Association of primary dysmenorrhea with anthropometrical and socio-economic factors in Polish university students

Social Determinants of Health and Dysmenorrhea: A Systematic Review

Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).

An Assessment of Women's Knowledge of the Menstrual Cycle and the Influence of Diet and Adherence to Dietary Patterns on the Alleviation or Exacerbation of Menstrual Distress

A growing number of women of reproductive age experience menstrual disorders. The menstrual cycle is considerably influenced by dietary habits, physical activity, and the use of stimulants. The main aim of this study was to assess women's knowledge about the menstrual cycle and the influence of diet and lifestyle factors on menstrual symptoms, and to identify dietary models that may alleviate or exacerbate menstrual distress. A total of 505 young women participated in the study. Nearly 90% of the respondents reported at least one menstrual disorder, mostly dysmenorrhea (70.7%), whereas secondary amenorrhea was least frequently reported (13.8%) (p = 0.002). In the study population, dysmenorrhea/menstrual distress was linked with higher consumption frequency of certain food groups. Women with severe dysmenorrhea consumed refined cereal products, processed meat, sugar, and water significantly more frequently than women with moderate menstrual pain. In turn, sweetened dairy products, animal fats, and fruit were consumed more frequently by women with low intensity of menstrual pain (mild pain). Significant differences in knowledge about the menstrual cycle and physiological changes in the body were observed between the compared dietary models.

Prevalence of Primary Dysmenorrhoea and Its Impact on Academic Performance among Croatian Students during the COVID-19 Pandemic

Background

Dysmenorrhoea is one of the most common gynaecological problems. Therefore, it is important to investigate its impact during the COVID-19 pandemic which has a great impact on the lives of menstruating people all over the world.

Aim

To determine the prevalence and impact of primary dysmenorrhoea on academic performance among students during the pandemic.

Materials and Methods

This cross-sectional study was conducted in April 2021. All data were collected by an anonymous self-assessed web-based questionnaire. Due to voluntary participation in the study, 1210 responses were received, but 956 were left for analysis after exclusion criteria were applied. Descriptive quantitative analysis was performed and Kendall rank correlation coefficient was used.

Results

The prevalence of primary dysmenorrhoea was 90.1%. Menstrual pain was mild in 7.4% of cases, moderate in 28.8%, and severe in 63.8%. The study found that primary dysmenorrhoea has a great perceived impact on all included aspects of academic performance. Most affected were concentration in class in 810 (94.1%) and doing homework and learning in 809 (94.0%) female students. There is also a correlation between menstrual pain intensity and its impact on academic performance (p < 0.001).

Conclusions

Our study found that the prevalence of primary dysmenorrhoea among students at the University of Zagreb is high. Painful menstruation greatly impacts academic performance and therefore it is important to do more research on this topic.

Effect of Guizhi Fuling Wan in primary dysmenorrhea: A randomized controlled trial

ETHNOPHARMACOLOGICAL RELEVANCE

Guizhi Fuling Wan (GFW) is one of the most widely known traditional Chinese medicine (TCM) formulations that has long been used in China for the treatment of primary dysmenorrhea (PD). However, the quality of evidence is limited and there are few studies on specific TCM syndromes of GFW for PD.

AIM OF THE STUDY

To evaluate the efficacy and safety of GFW on PD patients with the heat-burning blood-stasis syndrome.

MATERIALS AND METHODS

This was a randomized, double-blinded, placebo-controlled trial. Eligible patients were recruited and randomly assigned to one of two groups to receive GFW or the placebo twice daily for three menstrual cycles with a 3-month follow-up. The primary outcome was the baseline-to-month 6 change in pain intensity measured by a Visual Analog Scale (VAS). The secondary outcomes included the changes in the Cox Menstrual Symptom Scale (CMSS), the Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), and the TCM syndrome scale from baseline to month 6. Additionally, adverse effect was assessed.

