The Experience of Menarche in Adolescent Scoping Review

INTRODUCTION
The World Health Organization (WHO) defines adolescents as individuals in the
age group of 10-19 years who need attention in improving health. (World Health
Organization [WHO] -SEARO 2018) In the final cycle of adolescent girls puberty is the
occurrence of menarche (İşgüven, Yörük, and Çizmecioğlu 2015). Menarche (first
menstruation) is a sign of physical maturity and fertility (Marván and Molina-Abolnik
2012) which is a transition period in adolescents that has an impact on social
development (Natsuaki, Leve, and Mendle 2011)
Adolescents who have pre-menarche preparation will have an impact on
experiences associated with positive and negative feelings (Marván and Molina-Abolnik
2012). Adolescents who do not have preparation in facing menarche this is because the
adults around them, including parents and teachers do not provide information even
uncomfortable when discussing sexuality, reproduction, and menstruation. (Chandra-
Mouli and Patel 2017)
Menarche and menstruation have an impact on socio-cultural boundaries in
adolescents, but they never know the facts of the socio-cultural boundaries. (Sachdeva
and Sharma 2017). Adolescents follow the tradition when menarche and menstruation
well and are carried out strictly, in the tradition there is a belief that discussing the
function of organs is considered taboo. This will affect knowledge so that it is confusing
for adolescents so that it affects self-confidence during menstruation which should be a
normal thing, it can be turned into a threat to adolescents in social, physical and mental
welfare (Lahme, Stern, and Cooper 2018a) ( Hennegan et al. 2019).

RESULT AND DISCUSSION

This scoping review is intended to look at various experiences of menarche in
adolescents. The writer conducts a scoping review strategy with a broader scope.
Adolescent attitude towards menarche
Positive reception
In this review, there are several journals that examine the experience of menarche
in adolescents, that some participants consider menarche to be natural. they have a
happy feeling because they feel that they have matured, (H-L Liu, Chen, and Peng
2012) (Behera, Sivakami, and Behera 2015) and there is the ability to reproduce (Y. T.
Chang and Lin 2013). A positive attitude towards menarche in adolescents, this is
because of the information of knowledge that they got. The information was obtained
from their mother, sisters and school friends. The information that they got including
the use of pads, changes in body shape, and normal periods in menstruation (H.-L. Liu,
Chen, and Peng 2012). Participants who have more knowledge about menarche, will be
far more prepared when experiencing menarche. (Al Omari, Abdel Razeq, and Fooladi
2016)
Research conducted in Taiwan that some participants sought information on
menarche and menstruation through the internet, books, and magazines. Information
that is considered by the society is inappropriate for adolescents, but this makes
adolescents more aware of menarche and menstruation (Y. T. Chang and Lin 2013).
Research conducted in India (Behera, Sivakami, and Behera 2015) that adolescent girls
get information from their friends. The information that they got is when they
menstruate, and they know that menstruation lasts for 5-7 days every month.
Negative reception
The finding of several research said the opposite, in Jordan and Taiwan (Al Omari,
Abdel Razeq, and Fooladi 2016) (H. L. Liu, Chen, and Peng 2012) that most
participants consider menarche to be a negative feeling such as fear, confusion, anxiety,
surprised, strange feelings, and feel disturbed or stuttering menarche and menstruation
as disgusting. While research conducted in Aceh, Indonesia, and Taiwan that adolescent
feel unprepared when experiencing menarche. They feel scared, ashamed, and worried
when facing menarche and do not want to talk about this and about the reproductive
system because it is considered taboo and (Rizkia, Setyowati, and Ungsianik 2019) (Y.
T. Chang and Lin 2013) makes them tend to stay away from their social lives. (Behera,
Sivakami, and Behera 2015)
Research conducted in Taiwan stated that some participants were disappointed with
the response of their mother who did not provide an explanation when they experienced
menarche (Y. T. Chang and Lin 2013). According to research conducted in Jordan that
teachers and father gives a negative impression on menarche in women. And
adolescents never discuss menarche with their friends because they are considered to
have no manners..So that they let themselves alone with their own perception of the
menarche that they experienced (Al Omari, Abdel Razeq, and Fooladi 2016).

Changes that occur in adolescents with menarche

Physical
Some researches mention that participants feel physical changes that occur after
menarche. The changes in body shape include: breasts, increased body width, weight
gain, appearance of pimples on the face, pain in the stomach and back when menarche
(Behera, Sivakami, and Behera 2015). As well as dizzy, swelling in the breast (Chothe
dkk. 2014). Other physiological symptoms experienced by adolescents include
discomfort in the stomach, fatigue, thirst, craving for certain foods, and the presence of
emotional reactions. (H-L Liu, Chen, and Peng 2012).
Changes in the body, feelings and changes in their self-attitude, it is due to the
influence of hormones that occur in the menstrual cycle (do Amaral, Hardy, and
Hebling 2011). Changes that occur in adolescents, if not accompanied by providing
appropriate information, this can cause adolescents to undergo puberty and
menstruation under pressure and feeling of shame. (Meschke and Dettmer 2012).
Psychological
Some research studies discuss emotional stress or mood swing and the presence of
feelings of more irritability (Y. T. Chang and Lin 2013) and feeling easily offended, bad
mood and mood changes (H. L. Liu, Chen, and Peng 2012). The behavior of mocking,
laughing, and looking for pads in girls' bag, book or asking girls if they experience
menarche and menstruation by boys is considered normal. When dealing with such
behavior, girls often feel that nothing can help them (Y. T. Chang and Lin 2013) and
this makes teenagers unhappy and less confident. And sometimes they are traumatized
to go to school. They will tend to be stressed and skip school so that they can influence
the learning process, and result in a decline in the value of academic performance.
(Lahme, Stern, and Cooper 2018b)

