent females

for dysmenorrhoea. (Chanlay Banikarim, 2018)

Menstrual cramps experienced by a woman during her monthly menstrual

period are pains that occur in the abdomen and pelvic area. To some extent

50% of all women are affected by menstrual cramps and approximately 15%

of these women have severe cramps. 90% of girls still in their adolescence

have cramps. (Dr.Vijaya, 2016)

 Mint is a popular green leafy vegetable used in cooking for taste

and for its aromatic properties. It is also used to make chatni. It is

commonly called as Pudina. It is a perennial herb which is propagated

by root cutting transplantation. Mint has been used in medicine since

last 2000 years. There are over 30 mints in the mint family and each

one of them is used in preparation of the medicines. But spearmint

and peppermint is generally used in the preparation of medicine.

Peppermint is stronger of the two and is widely used in preparation of

many medicines. Spear mint is generally used in the preparation of

medicines used for alleviating colic in babies because peppermint will

fall heavy on their delicate stomach.

Julia, (2007) reported that most women have dysmenorrhoea

or menstrual cramps that can sometimes hamper their efficiency and

create deep distress. While menstrual cramps are very common

before or after the onset of periods, for some women dysmenorrhoea

can be unbearable and hence difficult to live with. Mint tea can be

used for curing dysmenorrhoea. Mint tea can be had twice or thrice a

day for best results. The cooling properties of this herb helps to

relieve pain and tension associated with dysmenorrhoea. She also

suggests to use mint candy for day long relief.

Mint has an antispasmodic effect and has a good medicinal

value. Hence, the investigator felt there is a need to conduct the study

on effectiveness of Mentha Bar on dysmenorrhoea among adolescent

girls.
Statement of the Problem:

A Study to Assess the Effectiveness of Mentha Bar In Reduction of

Dysmennorhea, Among Adolescent Girls In Selected Colleges Hyderabad.

Objectives:

1. To assess the level of dysmenorrhoea among adolescents girls in

experimental group and control group.

2. To a s s e s s t h e effectiveness of mentha bar on dysmenorrhoea among

adolescence girls in experimental group.

3. To associate the pretest level of dysmenorrhoea among adolescent girls

with their selected demographic variables in experimental and control group.

Operational Definitions:

Assess:

To judge the effect of Mentha Bar on dysmenorrhoea among adolescent girls using

dysmenorrhoea rating scale.

Effectiveness:

It is the outcome of the Mentha Bar on dysmenorrhoea among adolescent girls in

experimental group.
 Mentha Bar:

It refers to the mint leaves that are taken from the low growing plant, dried

under shadow and powdered. 5gm of mint powder along with peanuts,

Jaggery and coconut powder which all are mixed together in a shape of small

ball/Cube which is to be administered twice a day for 7 days (4 days prior to

menstrual period and continued till 3 days during menstruation).

Dysmenorrhoea:

In this study, dysmenorrhoea refers to the verbal response of adolescent girls

regarding discomfort such as spasmodic lower abdominal pain and other

physiological symptoms such as vomiting, fatigue, headache and body pain

which appears few hours before menstruation and last for maximum of 48

hours.

Adolescent girls:

Young girls between the age group of 13 to 19 years.

Assumptions:

1. Most of the adolescent girls may have dysmenorrhoea

2. Natural adjunct therapy will play an important role on dysmenorrhoea in

adolescent girls.

3. Adolescent girls may have some knowledge regarding Mentha Bar on

dysmenorrhoea.
 Hypotheses:

H1: There will be a significant difference between the pretest and post

test level of dysmenorrhoea among adolescent girls after

administration of Mentha Bar in experimental group at p<0.05

level.

H2: There will be a significant association between the pre test level of

dysmenorrhoea among adolescent girls and their selected

demographic variables in experimental and control group at

p<0.05 level.

Delimitations:

1. This study was limited to adolescent girls.

2. The data collection period was limited to 2-4weeks.

3. Sample size was limited to 60 subjects.

Projected Outcome:

This study would evaluate the effectiveness of Mentha Bar on the level of

dysmenorrhoea in adolescent girls. Findings of this study would help the

adolescent girls to practice the intake of Mentha Bar to reduce

dysmenorrhoea.
Conceptual Framework:

The conceptual framework was selected for the study is based on Rosentoch’s

Health Belief Model (1974). This model explains how individual perception cues to

action and demographic variables develop the perception of threat in individual which

encourage them to adopt certain measures to overcome that problem or threat.

Individual perception:

Adolescent girls feels uncomfortable with dysmenorrhoea and that is affecting their

daily routine activity.

Identifying factors:

Modifying factors focuses on demographic variable such as age, religion,

education, age at menarche, Number of days of menstrual flow, duration of

pain and type of pain.

Likelihood of action:

The likelihood of action that a person will take an action involves the person’s

perception of the benefits of taking action. Here the investigator had administered

5gms of Mentha Bar twice a day to the adolescent girls with dysmenorrhoea in

experimental group and found that there was significant reduction in the level of

dysmenorrhoea. The adolescent girls also expressed willingness to continue taking

Mentha Bar.