The Effect of Green Coconut Water on Primary Dysmenorrhoea in Adolescent Women

. Coconut water green is a healthy drink, it contains vitamin C, calcium, and magnesium, which can reduce tension muscles, and is a functional anti-inflammatory to lower painful menstruation. To know the effect of coconut water green on Primary dysmenorrhea in adolescent daughters. Research design This uses quasi-experiment pretest posttest , and retrieval sample using the technique of purposive sampling of as many as 30 respondents. data is collected using a questionnaire. A Numerical rating scale (NRS) is used before and after a given intervention. and analyzed using the Wilcoxon signed-rank test . Show that happen decline scale painful menstruation after consuming coconut water with a value ( P <0.000). There is an effect of giving coconut water green to decline painful Primary dysmenorrhea in adolescent daughters. Recommended to a teenage daughter who experiences pain at times menstruation for consuming coconut water green.


Introduction
Primary dysmenorrhea is defined as painful cramps stomach part that occur at the beginning of menstruation without an existing disease-identified pelvis and is one disturbance common complaints that teenagers often complain about or women moderately productive experience during menstruation.[1] pain normally takes place from 8 to 72 hours and is most severe in the day first and two menstruation Because of the enhancement of prostaglandin release during the period [2].
According to the World Health Organization (WHO) figures primary dysmenorrhea in the world is very larger on average than 50% of women in every country experience primary dysmenorrhea.In the United States, it is estimated almost 90% of women experience primary dysmenorrhea and 10-15% experience dysmenorrhea as heavy, which causes them to be not capable of doing activities and lowers their quality of life.
Corresponding author: ariyandyasir@unhas.ac.idEven in America, it is estimated Woman lose 1.7 million days of Work every month consequence of dysmenorrhea.Dysmenorrhea causes 14% of patients teenagers who often do not attend school or do not undergo activity daily.
In Indonesia, you can get it number of incidents of primary dysmenorrhea i.e. around 54.89% of women while 55.11% are women the rest suffer from dysmenorrhea secondary.In Indonesia lots of women experience painful periods no report or visit to a place of service health tends to belittle symptoms, society considers painful periods as disease psychosomatic, but because knowledge the more developed painful periods start to discussed a lot.
There are several factor reasons Primary dysmenorrhea among other factors psychological, endocrine, and factors risk primary dysmenorrhea i.e Age moment menstruation first < 12 years, menarche or age first time menstruating fast at age < 12 years, duration of menstruation, nutritional status, for overcome dysmenorrhea can done with two methods that are with method treatment pharmacological and non-pharmacological, treatment pharmacology used is drug analgesic and anti-inflammatory like sour mefenamic, ibuprofen, and others.Whereas non-pharmacological treatment can done with relaxing breath inside and giving coconut water green.
Coconut water's green content of calcium is 14.11 mg/100ml, magnesium 9.11 mg/100 ml, and vitamin C 8.59 mg/100 ml, contains sour folate is one component needed in the production of cell blood red, calcium and magnesium contained in coconut water green can reduce tension muscle and vitamin C which is substances Natural anti-inflammatory that helps relieve pain consequence cramps menstruation with hinder the enzyme cyclooxygenase which has a role in encourages the process of prostaglandin formation, easily absorbed by the body because content isotonic fluid with body humans [3].
Based on the survey The initial steps carried out at MTS 1 are: schools located in the work area public health center Wawolesea, on April 5, 2023, from 10 female students who are experiencing menstruation there is 1 female student who experienced painful severe, 4 people experienced it painful moderate and 3 female students experienced it painful light and 2 female students no there is pain.During This coconut water research green to decline painful period not yet once carried out on a teenage daughter who is in the work area Public health center Wawolesea.

Method study
This study uses a design experimenter with an approach two group pretest-posttest design.Place study This is in the work area of Public Health Center Wawolesea.population in the study This is all teenage daughters who are already menstruation totaling 232, samples were taken with purposive sampling technique in research this as many as 30 respondents, 15 respondents were categorized as group intervention and 15 respondents the rest as control group.Group coconut water intervention green and the control group is relaxation breath in.Dysmenorrhea pain was measured using a numeric rating scale (NRS) scale pain 0-10.Variable in study This covers age, age of menarche, length of menstruation, and Index mass body (BMI).Age is categorized become teenager early 12-16 years and teenagers At the end of 17-25 years, the age of menarche is categorized normal 12-14 years, abnormal <12 years and >14 years, menstrual period is categorized as normal 2-8 days abnormal < 2 and > 8 days, BMI is categorized be normal 18.5-25.0,thin <18.5, fat > 25. in the group intervention procedure giving coconut water 250 ml was given at a time pain on the scale painful currently namely 4-6 after 30 minutes of doing it return measurement scale pain and in groups control is provided technique relaxation breath in with method interesting breath from nose with count 1 2 3 and exhale in a way slowly through mouth done 15-20 times at intensity painful medium and later measure return level pain.Data analysis used the Wilcoxon signed rank