Socio-cultural
Several researches discuss the socio-cultural differences that adolescents receive
when menarche and menstruation. Research conducted in Taiwan that participants feel
very worried and frightened if blood will penetrate into their clothes, so they limit
activities at school and not follow the exercise. This sometimes shows that many
participants do not understand the actions taken when menarche and prefer to avoid
certain activities (Y. T. Chang and Lin 2013). Research conducted in India, some
participants also avoided schools, dance classes, outdoor games, and visiting temples, as
well as daily work so they feel confused about the reasons behind cultural and social
restriction for women who get menstruation that is done in the family and society.
(Chothe dkk. 2014)
Lack of open discourse on menstruation is a problem for boys and girls. Menarche
is a significant symbol of girl sexuality and sexual maturity. Most boys are quiet and
passive about this problem, and pretend not to be interested in the topic of menarche and
menstruation. However, research has shown that, in fact, boys are more likely to find
sources of information about menstruation and reproduction compared to girls (Y.
Chang, Hayter, and Lin 2011).
Research conducted (Al Omari, Abdel Razeq, and Fooladi 2016) in Jordan that
menarche changed the lives of adolescent girls, because it changed the social and
religious order. Adolescents who are menstruating are restricted from visiting holy
places (mosques) and from fasting, prayer, or touching the holy book. According to the
research (Behera, Sivakami, and Behera 2015) adolescents abstain from worshiping
God, cooking and doing housework, as well as prohibiting touching grains, preserved
food, and spices.
Coping mechanism during menarche
Openness
According to research (Al Omari, Abdel Razeq, and Fooladi 2016) conducted in
Jordan that participants told their mother after the first day they got menarche, and their
mother told how to maintain cleanliness during menarche. Another participant revealed
that the frightening experience of menarche turned into a normal thing. This changed
their way of thinking, by trying to be calmer and decided not to keep a secret that they
had menarche.
That the education system can be used to erase the negative aspects of, and
confidentiality associated with, menarche in an effort to prepare and support adolescent
girls at sensitive and significant times in their young lives. The more participants feel
ready to start menstruation, the more there are no secrets for them, the more positive
they are towards menstruation. (H.-L. Liu, Chen, and Peng 2012) adolescents who are
more knowledgeable about menarche and menstruation, they will tend to be more open
and reduce negative feeling towards menarche and menstruation. (Marván and Molina-
Abolnik 2012)
Efforts to relieve discomfort
Participants in relieving pain in the abdomen and back during menarche and
menstruation by eating chocolate, taking medication to relieve pain, and using hot
compresses, resting more during menstruation, and sometimes they exercise. (H. L. Liu,
Chen, and Peng 2012). Some girls say that they heat a stone and wrapping it in cloth
and storing it in the stomach, it can relieve pain. Sometimes, they also use drugs or go
to the doctor with their mother or the head of the hostel. (Behera, Sivakami, and Behera
2015).
Pain management during menarche and menstruation will make consideration in
providing health education to youth empowerment in making choices that are
appropriate to lifestyle. (Sveinsdóttir 2018) so that adolescents do not need to avoid
certain activities. (Behera, Sivakami, and Behera 2015) This can creating a good
psychosocial for adolescent girls (Hamajima dkk. 2012).

Conclusion
Menarche experiences in adolescents are different, depending on the information
that they got, especially menarche experiences in adolescents. So the experience of
menarche really makes a positive or negative impression on adolescents. The changes
that occur both physically, psychologically, this affects adolescents. In addition to the
socio-cultural and religious events that occur in adolescents that had already menarche
among the society. The existence of coping mechanisms during menarche is correct;
this makes them more open to the experience of menarche that they experience. As well
as the ability to relieve discomfort during proper menarche, makes the experience of
menarche become a good experience. The differences in the data generated from the
study of literature on the experience of menarche in adolescents, may be influenced by
the choice of country settings chosen, where there are countries with high economic and
some countries that have medium economy, as well as cultural differences. Lack of
support given to adolescents, this makes the experience of menarche not as a good
experience, but instead makes a negative experience.

Recommendation
Menarche experience in adolescents is still in need of attention and support of
health workers, families, mother and also counseling guidance teachers (BK). Providing
pre-menarche health education before adolescents reach menarche, so adolescents are
better prepared to get good experiences when menarche. Mother, family, and counseling
guidance teacher (BK) play a very important role for adolescents, so it is necessary to
provide health education related to menarche, to be more open to adolescents, so that
adolescents no longer feel closed and want to be open, so that the experience of
menarche is a positive thing.

Acknowledgments
The writer would like to thank Ms. Ismarwati for her thoughtful assistance,
guidance and advice for making this scoping review.