RESULTS

A total of 353 patients were screened for eligibility and 128 were randomly assigned, of whom 121 completed all treatments and follow-ups. In both the full analysis (FAS) and the per-protocol analysis (PPS), the VAS score of pain intensity decreased significantly more in the GFW group than in the placebo group from baseline to month 6 (P < 0.01). Similarly, the decrease in CMSS, SAS and TCM syndrome scores was greater in the GFW group compared with the placebo group (P < 0.01). There were no differences in SDS scores between the two groups (P > 0.05). In addition, no serious adverse events were observed.

CONCLUSION

Our findings revealed that GFW significantly alleviated the severity of menstrual pain in PD patients with the heat-burning blood-stasis syndrome without significant adverse effects.

Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis

This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. Of the 77 studies included in the meta-analysis, significant odds ratios (ORs) were obtained for eight factors associated with primary dysmenorrhea (PD): age ≥ 20 years (OR: 1.18; 95% confidence interval [CI]: 1.04−1.34), body mass index (BMI) < 18.5 kg/m2 (OR: 1.51; 95% CI: 1.01−2.26), longer menstrual periods (OR: 0.16; 95% CI: 0.04−0.28), irregular menstrual cycle (OR: 1.28; 95% CI: 1.13−1.45), family history of PD (OR: 3.80; 95% CI: 2.18−6.61), stress (OR: 1.88; 95% CI: 1.30−2.72), sleeping hours < 7 h (OR: 1.19; 95% CI: 1.04−1.35), and bedtime after 23:01 (OR: 1.30; 95% CI: 1.16−1.45). Two factors were associated with severity of PD (moderate vs. severe): BMI < 18.5 kg/m2 (OR: 1.89; 95% CI: 1.01−3.54) and smoking (OR: 1.94; 95% CI: 1.08−3.47). PD severity (mild vs. severe) and prevalence of premenstrual syndrome were associated with BMI < 18.5 kg/m2 (OR: 1.91; 95% CI: 1.04−3.50) and smoking (OR: 1.86; 95% CI: 1.31−2.66), respectively. The identified risk factors could be utilized to construct an appropriate strategy to improve menstrual symptoms and support women’s health.

Prevalence of menstrual symptoms change and influencing factors among international female students studying in china during acculturation period

Background

A number of previous studies have explored international students’ adaptation process with regards to language, lifestyle, food, and environment. However, there have yet been no studies conducted to address the menstrual symptoms challenges faced by international female students during the acculturation period. Thus, this study aims to describe the prevalence of menstrual symptoms change and to explore the influencing factors among international female students studying in China during the acculturation period.

Methods

An online cross sectional study was conducted among international female students studying in China during the acculturation period (defined as the first six months of living in the host country) in Hunan Province of China from March 2019 to July 2019. Menstrual symptoms questionnaire, sociocultural adaptation scale, China higher education student satisfaction scale, perceived stress scale, and Pittsburgh sleep quality index were used for data collection. Descriptive analysis, ANOVA, paired t-test, Pearson correlation, and multivariate linear regressions were used to analyze the data using SPSS 21.0 software.

Results

Three hundred and forty-five (97.18%, 345/355) female students from 45 countries fully completed the questionnaire. The mean age of the participants was (26.59 ± 6.439) years. In total, 18.49% of participants had encountered menstrual symptoms change. There were significant differences in the menstrual symptoms score between before arrival and evaluation during the first six months of living in China (t = − 11.700, p = 0.000). The main menstrual symptoms change included cramps (17.68%), irritation (14.78%), abdominal pain (12.46%), fatigue (12.46%), and headaches (9.85%). Cultural adaptation level (β = 0.198, 95% CI: 0.934, 2.995), sleep quality (β = 0.166, 95% CI: 0.112, 0.496), perceived stress (β = 0.193, 95% CI: 0.123, 0.410), time spent in the host environment, (β = − 0.270, 95% CI: − 3.200, − 1.444) and experience of visiting foreign countries (β = 0.184, 95% CI: 1.134, 4.125) were significantly correlated with menstrual symptoms change.

