The Relationship Between Ramadan Fasting with Menstrual Cycle Pattern Changes in Teenagers

Objective This study was to assess the relation between Ramadan fasting and menstrual cycle changes among teenagers Methods This is an observational study with cohort prospective approach. The target population was teenagers between 15-19 years old. 85 female students of 1 Senior High School in Manyak Payed District were enrolled in this study that fulfilled the inclusions criteria and failed exclusion criteria. Respondents were asked to fill the questionnaires regarding menstrual cycle for 4 consecutive months to assess their menstrual cycle. Parameter observed was changes in menstrual cycle which could be in duration, frequency, and menstrual blood volume. For menstrual blood volume, the quantification was using menstrual pictogram questionnaire. Results among 85 female students enrolled, 14 students were menorrhagia and 6 students were oligomenorrhea during Ramadan fasting. There was no difference in menstrual cycle abnormalities during Ramadan fasting between the respondents who started fasting in follicular phase or luteal phase (p > 0.05). However, for menstrual blood quantification, there was a significant difference between menstrual blood volume before and during Ramadan fasting. This was marked by the increased mean in menstrual blood volume as much as 13.84 mL (SD 18.69 mL; 9.8-17.87 mL 95% CI) with p value < 0.0001. Conclusion During Ramadan  fasting, there were changes in teenagers’  menstrual cycle especially in menstrual blood volume. There was significant difference (p < 0.0001) in menstrual blood volume before and during Ramadan fasting. But, there was no difference in menstrual cycle abnormalities (menorrhagia and oligomenorrhea) between respondents who started fasting in follicular phase or luteal phase (p > 0.05).