{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:16:29Z","timestamp":1787170589321,"version":"build-2736575974"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012017","name":"Noguchi Memorial Institute for Medical Research (NMIMR) Office for Research Support Fund","doi-asserted-by":"publisher","award":["EC\/P25421\/03"],"award-info":[{"award-number":["EC\/P25421\/03"]}],"id":[{"id":"10.13039\/501100012017","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adolescent girls are more sensitive to hormonal imbalance with major impact on their nutritional, reproductive, physical, psychosocial, and academic wellbeing. This study explored adolescent girls\u2019 knowledge and perceptions of causes and management of symptoms of hormonal imbalance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Using a qualitative approach, focus group discussions were conducted with 116 assented in-school adolescent girls aged 10\u201319 years between 3rd and 19th October 2022. Two urban and two rural communities in two regions were purposively selected for the study. Using a convenient sampling approach, participants were recruited from Upper Primary, Junior, and Senior High schools. Data was analyzed thematically using both inductive and deductive approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Senior High School participants had a fair understanding of hormonal imbalance in both regions. Symptoms were perceived to include headaches, heavy and painful periods, and pimples, most of which participants alluded to experiencing. Perceived causes included natural process of adolescent growth, consumption of unhealthy diets, use of cosmetics and medications. Perceived reproductive effects included infertility, pregnancy disorders, breastfeeding challenges, and low sexual drive. Physiological effects included extreme fatigue, loss of appetite and impaired growth. Psychosocial and academic effects included mood swings\/irritability, low self-esteem, poor inter-personal relationship, poor concentration in class and irregular school attendance. Female relatives and friends were mostly consulted for advice. Self-medication, dietary modification, physical activities, and personal hygiene were adopted to manage perceived symptoms. Self-medication was common, but physical activities and dietary modification were also adopted by most participants to manage symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is recommended that Ghana Education Service should formally incorporate hormonal-related issues into its School Health Education Programmes to enhance knowledge, attitudes, and management among adolescent girls at all levels of education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frph.2024.1502352","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T01:21:47Z","timestamp":1734052907000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Knowledge, perceptions, and management of symptoms of hormonal imbalance among adolescent girls in selected schools in Ghana: a qualitative exploratory study"],"prefix":"10.3389","volume":"6","author":[{"given":"Sawudatu","family":"Zakariah-Akoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Abuaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfred","family":"Egbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bismark Edem Kofi","family":"Klu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Kyei-Baafour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Fokuo","family":"Ofori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collins Stephen","family":"Ahorlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Yeboah-Manu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"B1","volume-title":"WHO recommendations on Adolescent Sexual and Reproductive Health and Rights","year":"2018"},{"key":"B2","doi-asserted-by":"publisher","first-page":"237","DOI":"10.26479\/2018.0402.18","article-title":"Hormone imbalance\u2014a cause for concern in women","volume":"4","author":"Roop","year":"2018","journal-title":"Res J Life Sci Bioinform Pharmacautical Chem Sci"},{"key":"B3","first-page":"03","article-title":"The perspective of hormonal imbalance in humans: a Review","volume":"3","author":"Johnkennedy","year":"2022","journal-title":"Acta Sci Clin Case Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"141","DOI":"10.3389\/fpubh.2018.00141","article-title":"Steroid hormones and their action in Women\u2019s brains: the importance of hormonal balance","volume":"6","author":"R\u00edo","year":"2018","journal-title":"Front Public Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"101010","DOI":"10.1016\/j.yfrne.2022.101010","article-title":"Sex