Conclusion

The prevalence of menstrual symptoms change among international female students should not be overlooked when considering menstrual health in this population. Poorer cultural adaptation, poorer sleep quality, higher stress, and lack of overseas living experiences significantly influence the menstrual symptoms of international female students studying in China.

Prevalence and Risk Factors of Primary Dysmenorrhea in Students: A Meta-Analysis

OBJECTIVES

Primary dysmenorrhea (PD), as the most common complaint among students, is also one of the public problems worldwide. Prevalence and risk factors of PD were variant between studies; as the main population, no meta-analysis for PD has hitherto been conducted in students.

METHODS

We searched the published literature in PubMed, Embase, the Cochrane Library, Web of Science, National Knowledge Infrastructure, WANFANG, and VIP database. After screening and assessing the quality of studies, data from eligible studies were extracted for meta-analysis via the R language.

RESULTS

A total of 96 studies published from 1991 to 2021 with 78 068 students were included, the mean age of participants was 19.4, and 79.9% were university students. The pooled overall prevalence of PD was 66.1% (95% confidence interval [CI] 63.4-68.9), and 31.1% (CI 28.1-34.3), 25.7% (CI 23.4-28.0), and 8.3% of students (CI 7.4-9.3) reported mild, moderate, and severe PD, respectively. Besides, the prevalence of PD was estimated at 58.8% (CI 54.3-63.7) before 2010, but ascended to 68.5% (CI 65.5-71.6) after 2010 and rose to 71.5% (CI 65.8-76.6) in 2015 to 2021. About risk factors for PD, underweight, skipping breakfast, poor sleep quality, staying up late, lack of physical exercise, exposure to cold and eating cold or spicy foods during menstruation, dietary bias, prefer snacks, family history of dysmenorrhea, irregular menstrual cycle, heavy stress, negative emotion during menstruation, and anxiety were significantly related to PD.

CONCLUSIONS

The overall prevalence of PD among students was 66.1% and had a rising tendency in the last 10 years. Our findings helped understand the current prevalence and improve the administration of PD among students.

The relation between body mass index and primary dysmenorrhea: A systematic review and meta-analysis

INTRODUCTION

The relation between body mass index (BMI) categories and the occurrence of primary dysmenorrhea has been investigated, but the results of these studies are inconsistent and controversial. The aim of our study was to systematically review the literature and investigate the association between each category of BMI and the occurrence of primary dysmenorrhea.

MATERIAL AND METHODS

We conducted a systematic review and meta-analysis of observational studies related to BMI and primary dysmenorrhea. Eleven databases-PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database (CBM), and Wanfang database-were systematically searched from inception to March 2022. We used the 11 items recommended by the Agency for Healthcare Research and Quality to assess the quality of included studies. The Q test and the I² test were used to evaluate the heterogeneity among studies. Odds ratios (OR) and their 95% confidence intervals (CI) were pooled by fixed-effects models or random-effects models. Stata software version 16.0 was used to complete the statistical analyses.

RESULTS

A total of 4181 articles were collected from the database, and 12 studies were included based on inclusion and exclusion criteria. A total of 29 647 participants were included in the study, with a mean baseline age of 17-45 years. All included literature was published between 2017 and 2021 and was conducted in six countries. Eleven included studies were of medium quality and one included study was of high quality. Being underweight may be related to the occurrence of primary dysmenorrhea (12 studies, n = 6545, OR 1.43, 95% CI 1.18-1.73). Being overweight (12 studies, n = 3098) and obesity (four studies, n = 94) may not be associated with the development of primary dysmenorrhea.

CONCLUSIONS

Being underweight may increase the risk of the occurrence of primary dysmenorrhea, whereas overweight and obesity might not be associated with primary dysmenorrhea. Due to the limitations of the meta-analysis, more studies are needed to investigate the relation between each category of BMI and the occurrence of primary dysmenorrhea. To maintain a balanced diet and an appropriate lifestyle is beneficial for people to have the normal category of BMI and live a healthy life, which may play a role in preventing the occurrence of primary dysmenorrhea.

