Nearly two in three adolescent girls in rural Bangladesh experience menstrual disorders, with painful periods disrupting daily life and forcing many to miss school, according to new findings from the AdSEARCH study led by icddr,b.
The study also found significant gaps in sexual and reproductive health and rights (SRHR) knowledge among adolescents, highlighting the need for earlier and more effective health education.
The findings were presented at a dissemination seminar held at the Canada Club in Dhaka on Thursday, bringing together health experts, policymakers, representatives from the Directorate General of Health Services (DGHS) and Directorate General of Family Planning (DGFP), and development partners to discuss the state of adolescent health in Bangladesh.
The event highlighted findings from a 24-month cohort study involving 2,713 adolescents from icddr,b’s Baliakandi Health and Demographic Surveillance System (HDSS), with data collected every four months between 2023 and 2025.
One component followed 1,255 adolescent girls aged 12–16 years and found that 64% of them experienced at least one menstrual disorder.
Painful periods, or dysmenorrhoea, were the most common condition, affecting 56% of girls. One in three experienced painful periods during three or more menstrual cycles over the study period, while 9% reported persistent menstrual pain.
Nearly 40% girls said menstrual pain interfered with daily activities, and around one in four missed school because of period pain or heavy bleeding. Among girls with persistent menstrual pain, 43% also experienced additional menstrual complications.
A separate analysis involving 1,077 unmarried adolescents aged 16 years from Baliakandi and Rajbari, revealed major gaps in reproductive health knowledge. More than one-third of boys, 34%, did not know that girls can become pregnant after the onset of menstruation, compared with 16% of girls. Awareness of family planning methods was also limited, particularly among girls. While 84% of boys had heard of condoms, only 45% of girls had, and only 4% of girls knew about emergency contraceptive pills compared with 38% of boys.
The findings suggest that reproductive health knowledge before marriage may influence later outcomes. Girls who knew about family planning before marriage were about half as likely to experience an unplanned pregnancy as those who lacked such knowledge, 5% compared with 10%. During the follow-up period, nearly 200 girls were married, and 72 became pregnant, underscoring the need for accurate reproductive health information before marriage.
The event also highlighted two AdSEARCH innovations aimed at improving adolescents’ access to reliable information on sexual and reproductive health, safety, and wellbeing. These included a smartphone-based learning project in Matlab, which was preferred by 83% of participants, and Koishor-Kotha, a free Bangla-language mobile app featuring animated videos, infographics, and myth-versus-fact explainers.
The event concluded with a panel discussion moderated by Dr Fauzia Akhter Huda, scientist at icddr,b. Discussants included Professor Dr Farhana Dewan, former president of the Obstetrical and Gynaecological Society of Bangladesh; Syed Md Nuruddin, adviser on Sexual and Reproductive Health and Rights at Plan International; Nondini Lopa, country coordinator for the Global Financing Facility at the World Bank; Dr Md Manjur Hossain, assistant director of the MCH Service Unit at DGFP; and Dr Asif Iqbal, assistant director for School Health at DGHS.
During the panel discussion, Professor Dr Farhana Dewan called for greater attention to menstrual health stigma, particularly among adolescent girls in rural areas. Syed Md Nuruddin underscored the need to prevent child marriage through school-based communication, girls’ education, and engagement of both girls and boys. Dr Md Manjur Hossain emphasised that family planning information must reach girls before marriage, noting that DGFP is working to incorporate pre-marital counselling into its curriculum. Dr Asif Iqbal shared ongoing government efforts to expand adolescent-friendly health services and improve access to SRHR information.
In his remarks, Edward Cabrera, first secretary - Development (Health), High Commission of Canada to Bangladesh, highlighted Global Affairs Canada's commitment to adolescent SRHR in Bangladesh.
The findings call for stronger investment in adolescent health education and services, including menstrual health support, reproductive health information, and adolescent-friendly care, so that young people can make informed decisions and stay healthy.