hormone fluctuation and increased female risk for depression and anxiety disorders: from clinical evidence to molecular mechanisms","volume":"66","author":"Kundakovic","year":"2022","journal-title":"Front Neuroendocrinol"},{"key":"B6","first-page":"01","article-title":"A study on hormonal imbalance","volume":"11","author":"Abrams","year":"2022","journal-title":"J Mol Pathophysiol"},{"key":"B7","first-page":"1","article-title":"Hormonal imbalance and hormone regulated Issues","volume":"10","author":"Abrams","year":"2021","journal-title":"J Mol Pathophysiol"},{"key":"B8","first-page":"12","article-title":"Hormonal imbalance and its causes in young females","volume":"2","author":"Naveed","year":"2015","journal-title":"JInnov Pharm Biol Sci"},{"key":"B9","first-page":"1","volume-title":"A Case Study of Polycystic Ovarian Syndrome","author":"Lynch","year":"2013"},{"key":"B10","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1186\/s13104-019-4593-5","article-title":"Weight management merits attention in women with infertility: a cross-sectional study on the association of anthropometric indices with hormonal imbalance in a Ghanaian population","volume":"12","author":"Owiredu","year":"2019","journal-title":"BMC Res Notes"},{"key":"B11","doi-asserted-by":"publisher","first-page":"708910","DOI":"10.3389\/fendo.2021.708910","article-title":"Metabolic and hormonal profile of adolescent girls with polycystic ovary syndrome with concomitant autoimmune thyroiditis","volume":"12","author":"Skrzynska","year":"2021","journal-title":"Front Endocrinol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"341","DOI":"10.4103\/ijnmr.IJNMR_276_19","article-title":"Pshychological experiences of adolesent girls with polycystic ovary syndrome: a qualitative study","volume":"25","author":"Ekramzadeh","year":"2020","journal-title":"Iran J Nurs Midwifery Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"173","DOI":"10.2147\/OAJC.S320038","article-title":"A qualitative exlporation of factors explaining non-uptake of hormonal contraceptives among adolescent girls in rural Ghana: the adolescent Girls\u2019 perspective","volume":"12","author":"Boamah-Kaali","year":"2021","journal-title":"J Contraception"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1056235","DOI":"10.1155\/2016\/1056235","article-title":"Relationship between female university Students\u2019 knowledge on menstruation and their mentrual hygiene PRactices: a study in tamale, Ghana","volume":"2016","author":"Ameade","year":"2016","journal-title":"Adv Prev Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"6613","DOI":"10.3390\/ijerph17186613","article-title":"A qualitative study exploring menstruation experiences and practices among adolescent girls living in the nakivale refugee settlement, Uganda","volume":"17","author":"Kemigisha","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B16","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1002\/eat.22211","article-title":"Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status","volume":"47","author":"Jappe","year":"2014","journal-title":"Int J Eat Disord"},{"key":"B17","doi-asserted-by":"publisher","first-page":"910437","DOI":"10.5402\/2012\/910437","article-title":"Hormonal link to autoimmune allergies","volume":"2012","author":"Shah","year":"2012","journal-title":"ISRN Allergy"},{"key":"B18","first-page":"393","volume-title":"Qualitative Inquiry and Research Design: Choosing among Five Approaches","author":"Creswell","year":"2007"},{"key":"B19","volume-title":"Qualitative Research: The Essential Guide to Theory and Practice","author":"Savin-Baden","year":"2013"},{"key":"B20","first-page":"103","article-title":"Age of menarche among basic level school girls in medina, Accra","volume":"15","author":"Aryeetey","year":"2011","journal-title":"Afr J Reprod Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"159","DOI":"10.3109\/01443615.2011.638092","article-title":"Menarcheal and pubertal development and determining factors among schoolgirls in Kumasi, Ghana","volume":"32","author":"Opare-Addo","year":"2012","journal-title":"J Obstet Gynaecol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e143","DOI":"10.1097\/AOG.0000000000001215","article-title":"Menstruation in girls and adolescents: using the menstrual cycle as a vital sign","volume":"126","year":"2015","journal-title":"Am Coll Obstet Gynecol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3047526","DOI":"10.1155\/2022\/3047526","article-title":"Evaluation of hormonal profile and ovarian morphology among adolescent girls with