Instruments to Identify Menstrual Complaints and Their Impact on Adolescents: A Systematic Review

Habibe Özcan; Nicole B Burger; Eline van Dulmen-den Broeder; Marchien W van Baal; Emmy van den Boogaard; Robert A De Leeuw; Judith A F Huirne

doi:10.1016/j.jpag.2023.11.011

Instruments to Identify Menstrual Complaints and Their Impact on Adolescents: A Systematic Review

J Pediatr Adolesc Gynecol. 2024 Apr;37(2):106-120. doi: 10.1016/j.jpag.2023.11.011. Epub 2023 Dec 16.

Authors

Habibe Özcan¹, Nicole B Burger¹, Eline van Dulmen-den Broeder¹, Marchien W van Baal², Emmy van den Boogaard¹, Robert A De Leeuw¹, Judith A F Huirne³

Affiliations

¹ Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands.
² Department of Obstetrics and Gynaecology, Flevo Hospital, Almere, The Netherlands.
³ Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands. Electronic address: j.huirne@amsterdamumc.nl.

PMID: 38104798
DOI: 10.1016/j.jpag.2023.11.011

Abstract

Study objective: The aim of this review was to create an overview of available instruments used to evaluate the menstrual complaints of dysmenorrhea and heavy menstrual bleeding (HMB) in adolescents.

Methods: The search was conducted in PubMed, Web of Science, Embase, and PsycINFO on December 1, 2022. Studies published in English reporting on menstrual complaints among girls aged 10-19 were included. The quality and bias risk was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2.

Results: Of 8994 identified studies, 57 were included. In these studies, 19 instruments were described, of which 8 were validated in adolescents. One was difficult to use in daily practice, 1 had low sensitivity and specificity in the detection of HMB, 2 were validated by face validity, and 2 were not specifically developed to evaluate (the impact of) menstrual complaints. Therefore, only 2 were validated and feasible to measure adolescent menstrual complaints: the Period ImPact and Pain Assessment (PIPPA) and the Adolescent Menstrual Bleeding Questionnaire (aMBQ). Remarkably, the Pictorial Blood Loss Assessment Chart (PBAC) was the most frequently used instrument in adolescents. There was one modified version of the PBAC for adolescents, which had a lower cutoff value for HMB and low sensitivity and specificity.

Conclusion: We found that the PIPPA and aMBQ are suitable for assessing menstrual complaints and their impact on daily activities and health-related quality of life in adolescents. The PBAC, which is used frequently in adults, needs to be further assessed specifically for adolescents. In particular, the clinical relevance of the PBAC cutoff value for HMB should be determined for this age group. Considering the different interpretations, experiences, and limited knowledge of menstrual complaints, instruments suitable for adults may not be suitable for adolescents.

Keywords: Adolescent; Dysmenorrhea; Heavy menstrual bleeding; PIPPA; Quality of life; Systematic review; aMBQ.

Publication types

Systematic Review
Review

MeSH terms

Adolescent
Adult
Dysmenorrhea / diagnosis
Female
Humans
Menorrhagia* / diagnosis
Menstruation
Quality of Life*
Sensitivity and Specificity