Menstrual disorders affect nearly two in three rural adolescent girls: icddr,b study

Nearly two in three adolescent girls in rural Bangladesh experienced menstrual disorders, with painful periods disrupting daily activities and causing many to miss school, a new AdSEARCH study led by icddr,b has found.

The study also found wide gaps in adolescents' knowledge of sexual and reproductive health and rights (SRHR), findings that were presented today (18 June) at a dissemination seminar at the Canada Club in Dhaka.

These findings highlighted the need for earlier and more effective health education. 

The seminar brought together health experts, policymakers, representatives of the Directorate General of Health Services (DGHS) and Directorate General of Family Planning (DGFP), and development partners to discuss adolescent health in Bangladesh.

The 24-month cohort study involved 2,713 adolescents from icddr,b's Baliakandi Health and Demographic Surveillance System (HDSS), with data collected every four months between 2023 and 2025.

One component of the study followed 1,255 adolescent girls aged 12-16 and found that 64% experienced at least one menstrual disorder.

Painful periods, or dysmenorrhoea, were the most common condition, affecting 56% of the girls. One in three experienced painful periods during three or more menstrual cycles over the study period, while 9% reported persistent menstrual pain.

Nearly 40% of the girls said period pain interfered with their daily activities, while around one in four missed school because of period pain or heavy bleeding.

Among girls with persistent menstrual pain, 43% also experienced other menstrual complications.

A separate analysis involving 1,077 unmarried adolescents aged 16 from Baliakandi upazila and Rajbari Sadar upazila revealed wide gaps in reproductive health knowledge.

While 16% of girls lacked awareness that pregnancy is possible after the onset of menstruation, the figure was 34% among boys.

Awareness of family planning methods was also limited, particularly among girls. While 84% of boys had heard of condoms, only 45% of girls had. Only 4% of girls knew about emergency contraceptive pills, compared with 38% of boys.

The findings suggested that girls who knew about family planning before marriage were less likely to report an unplanned pregnancy than those who lacked such knowledge, 5% compared with 10%.

During the follow-up period, nearly 200 girls were married, and 72 became pregnant, highlighting the need for accurate reproductive health information before marriage, the study said.

The seminar also highlighted two AdSEARCH initiatives aimed at improving adolescents' access to reliable information on sexual and reproductive health, safety and wellbeing.

These included a smartphone-based learning project in Matlab, preferred by 83% of participants, and Koishor-Kotha, a free Bangla-language mobile app featuring animated videos, infographics and myth-versus-fact explainers.

The findings pointed to the need for stronger investment in menstrual health support, reproductive health information and adolescent-friendly care to help young people make informed decisions and stay healthy