Nearly two-thirds of rural adolescent girls suffer menstrual disorders: icddr,b study

Nearly two in three adolescent girls in rural Bangladesh suffer menstrual disorders, with painful periods disrupting their daily lives and forcing many to miss school, according to a new study conducted by icddr,b.

The findings, presented at a dissemination seminar at the Canada Club in Dhaka on Wednesday, also revealed significant gaps in adolescents' knowledge of sexual and reproductive health and rights (SRHR), underscoring 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 the state of adolescent health in Bangladesh.

The findings are based on the AdSEARCH study, a 24-month cohort study involving 2,713 adolescents from icddr,b's Baliakandi Health and Demographic Surveillance System (HDSS). Data were collected every four months between 2023 and 2025.

One component of the study followed 1,255 girls aged 12 to 16 and found that 64% experienced at least one menstrual disorder. Painful periods, or dysmenorrhoea, were the most common condition, affecting 56% of participants. One in three girls experienced painful periods during three or more menstrual cycles, while 9% reported persistent menstrual pain.

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Nearly 40% of the girls said menstrual pain interfered with their daily activities, and around one in four missed school because of period pain or heavy bleeding. Among those with persistent pain, 43% also experienced additional menstrual complications.

A separate analysis involving 1,077 unmarried adolescents aged 16 from Baliakandi and Rajbari found major gaps in reproductive health knowledge. More than one-third of boys (34%) did not know that girls can become pregnant after the onset of menstruation, compared with 16% of girls.

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

The study found that girls who knew about family planning before marriage were about half as likely to experience an unplanned pregnancy as those who lacked such knowledge, with rates of 5% and 10%, respectively.

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 event also showcased two AdSEARCH innovations 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 seminar concluded with a panel discussion moderated by Dr Fauzia Akhter Huda, scientist at icddr,b.

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Among the panellists, Professor Dr Farhana Dewan called for greater attention to menstrual health stigma, particularly in rural areas.

Syed Md Nuruddin stressed the importance of preventing child marriage through school-based communication, girls' education and engagement of both boys and girls.

Dr Md Manjur Hossain said family planning information must reach girls before marriage and noted that the DGFP is working to incorporate premarital counselling into its curriculum.

Dr Asif Iqbal highlighted ongoing efforts to expand adolescent-friendly health services and improve access to SRHR information.

Edward Cabrera, First Secretary (Development–Health) at the High Commission of Canada to Bangladesh, reaffirmed Global Affairs Canada's commitment to supporting adolescent SRHR initiatives in Bangladesh.

The findings call for stronger investment in adolescent health education and services, including menstrual health support, reproductive health information and adolescent-friendly care, to help young people make informed decisions and lead healthier lives.