The Effect of Long-Term Menstrual Pain on Large-Scale Brain Network in Primary Dysmenorrhea Patients

Purpose

Primary dysmenorrhea (PD) is a common gynecological disease, characterized by crampy and suprapubic pain occurring with menses. Growing evidences demonstrated that PD patients were associated with abnormalities in brain function and structure. However, little is known regarding whether the large-scale brain network changes in PD patients. The purpose of this study was to investigate the effect of long-term menstrual pain on large-scale brain network in PD patients using independent component analysis (ICA) method.

Methods

Twenty-eight PD patients (female, mean age, 24.25±1.00 years) and twenty-eight healthy controls (HCs) (mean age, 24.46±1.31 years), closely matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. ICA was applied to extract the resting-state networks (RSNs) in two groups. Then, two-sample t-tests were conducted to investigate different intranetwork FCs within RSNs and interactions among RSNs between two groups.

Results

Compared to the HC group, PD patients showed significant increased intra-network FCs within the auditory network (AN), sensorimotor network (SMN), right executive control network (RECN). However, PD patients showed significant decreased intra-network FCs within ventral default mode network (vDMN) and salience network (SN). Moreover, FNC analysis showed increased VN-AN and decreased VN-SMN functional connectivity between two groups.

Conclusion

Our study highlighted that PD patients had abnormal brain networks related to auditory, sensorimotor and higher cognitive network. Our results offer important insights into the altered large-scale brain network neural mechanisms of pain in PD patients.

Efficacy of Guizhi Fuling Wan for primary dysmenorrhea: protocol for a randomized controlled trial

Background

Primary dysmenorrhea (PD) is one of the main gynecological complaints in women of child-bearing age, but limited effective treatments are available. Guizhi Fuling Wan (GFW), one of the most widely known traditional Chinese medicine (TCM) formulations, has been commonly used in clinical practice to treat gynecological disorders in China. In recent years, a growing number of studies have shown that GFW is beneficial for patients with PD. However, the quality of evidence is limited, and there are few studies on specific TCM syndromes of GFW for PD. Therefore, we plan to conduct a randomized controlled trial to explore the efficacy and safety of GFW for PD patients with heat-burning blood-stasis syndrome.

Methods and analysis

The clinical study is a randomized, double-blinded, placebo-controlled trial. Eligible patients will be randomly assigned to the GFW group (treated with GFW) and the control group (treated with a matching placebo) in a 1:1 ratio for three menstrual cycles with a 3-month follow-up. The primary outcome will be the mean change of pain intensity measured by the visual analog scale (VAS). The secondary outcomes will include the Cox Menstrual Symptom Scale (CMSS), the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the TCM syndrome scale. Adverse events will also be reported.

Discussion

This randomized trial will be the first rigorous study designed to assess the efficacy and safety of GFW in treating PD with heat-burning blood-stasis syndrome. The finding of this study will provide an objective clinical basis for the use of GFW for PD in the future.

Trial registration

Chinese Clinical Trial Registry ChiCTR2000034118. Registered on 24 June 2020

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05834-0.

Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

OBJECTIVES

The study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.

DESIGN AND METHOD

Institution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.

SETTING AND PARTICIPANTS

Ethiopia (2019: n=647 female university students).

OUTCOMES

The primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.

RESULTS

The prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).

CONCLUSIONS

Dysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

The Influence of Age at Menarche on the Menstrual Pattern of Polish University Students

PURPOSE

The aim of the study was to examine the relationships between age at menarche and menstrual cycle characteristics in young female subjects.

METHODS

Anthropometric measurements were performed, and questionnaire data were collected from 1,323 women, aged 19-25 years.

