Risk Factors of Primary Dysmenorrhea among Undergraduate Students of a Medical Institution of Nepal

Authors

DOI:

https://doi.org/10.70280/njph(2025)v2i1.26

Keywords:

Dysmenorrhea, undergraduate students, menstruation, medical

Abstract

Background: Primary dysmenorrhea (PD) has significant impact on life of young females. This study aimed to find various risk factors of primary dysmenorrhea and its impact on daily life.

Methods: A cross-sectional study was done in 165 female undergraduate students (age ≤24 years) of Institute of Medicine by convenience sampling method. It was a questionnaire-based study. Anthropometric measurements were taken for Body Mass Index (BMI), waist circumference and waist hip ratio.

Results: The study showed presence of PD in 98.2% participants among whom 20.6% had mild, 32.6% had moderate and 44.8% had severe PD. Pre-menstrual symptoms (PMS) was significantly associated with severity of PD (p <0.001, OR: 3.603, CI: 1.675-7.752). However, there was no statistically significant correlation seen with early age of menarche (p = 0.932) and family history of dysmenorrhea (p value= 0.70). No association was seen between severity of PD with BMI (p = 0.720), waist circumference (p = 0.850) and waist hip ratio (p = 0.858).

Severity of PD was associated with limitations in daily activity (p value<0.001, OR:6.302, CI: 2.855-13.911), behavioral changes (p =0.001, OR: 2.638, CI: 1.186-5.864) and skipping of college (p < 0.001, OR: 10.00, CI: 2.922-34.227).

Conclusions: The prevalence of primary dysmenorrhea was very high in young females. Institutional and social support system, plans and policies to support and create easy accessibility to treatment is needed. Only then young women will be able to achieve their full potential and hence social equity will be achieved.

References

1. Mohapatra D, Mishra T, Behera M, Panda P. A Study Of Relation Between Body Mass Index And Dysmenorrhea And Its Impact On Daily Activities Of Medical Students. Asian J Pharm Clin Res . 2016 Dec. 1;9(9):297-99. Available from:

https://innovareacademics.in/journals/index.php/ajpcr/article/view/14753

2. Ju H, Jones M, Mishra GD. A U-Shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study. PLoS One. 2015 Jul 28;10(7):e0134187. doi: 10.1371/journal.pone.0134187. PMID: 26218569; PMCID: PMC4517870.

3. Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update. 2015 Nov-Dec;21(6):762-78. doi: 10.1093/humupd/dmv039. Epub 2015 Sep 7. PMID: 26346058.

4. Parker MA, Sneddon AE, Arbon P. The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers. BJOG. 2010 Jan;117(2):185-92. doi: 10.1111/j.1471-0528.2009.02407.x. PMID: 19874294.

5. Katwal PC , Karki NR , Sharma P , Tamrakar SR . Dysmenorrhea and Stress among the Nepalese Medical Students. Kathmandu Univ Med J (KUMJ). 2016 Oct.-Dec.;14(56):318-21. PMID: 29336418.

6. Sigdel D, Joshi A, Thapa T, Koirala P, Sharma K. Prevalance and Predictors of Dysmenorrhea and it’s effects among adolescent girls in Chitwan, Nepal. JCMC. 2023 Mar;13(1):15-23. Doi: https://doi.org/10.54530/jcmc.1251

7. Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates. Korean J Fam Med. 2022 Mar;43(2):101-108. doi: 10.4082/kjfm.21.0103. Epub 2022 Mar 17. PMID: 35320895; PMCID: PMC8943241

8. Mendiratta V, Lentz GM. In: Comprehensive gynecology. 7th ed. Philadelphia (PA): Elsevier Inc; 2017. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder; pp. 815–28.

9. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Dysmenorrhea and related disorders. F1000Res. 2017 Sep 5;6:1645. doi: 10.12688/f1000research.11682.1. PMID: 28944048; PMCID: PMC5585876

10. Hirata M, Kumabe K, Inoue Y. Relationship between the frequency of menstrual pain and bodyweight in female adolescents. Nihon Koshu Eisei Zasshi. 2002 Jun;49(6):516-24. Japanese. PMID: 12138714.

