Endo-Teach: An innovative secondary school teaching package to educate on menstrual health and to build awareness of endometriosis in Switzerland

Abstract

Introduction:

Endometriosis, a chronic inflammatory disease often beginning in adolescence, significantly impacts quality of life. Delayed diagnosis contributes to prolonged suffering, educational disruption, and high healthcare costs. Promoting menstrual health education in schools may aid early recognition and intervention. This study aimed to implement and evaluate Endo-Teach, a menstrual health and endometriosis education program for seventh and eighth grade students, assessing its effectiveness in improving their understanding of endometriosis.

Methods:

The implementation of the teaching package Endo-Teach, developed by a group of specialists at the certified endometriosis center of the Bern University Hospital, Switzerland, was evaluated using a voluntary questionnaire distributed before and after the class.

Results:

Within a total collective of 177 students, the mean age was 14.37 years. Awareness of endometriosis among adolescents was initially low (30.4%). Just over half (50.6%) of female adolescents reported having very painful menstruation; 54.5% of the adolescents reporting very painful period or insecurity about it needed to take pain medication, and 23.6% missed school regularly due to menstrual pain. The teaching package was evaluated as clear (96.5%) and educative (97.7%).

Conclusion:

The teaching package Endo-Teach in its actual form is a valid option to promote awareness of menstrual health and endometriosis in secondary schools. In Switzerland, the prevalence of severe menstrual pain in secondary-school students, including the use of pain medication and school absenteeism, is high, whereas awareness of endometriosis is low. This shows that offering age-appropriate educational measures in a broader context is important to reduce the burden of the disease.

Keywords

Adolescent awareness dysmenorrhea education endometriosis menstruation

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References

Zondervan

Becker

Koga

, et al. Endometriosis. Nat Rev Dis Primers 2018; 4: 9. https://doi.org/10.1038/S41572-018-0008-5.

Shafrir

Farland

Shah

, et al. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol 2018; 51: 1–15. https://doi.org/10.1016/j.bpobgyn.2018.06.001.

Shim

Laufer

MR.

Adolescent endometriosis: an update. J Pediatr Adolesc Gynecol 2020; 33: 112–119. https://doi.org/10.1016/J.JPAG.2019.11.011.

Liakopoulou

Tsarna

Eleftheriades

, et al. Medical and behavioral aspects of adolescent endometriosis: a review of the literature. Children 2022; 9: 384. https://doi.org/10.3390/CHILDREN9030384.

Nirgianakis

Egger

Kalaitzopoulos

, et al. Effectiveness of dietary interventions in the treatment of endometriosis: a systematic review. Reprod Sci 2022; 29: 26. https://doi.org/10.1007/S43032-020-00418-W.

Harada

Dysmenorrhea and endometriosis in young women. Yonago Acta Med 2013; 56: 81–84.

Sieberg

Lunde

Borsook

Endometriosis and pain in the adolescent- striking early to limit suffering: a narrative review. Neurosci Biobehav Rev 2020; 108: 866–876. https://doi.org/10.1016/J.NEUBIOREV.2019.12.004.

Hirsch

Dhillon-Smith

Cutner

, et al. The prevalence of endometriosis in adolescents with pelvic pain: a systematic review. J Pediatr Adolesc Gynecol 2020; 33: 623–630. https://doi.org/10.1016/J.JPAG.2020.07.011.

Martire

Piccione

Exacoustos

, et al. Endometriosis and adolescence: the impact of dysmenorrhea. J Clin Med 2023; 12: 5624. https://doi.org/10.3390/JCM12175624.

10.

Wüest

Limacher

Dingeldein

, et al. Pain levels of women diagnosed with endometriosis: is there a difference in younger women? J Pediatr Adolesc Gynecol 2023; 36: 140–147. https://doi.org/10.1016/j.jpag.2022.10.011

11.

DiVasta

Vitonis

Laufer

, et al. Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood. Am J Obstet Gynecol 2018; 218: 324.e1–324.e11. https://doi.org/10.1016/J.AJOG.2017.12.007.

12.

Greene

Stratton

Cleary

, et al. Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis. Fertil Steril 2009; 91: 32–39. https://doi.org/10.1016/j.fertnstert.2007.11.020.

13.

Treloar

Bell

Nagle

, et al. Early menstrual characteristics associated with subsequent diagnosis of endometriosis. Am J Obstet Gynecol 2010; 202: 534.e1–534.e6. https://doi.org/10.1016/j.ajog.2009.10.857.

14.

Ballweg

ML.

Big picture of endometriosis helps provide guidance on approach to teens: comparative historical data show endo starting younger, is more severe. J Pediatr Adolesc Gynecol 2003; 16: S21–S26. https://doi.org/10.1016/S1083-3188(03)00063-9.

15.

Dunselman

Vermeulen

Becker

, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod 2014; 29: 400–412. https://doi.org/10.1093/humrep/det457.

16.

Chapron

Marcellin

Borghese

, et al. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol 2019; 15(11): 666–682. https://doi.org/10.1038/s41574-019-0245-z.

17.

Lukas

Kohl-Schwartz

Geraedts

, et al. Satisfaction with medical support in women with endometriosis. PLoS ONE 2018; 13(11): e0208023. https://doi.org/10.1371/journal.pone.0208023.

18.

Gallagher

DiVasta

Vitonis

, et al. The impact of endometriosis on quality of life in adolescents. J Adolesc Health 2018; 63: 766–772. https://doi.org/10.1016/j.jadohealth.2018.06.027.

