ROLE OF PHASES OF MENSTRUAL CYCLE IN FATAL SELF-DIRECTED VIOLENCE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 65
Abstract
BACKGROUND India accounted for the highest number of suicides in 2012, according to a report by WHO published on September 4, 2014, which also reported that one person commits suicide every 40 seconds globally. As per the report, 258,075 people committed suicide in India in 2012 of which 99,977 were female and 158,098 were male. India’s suicide rate was 21.1 per 100,000 according to the report. Kerala constitutes 6.3% share of total suicides in India which is at the 4th place, 1st being Pondicherry (37 per 100,000). Kerala’s suicide rate is 24 per 100,000. Among the females who committed suicide, 75% were between the age group of 15-44 years, the reproductive age group. This value clearly shows that a higher incidence of suicide occurs among females of menstruating age group. Hence, it is important to evaluate whether there is any role for menstruation or menstrual and premenstrual stress for this higher incidence. If there is any association, an intervention at the right time could bring down the suicide rate among females in the reproductive age group. Objectives- To measure the pattern of menstrual cycle phase among cadavers of fatal self-directed violence. MATERIALS AND METHODS This is a descriptive study conducted at the Department of Forensic Medicine, Govt. Medical College, Kottayam during the period 09/06/2015 to 08/06/2016, during which 96 female cases of fatal self-inflicted violence cases were autopsied belonging to the reproductive age group (15-45 years). History was collected from relatives. Uterus and appendages were examined during dissection and tissue bits were sent for histopathological examination. Endometrial findings were categorised in to five groups: 1. Lytic phase/menstrual phase; 2. Early proliferative phase; 3. Late proliferative phase; 4. Early secretory phase; and 5. Late secretory phase. The data obtained were entered in MS Excel Sheet and analysed by SPSS software. RESULTS Among the 96 cases included in the study, it was noted that majority of deaths were in the age group of 20 to 37 years. The cases under age group 19 years were 27.1%; those between 20-38 years were 46.9%; and those above 39 were 26%. Religion wise, Hindus were 57, Christians 29 and Muslims 9. Methods adopted for suicide were: hanging (49 cases); burns 22; poisoning 20; drowning 4 and one committed suicide by ‘railway occurrence’. Majority of women, 40 cases (41.7%) committed suicide during late secretory phase or premenstrual period of menstrual cycle, followed by early proliferative phase (30.2%), late proliferative phase (13.5%), and least in the lytic and early secretory phase (7 cases in each phase). This finding was found to be statistically significant. CONCLUSION Most of the global studies conducted regarding this were in Psychiatry Department among victims of non-fatal self-directed violence and these studies revealed a positive correlation between attempted suicides and premenstrual period and they attributed these results as a part of premenstrual syndrome or as a premenstrual stress response. But two related studies conducted in Kerala on completed cases of female suicide could not establish a significant association between the phase of menstruation and suicide among females. Late secretory phase of the menstrual cycle (Premenstrual period) has got maximum relation with fatal self-directed violence among females in the reproductive age group 15-45 years.
Authors and Affiliations
Jidhin V. S, Rajeev V. M, Shilpa S. Babu, Anwar K. A, Neethu M Babu, Aiswarya Rani, Reshma A. A, Alfia A
Keywords
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- EP ID EP231680
- DOI 10.14260/Jemds/2017/1019
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