menstrual irregularities in a tertiary care centre at central India","volume":"15","author":"Patel","year":"2022","journal-title":"SciWorldJ"},{"key":"B24","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1590\/1984-0462\/2022\/40\/2020494","article-title":"Menstrual cycle among adolescents: girls\u2019 awareness and influence of age at menarche and overweight Ciclo menstrual em adolescentes: percep\u00e7\u00e3o das adolescentes e influ\u00eancia da idade de menarca e excesso de peso","volume":"40","author":"Marquesa","year":"2022","journal-title":"Rev Paul Pediatr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s12905-016-0354-y","article-title":"Menstrual pattern among adolescent girls of pokhara valley: a cross sectional study","volume":"16","author":"Sharma","year":"2016","journal-title":"BMC Women\u2019s Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/0020-7292(89)90217-8","article-title":"Menarcheal age in Ghanaian school girls","volume":"30","author":"Adadevoh","year":"1989","journal-title":"Int J Gynaecol Obstet"},{"key":"B27","first-page":"2","article-title":"The age of menarche","volume":"4","author":"Rees","year":"1995","journal-title":"ORGYN"},{"key":"B28","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12905-019-0874-3","article-title":"Knowledge and practice of adolescent females about menstruation and menstruation hygiene visiting a public healthcare institute of Quetta, Pakistan","volume":"20","author":"Michael","year":"2020","journal-title":"BMC Women\u2019s Health"},{"key":"B29","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/S0197-0070(86)80015-8","article-title":"Multicentre study on menstrual and ovalutary pstterns in adolescent girls. II. Longitudinal study of menstrual pattern in the early postmenarcheal period, duration of bleeding episodes and menstrual cycles. World Wealth Organization Task Force on Adolescent Reproductive Health","volume":"7","year":"1986","journal-title":"J Adolesc Health Care"},{"key":"B30","first-page":"150","article-title":"Nutritional status and menarche in a rural community in the Philippines","volume":"36","author":"Osteria","year":"1983","journal-title":"Philipp J Nutr"},{"key":"B31","doi-asserted-by":"publisher","first-page":"E560","DOI":"10.1503\/cmaj.201972","article-title":"Painful periods in adolescents","volume":"193","author":"Kciuk","year":"2021","journal-title":"CMAJ"},{"key":"B32","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2147\/JPR.S30602","article-title":"Prevalence of menstrual pain in young women: what is dysmenorrhea?","volume":"5","author":"Grandi","year":"2012","journal-title":"J Pain Res"},{"key":"B33","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1177\/0743558411400908","article-title":"Teens reflect on their sources of contraceptive information","volume":"26","author":"Jones","year":"2011","journal-title":"J Adolesc Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1016\/j.socscimed.2009.08.039","article-title":"Parental education and children\u2019s online health information ssking: beyond the digital divide","volume":"69","author":"Zhoa","year":"2009","journal-title":"Soc Sci Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1353\/hpu.2014.0047","article-title":"Health care information in African-American churches","volume":"25","author":"Harmon","year":"2014","journal-title":"J Health Care Poor Underserved"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.3324\/haematol.2019.225656","article-title":"Bleeding disorders in adolescents with heavy menstrual bleeding in a multicenter prospective US cohort","volume":"105","author":"Zia","year":"2020","journal-title":"Haematologica"},{"key":"B37","volume-title":"Headache Disorders","year":"2023"},{"key":"B38","doi-asserted-by":"publisher","first-page":"549038","DOI":"10.3389\/fneur.2020.549038","article-title":"Giving researchers a headache\u2014sex and gender differences in migraine","volume":"11","author":"Al-Hassany","year":"2020","journal-title":"Front Neurol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/j.1526-4610.2012.02265.x","article-title":"Barriers to the diagnosis and treatment of migraine: effects of sex, income, and headache features","volume":"53","author":"Lipton","year":"2012","journal-title":"Am Headache Soc"},{"key":"B40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5070\/D34HP8N68P","article-title":"Acne in adolescents: quality of life, self-esteem, mood and psychological disorders","volume":"17","author":"Dunn","year":"2011","journal-title":"Dermatol Online