19.

Missmer

Soliman

, et al. Impact of endometriosis on women’s life decisions and goal attainment: a cross-sectional survey of members of an online patient community. BMJ Open 2022; 12: 52765. https://doi.org/10.1136/bmjopen-2021-052765.

20.

Schneider

Vitonis

Fadayomi

, et al. Quality of life in adolescent and young adult women with dyspareunia and endometriosis. J Adolesc Health 2020; 67: 557–561. https://doi.org/10.1016/j.jadohealth.2020.02.024.

21.

Missmer

Agarwal

, et al. Impact of endometriosis on life-course potential: a narrative review. Int J Gen Med 2021; 14: 9. https://doi.org/10.2147/IJGM.S261139.

22.

Bush

Brick

East

, et al. Endometriosis education in schools: a New Zealand model examining the impact of an education program in schools on early recognition of symptoms suggesting endometriosis. Aust N Z J Obstet Gynaecol 2017; 57: 452–457. https://doi.org/10.1111/AJO.12614.

23.

Unger

Laufer

MR.

Progression of endometriosis in non-medically managed adolescents: a case series. J Pediatr Adolesc Gynecol 2011; 24: e21–e23. https://doi.org/10.1016/j.jpag.2010.08.002.

24.

Agarwal

Chapron

Giudice

, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019; 220: 354.e1–354.e12. https://doi.org/10.1016/j.ajog.2018.12.039.

25.

Soliman

Surrey

Bonafede

, et al. Real-world evaluation of direct and indirect economic burden among endometriosis patients in the United States. Adv Ther 2018; 35: 408–423. https://doi.org/10.1007/S12325-018-0667-3.

26.

Khan

Ogawa

Iwasa

, et al. A targeted educational programme improves fundamental knowledge of menstrual pain and endometriosis in young women: the endometriosis awareness promotion project. Reprod Biomed Online 2022; 45: 1216–1229. https://doi.org/10.1016/j

27.

Shadbolt

Parker

Orthia

LA.

Communicating endometriosis with young women to decrease diagnosis time. Health Promot J Austr 2013; 24: 151–154. https://doi.org/10.1071/HE12915.

28.

Ortiz

Rangel-Flores

Carrillo-Alarcón

, et al. Prevalence and impact of primary dysmenorrhea among Mexican high school students. Int J Gynaecol Obstet 2009; 107: 240–243. https://doi.org/10.1016/J.IJGO.2009.07.031.

29.

Agarwal

Venkat

Questionnaire study on menstrual disorders in adolescent girls in Singapore. J Pediatr Adolesc Gynecol 2009; 22: 365–371. https://doi.org/10.1016/J.JPAG.2009.02.005.

30.

World Health Organization. https://www.who.int/ (n.d., accessed 4 January 2024).

31.

Parker

Sneddon

Arbon

The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers. BJOG 2010; 117: 185–192. https://doi.org/10.1111/j.1471-0528.2009.02407.x.

32.

Pitangui

Gomes

Lima

, et al. Menstruation disturbances: prevalence, characteristics, and effects on the activities of daily living among adolescent girls from Brazil. J Pediatr Adolesc Gynecol 2013; 26: 148–152. https://doi.org/10.1016/j.jpag.2012.12.001.

33.

Randhawa

Tufte-Hewett

Weckesser

, et al. Secondary school girls’ experiences of menstruation and awareness of endometriosis: a cross-sectional study. J Pediatr Adolesc Gynecol 2021; 34: 643–648. https://doi.org/10.1016/j.jpag.2021.01.021.

34.

Zannoni

Giorgi

Spagnolo

, et al. Dysmenorrhea, absenteeism from school, and symptoms suspicious for endometriosis in adolescents. J Pediatr Adolesc Gynecol 2014; 27: 258–265. https://doi.org/10.1016/J.JPAG.2013.11.008.

35.

Morlion

Coluzzi

Aldington

, et al. Pain chronification: what should a non-pain medicine specialist know? Curr Med Res Opin 2018; 34: 1169–1178. https://doi.org/10.1080/03007995.2018.1449738.

36.

Munro

Walker

Schembri

, et al. Periods shouldn’t bring any adolescents’ world to a full stop. Period. An online survey of adolescents’ experience of menstruation. J Pediatr Adolesc Gynecol 2023; 37: 18–24. https://doi.org/10.1016/j.jpag.2023.09.004.

37.

Pelvic Pain Foundation. PPEP Talk® - Pelvic Pain Foundation, https://www.pelvicpain.org.au/ppep-talk-schools-program/ (n.d., accessed 30 October 2023).

38.

Endometriosis Outreach | The Endometriosis Association, https://endometriosisassn.org/our-work/education/ (n.d., accessed 13 November 2023).

39.

Dienste des Deutschen Bundestages W. Deutscher Bundestag Wissenschaftliche Dienste Dokumententyp: Sachstand Titel: Zur weiteren Erforschung der Endometriose-Erkrankung Untertitel: Strategien in Australien und Frankreich Zur weiteren Erforschung der Endometriose-Erkrankung Strategien in Australien und Frankreich Sachstand Wissenschaftliche Dienste [German Bundestag Scientific Services Document type: Status report Title: On further research into endometriosis Subtitle: Strategies in Australia and France On further research into endometriosis Strategies in Australia and France Status report Scientific Services], 2022.

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