RESULTS

No differences were found in terms of cycle duration or the number of days of bleeding between women with early, average, or late menarche. Each of those groups had a similar percentage of women who declared that their cycles last longer than 35 days, those who declared that their cycles are shorter than 21 days, and those who reported prolonged bleeding. Irregular cycles were associated with late age at menarche. Women with early age at menarche complained about menstrual cramps more frequently. The existence of a relationship between age at menarche and menstrual cycle disorders was confirmed by the results of logistic regression.

CONCLUSIONS

Both early and late age at menarche are associated with increased risk of menstrual cycle disorders.

Dysmenorrhea and Associated Factors among Polish Women: A Cross-Sectional Study

Purpose

The aim of the research was to conduct an assessment of the prevalence of dysmenorrhea and associated factors among Polish women. Patients and Methods. A cross-sectional study was conducted among Polish women using an online questionnaire. The mean age of the participants was 23 ± 4 years. Out of the total of 1,317 women who took part in the study, 1,127 were included in the analysis, and 190 were excluded due to incomplete answers. The questionnaire consisted of 19 questions that were grouped into three parts. The first concerned sociodemographic data such as age, weight, education, and residence (urban or rural). The second part of the questionnaire pertained to the factors of dysmenorrhea (premenstrual syndrome, age of menarche, and family history of dysmenorrhea.). In the third part, the women were asked about their diet, alcohol intake, cigarette smoking, and physical activity.

Results

Dysmenorrhea affected 94% of the interviewed women. Dysmenorrhea was most likely to occur among respondents whose mothers had a history of dysmenorrhea (p < 0.005). Significant relationship between the occurrence of dysmenorrhea among respondents and their sisters was also observed (p < 0.005). The prevalence of premenstrual syndrome (PMS) was significantly higher in women reporting dysmenorrhea (p < 0.005). Other significant factors associated with dysmenorrhea were age of menarche (p < 0.005), stress frequency (p=0.005), lack of physical activity (p=0.037), and self-esteem (p=0.042). However, in the respondents, no significant relationship was observed between dysmenorrhea and diet, smoking, body mass index, and alcohol intake.

Conclusion

The study points to the fact that the problem of dysmenorrhea affects many Polish women. Women with dysmenorrhea were characterized with a family history of dysmenorrhea, occurrence of PMS, early age of menarche, stressful lifestyle, lack of physical activity, and low self-esteem. We suggest that further assessment of factors contributing for dysmenorrhea among women is necessary.

Prevalence and Risk Factors Associated with Primary Dysmenorrhea among Chinese Female University Students: A Cross-sectional Study

STUDY OBJECTIVE

To examine prevalence and risk factors associated with primary dysmenorrhea among Chinese female university students in Hunan province, China.

DESIGN

A cross-sectional study.

SETTING

Female university students in Changsha city, Hunan province, China.

PARTICIPANTS

Four thousand six hundred six female individuals selected using a multistage cluster random sampling method.

INTERVENTIONS

A self-administered questionnaire, which included sociodemographic information, lifestyle habits, emotional characteristics, and menstruation pattern, was used to collect data.

MAIN OUTCOME MEASURES

Information about menarche, body mass index, cycle length and regularity, primary dysmenorrhea, physical exercise, depression, and anxiety.

RESULTS

The prevalence of primary dysmenorrhea was 41.7% (1921/4606) among Chinese female university students. Multivariate binary logistic regression indicated that being a minority (odds ratio [OR], 1.335; 95% confidence interval [CI], 1.083-1.646), underweight (OR, 1.249; 95% CI, 1.08-1.42), annual household income less than 80,000 CNY (OR, 1.169; 95% CI, 1.018-1.342), maternal history of dysmenorrhea (OR, 2.553; 95% CI, 2.236-2.915), age at menarche younger than 12 years (OR, 1.161; 95% CI, 1.013-1.329), irregular menstrual cycle (OR, 1.216; 95% CI, 1.063-1.391), and skipping breakfast (OR, 1.294; 95% CI, 1.124-1.490) were associated risk factors of primary dysmenorrhea.