Research results
Characteristics respondents in the study This discusses age, age at menarche, length of menstruation, Index mass body (BMI), and scale of painful dysmenorrhea before intervention and after done intervention use of coconut water more he explained in Table 1 below:  Based on Table 2 shows that at the moment giving intervention shows an average of 30 respondents experienced pain while there were 15 respondents in the group intervention and 15 respondents in group control.After giving it coconut water intervention green There is a decline scale of pain 8 respondents had No pain and 7 respondents had painful light while in group control 4 had no pain and 11 had pain light.Based on Table 2 shows the mean value of primary dysmenorrhea before given intervention the mean value is 5.47 whereas the control was 5.53 after being given intervention the average value of primary dysmenorrhea decreased in the coconut water group green was 1.40 and control 1.80 ie There was a significant influence between coconut water green to primary dysmenorrhea.

Discussion
Analysis results This shows that there is a difference between giving coconut water green before and after so that can be concluded that There is an influence giving coconut water green to painful dysmenorrhea in adolescent daughters in the work area Public health center Wawolesea Regency Kona we north.
A study the same before once performed by [2] declined painful dysmenorrhea in adolescent daughters at the Stikes Papua dormitory.A study ever before carried out by Siti Khadijah in 2017 that there is a difference in the decline level of painful dysmenorrhea before and after giving coconut water green, aside That research conducted by [4] on teenage daughter level 1 Pharmacy Kudus Muhammadiyah University that exists A influence giving coconut water green as therapy experience to decline primary dysmenorrhea.
Decline pain is caused by giving coconut water Because the content of calcium and magnesium in coconut water green that can relax muscles womb consequence from prostaglandins increases [5] and coconut water green contains vitamin C which is substance Natural anti-inflammatory that helps relieve pain consequence cramps menstruation with hinder enzyme cyclooxygenase which has a role in encourages the process of prostaglandin.Prostaglandin secretion can increase uterine contractions and at excessive levels activate intestines big an increase in PGF2α which is something cyclooxygenase (COX-2) which can cause hypertonus and vasoconstriction of the myometrium so that annoying ischemia and pain at the time menstruation.Besides internal hormonal changes body, Other factors including pattern eating, age menarche early, stress, long menstruation, and level severity period menstruation and occurs syndrome premenstrual (PMS) can contribute to pathomechanism dysmenorrhea.
Composition content substance chemicals found in coconut water include acid ascorbate or vitamin C, protein, fat, hydrated charcoal, calcium, and potassium.Minerals contained in coconut water are iron, phosphorus, and sugar consisting of glucose, fructose, and sucrose.The water content in the fruit coconut a number 95.5 grams for every 100 grams.
According to [6], moment menstruation body emits fluid and blood.Coconut water contains fluid electrolytes that can prevent dehydration.Sour folate contained in coconut water is beneficial For replacing blood that comes out and is one components needed in the production cell blood red, with production of enough blood will expedite the circulation of blood.Circulation smooth blood will sufficient cells will need oxygen and nutrients and conditions This body will more stand to sensation the pain caused moment dysmenorrhea.
Coconut water can relax muscles caused by prostaglandin activity because when the menstruation layer is The damaged uterus is removed and will be replaced with new, compound molecules called prostaglandins are released, compounds This causes muscles to contract.When it happens contraction muscle uterus, then supplies blood the endometrium narrows ( vasoconstriction ) and this process causes pain moment menstruation other known substances as leukotrienes, which are material chemistry play a role in the inflammatory process and also increase at times related to the emergence of painful menstruation [7].

Conclusion
From the test results in the intervention and control groups, the primary dysmenorrhea pain scale before the intervention was given was on the moderate pain scale, after the intervention was given it dropped to mild pain and no pain.The results of statistical tests show that there no significant difference, however, these two methods can be used as non-pharmacological methods to reduce pain intensity in adolescents with primary dysmenorrhea.It is hoped that health workers will disseminate the results of this research to all young women as a non-pharmacological therapy in treating dysmenorrhea.

table 1 .
This shows that the characteristics of respondents are teenager-daughteraged teenagers early and adolescents end with normal menarche age, normal menstrual duration, have index mass body with normal category.

Table 2 .
Distribution frequency scale painful dysmenorrhea before and after giving coconut water green.

Table 3 .
Influence giving coconut water young to painful pretest and posttest dysmenorrhea.