J"},{"key":"B41","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1590\/S0365-05962012000600007","article-title":"The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece. Results of a population survey","volume":"87","author":"Tasoula","year":"2012","journal-title":"An Bras Dermatol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/cdep.12397","article-title":"Adolescent acne and disparities in mental health","author":"Natsuaki","year":"2021","journal-title":"Child Dev Perspect"},{"key":"B43","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2147\/AHMT.S55832","article-title":"The epidemiology of acne vulgaris in late adolescence. Adolescent health","volume":"19","author":"Lynn","year":"2016","journal-title":"Med Ther"},{"key":"B44","doi-asserted-by":"publisher","first-page":"450","DOI":"10.3389\/fpubh.2020.00450","article-title":"A review of advancement on influencing factors of acne: an emphasis on environment characteristics","volume":"8","author":"Yang","year":"2020","journal-title":"Front Public Health"},{"key":"B45","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.socscimed.2015.03.031","article-title":"Puberty and perimenopause: reproductive transitions and their implications for Women\u2019s health","volume":"132","author":"Hoyt","year":"2015","journal-title":"Soc Sci Med"},{"key":"B46","volume-title":"Endometriosis","year":"2024"},{"key":"B47","doi-asserted-by":"publisher","first-page":"60","DOI":"10.24940\/ijird\/2019\/v8\/i6\/JUN19032","article-title":"School-based health service delivery in Ghana: the actualities of an observation","volume":"8","author":"Mensah","year":"2019","journal-title":"Int J Innov Res Dev"},{"key":"B48","doi-asserted-by":"publisher","first-page":"4","DOI":"10.24926\/iip.v9i3.979","article-title":"Adolescents\u2019 misuse of over-the-counter medications: the need for pharmacist-led intervention","volume":"9","author":"Abraham","year":"2018","journal-title":"Inov Pharm"},{"key":"B49","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1001\/archpedi.1997.02170420019003","article-title":"lSelf-administration of over-the-counter medication for pain among adolescents","volume":"151","author":"Chambers","year":"1997","journal-title":"Arch Padiatr Adolesc Med"},{"key":"B50","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/s12889-019-6470-5","article-title":"Self-medication with over the counter drugs, prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea","volume":"19","author":"Tesfamariam","year":"2019","journal-title":"BMC Public Health"},{"key":"B51","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s12902-020-00552-1","article-title":"Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis","volume":"20","author":"Abdolahian","year":"2020","journal-title":"BMC Endocr Disord"},{"key":"B52","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12905-021-01184-w","article-title":"The role of water intake in the severity of pain and menstrual distress among females suffering from primary dysmenorrhea: a semi-experimental study","volume":"21","author":"Torkan","year":"2021","journal-title":"BMC Women\u2019s Health"},{"key":"B53","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3399\/bjgp09X420301","article-title":"The role of exercise in the treatment of menstrual disorders: the evidence","volume":"59","author":"Daley","year":"2009","journal-title":"Br J Gen Pract"},{"key":"B54","volume-title":"Plates, Pyramids, Planet\u2014developments in National Healthy and Sustainable Dietary Guidelines: A State of Play Assessment","author":"Gonzalez Fischer","year":"2016"},{"key":"B55","volume-title":"Food-Based Dietary Guidelines, Accra","year":"2023"},{"key":"B56","doi-asserted-by":"publisher","first-page":"19702","DOI":"10.18697\/ajfand.107.21830","article-title":"Process and lessons learned in the development of food-based dietary guidelines in Ghana","volume":"22","author":"Aryeetey","year":"2022","journal-title":"Afr J Food Agric Nutr Dev"},{"key":"B57","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3389\/fphar.2013.00177","article-title":"The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety","volume":"4","author":"Ekor","year":"2014","journal-title":"Front Pharmacol"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2024.1502352\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T01:21:56Z","timestamp":1734052916000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2024.1502352\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,13]]},"references-count":57,"alternative-id":["10.3389\/frph.2024.1502352"],"URL":"https:\/\/doi.org\/10.3389\/frph.2024.1502352","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,13]]},"article-number":"1502352"}}