CONCLUSION

The prevalence of primary dysmenorrhea among Chinese university students is relatively high. Various risk factors were identified that associated with primary dysmenorrhea. More effort and attention should therefore be directed toward this health problem in China.

Primary dysmenorrhea and self-care strategies among Chinese college girls: a cross-sectional study

OBJECTIVES

To explore the prevalence of primary dysmenorrhea (PD), the characteristics of PD and self-care strategies for managing PD among Chinese college girls.

DESIGN

Cross-sectional study.

SETTING

Changsha, China.

PARTICIPANTS

A total of 2555 college girls were recruited using multistage cluster random sampling.

OUTCOME MEASURES

A self-report questionnaire was used to measure sociodemographic information, characteristics of PD and self-care strategies for managing PD. Additionally, a Visual Analogue Scale was used to measure pain severity.

RESULTS

Of the 2555 girls, 1306 had experienced PD, representing a 51.1% prevalence. In addition, the prevalence rates of mild, moderate and severe pain in PD were 18.1%, 27.7% and 5.4%, respectively. The most common symptoms associated with PD were cramps (96.9%), weakness (70.0%), backache (65.1%), facial blemishes (55.3%) and irritability (55.3%). Commonly used self-care strategies for managing PD comprised reducing physical activity (94.6%), keeping warm (84.6%), communicating dysmenorrhea with friends or classmates (79.0%), drinking warm beverages (75.7%) and avoiding cold drinks and foods (74.2%). In addition, only 34.8% self-medicated with Western medicine (15.6%), traditional Chinese medicine (8.6%), or both (10.6%). Medical advice was sought by 27.4% of subjects from a Western medical doctor (10.3%), a doctor of traditional Chinese medicine (13.6%), or both (3.5%). Girls who had greater pain severity were more likely to be self-medicated (OR=7.01; 95% CI 4.50 to 10.91), use complementary therapies (OR=2.64; 95% CI 1.70 to 4.10) and seek medical advice (OR=5.93; 95% CI 3.80 to 9.24).

CONCLUSIONS

PD is highly prevalent among Chinese college girls, with a high burden of symptoms. In addition, these girls are most likely to change their lifestyle, communicate dysmenorrhea with friends or mothers, use heat therapy and engage in self-talk, but less likely to self-medicate or seek medical advice for managing PD.

The Prevalence and Academic Impact of Dysmenorrhea in 21,573 Young Women: A Systematic Review and Meta-Analysis

Introduction: Dysmenorrhea (period pain) and associated symptoms are very common in young women <25 years. This time corresponds with a significant stage in adolescents and young women's academic lives at both school and in higher education. Dysmenorrhea may cause absenteeism from class or result in reduced classroom concentration and performance. Owing to cultural and economic differences, any impact may vary by country. This systematic review and meta-analysis examines the prevalence of dysmenorrhea in young women and explores any impact it has on their academic performance and other school-related activities. Materials and Methods: A search in Medline, PsychINFO, EMBASE, and Cumulative Index to Nursing and Allied Health Literature was carried out in June 2018. Results: Thirty-eight studies including 21,573 young women were eligible and included in the meta-analysis. Twenty-three studies were from low-, lower middle-, or upper middle-income countries, and 15 studies were from high-income countries. The prevalence of dysmenorrhea was high 71.1% (N = 37, n = 20,813, 95% confidence interval [CI] 66.6-75.2) irrespective of the economic status of the country. Rates of dysmenorrhea were similar between students at school (N = 24, 72.5%, 95% CI 67.5-77.0) and at university (N = 7, 74.9%, 95% CI 62.9-84.0). Academic impact was significant, with 20.1% reporting absence from school or university due to dysmenorrhea (N = 19, n = 11,226, 95% CI 14.9-26.7) and 40.9% reporting classroom performance or concentration being negatively affected (N = 10, n = 5126, 95% CI 28.3-54.9). Conclusions: The prevalence of dysmenorrhea was high, irrespective of country, with dysmenorrhea having a significant negative impact on academic performance both at school and during higher education.