Menstrual Problems in Adolescents With Juvenile Idiopathic Arthritis: A Comparison With Healthy Controls

Although menstrual disorders are frequent in adolescent girls, limited data exist regarding their occurrence and characteristics in patients with juvenile idiopathic arthritis (JIA). This study aimed to determine the frequency of menstrual problems, premenstrual syndrome (PMS), and dysmenorrhea-related coping skills in adolescents with JIA, and to examine their potential associations with disease-related parameters, treatment, and quality of life (QoL).

This cross-sectional study included 51 adolescents with JIA and 56 age- and BMI-matched healthy controls (HC) recruited from pediatric rheumatology and adolescent health clinics. Menstrual characteristics, PMS, and dysmenorrhea were assessed using structured questionnaires, the Premenstrual Syndrome Scale, and the Adolescent Dysmenorrhea Self-Care Scale (ADSCS). QoL was measured by the Pediatric Quality of Life Inventory (PedsQL). Disease-related data, treatment history, and laboratory findings were obtained from medical records.

The age at menarche was significantly later in the JIA group than in HC (13 vs 12 years, p = .001). Dysmenorrhea was common in both groups (74.5% vs 89.2%, p = .046) but coping scores were lower in the JIA group (79 vs 99, p = .004). PMS frequency was lower in JIA (39.2% vs 57.1%, p = .064), and total PMS scores were significantly reduced (102 vs 118.5, p = .005). No associations were found between menstrual problems and disease activity, steroid dose, or methotrexat/biologic use.

Adolescents with JIA experience frequent menstrual problems and delayed menarche. During routine pediatric rheumatology visits, adolescent girls' menstrual history should be systematically assessed, and those with significant or troubling gynecological problems should be referred appropriately.