Unpacking the mysteries of puberty among school going adolescents in district of East Khasi Hills, Meghalaya.

Objectives: Pubertal age carries the risk of different challenges and experiences. However, lack of data on the subject made it necessary to estimate the magnitude of pubertal problems and its determinants.

Methods: A mixed methods study was conducted among the school students aged 10-17 years during May 2022 in three selected schools of Shillong. The cross-sectional quantitative component (pre-designed semi-structured questionnaire) included 418 students and eight students were selected purposively for the qualitative component (in-depth interviews).

Results: The mean age of the students was 13.5 years with 52.9% boys. At least one of the pubertal problems was present among 57.2% (95%CI: 52.3-69.2%). With regards to physical, hormonal/behavioural and mental problems, the prevalence was reported to be 34.2, 31.8 and 12.0% respectively. Premenstrual symptoms were present among 89.4% girls. Mental problems were significantly higher among the girls [PR: 1.83 (95%CI: 1.06-3.13; p=0.02)] and the hormonal problems were significantly lesser among the girls [PR: 0.41 (95%CI: 0.29-0.57; p<0.001)]. With regards to age, the mental and hormonal problems was significantly higher among the late adolescents. About 55.2% sought help for their problems of which 56.9% primarily sought help from parents. In-depth interviews yielded five themes for the problems of puberty which included individuals related (hormonal, impulse control etc.), school related (safety, relationship with teachers), family related (behavioural regulations, literacy etc.), friends/peers related (networks/relationships) and coping behaviours.

Conclusions and recommendations: Pubertal problems were reported among a considerable proportion of students which provides policy implications for addressing behavioural problems, interpersonal relationships and cordial school environment.