11. Baidhya N, Prasad Paneru D. Prevalence of Dysmenorrhea and its Associated Factors among Adolescent Girls Studying in Technical Schools of Dang, Nepal. Journal of Health and Allied Sciences. 2020 May14;10(1):24-9. Available from:

https://www.jhas.org.np/jhas/index.php/jhas/article/view/182 9

12. Booton DA, Seideman RY. Relationship between premenstrual syndrome and dysmenorrhea. AAOHN J. 1989 Aug;37(8):308-15. PMID: 2757707

13. Khodakarami B, Masoomi SZ, Faradmal J, Nazari M, Saadati M, Sharifi F, Shakhbabaei M. The Severity of Dysmenorrhea and its Relationship with Body Mass Index among Female Adolescents in Hamadan, Iran. Journal of Midwifery and Reproductive Health.2015;3(4):444-50. doi:

10.22038/jmrh.2015.4618

14. Pullon S, Reinken J, Sparrow M. Prevalence of dysmenorrhoea in Wellington women. N Z Med J. 1988 Feb 10;101(839):52-4. PMID: 3380425.

15. Unsal A, Ayranci U, Tozun M, Arslan G, Calik E. Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Ups J Med Sci. 2010 May;115(2):138-45. doi: 10.3109/03009730903457218. PMID: 20074018; PMCID: PMC2853792.

16. Amgain K, Neupane S. Effects of Food Habits on Menstrual Cycle among Adolescent Girls. Europasian J Med Sci. 2019; 1(1):53-61.

17. Atisook R, Euasobhon P, Saengsanon A, Jensen MP. Validity and Utility of Four Pain Intensity Measures for Use in International Research. J Pain Res. 2021 Apr21;14:1129-39. doi: 10.2147/JPR.S303305. PMID: 33907460; PMCID: PMC8071079

18. Vanessa Burholt, Paul Nash, Short Form 36 (SF-36) Health Survey Questionnaire: normative data for Wales. Journal of Public Health. December 2011; 33( 4): 587–603, https://doi.org/10.1093/pubmed/fdr006

19. El Kosery SM, Mostafa NT, Yosseuf HH. Effect of Body Mass Index on Primary Dysmenorrhea and daily activities in adolescents. Med. J. Cairo Univ. 2020 March; 88(1): 179-84

20. Rad M, Sabzevari MT, Rastaghi S, Dehnavi ZM. The relationship between anthropometric index and primary dysmenorehea in female high school students . JEducHealth Promot. 2018 Mar 1;7(34): 1-6. doi:

10.4103/jehp.jehp_117_17. PMID: 29619385; PMCID: PMC5868224.

21. Yonkers KA, O'Brien PM, Eriksson E. Premenstrual syndrome. Lancet. 2008 Apr5;371(9619):1200-10. doi: 10.1016/S0140-6736(08)60527-9. PMID: 18395582; PMCID: PMC3118460

22 Department of Nutrition for Health and Development. World Health Organization. Waist circumference and waist–hip ratio: report of a WHO expert consultation. Geneva, 8–11 December 2008. 39 p. ISBN 978 92 4 150149 1

23. Andersch B, Milsom I. An epidemiologic study of young women with dysmenorrhea. Am J Obstet Gynecol. 1982 Nov15;144(6):655-60. doi: 10.1016/0002-9378(82)90433-1. PMID: 7137249

24. Ugarriza DN, Klingner S, O'Brien S. Premenstrual syndrome: diagnosis and intervention. Nurse Pract. 1998 Sep;23(9):40, 45, 49-52 passim. PMID: 9778669.

25. Babapour F, Elyasi F, Shahhosseini Z, Hosseini Tabaghdehi M. The prevalence of moderate-severe premenstrual syndrome and premenstrual dysphoric disorder and the related factors in high school students: A cross-sectional study. Neuropsychopharmacol Rep. 2023 Jun;43(2):249-254. doi: 10.1002/npr2.12338. Epub 2023 May 8. PMID: 37154790; PMCID: PMC10275287.

26. Mahat A, Dhungana R, Amatya A. Pre-menstrual Syndrome and Pre-menstrual Dysphoric Disorder in Female Medical Students of Nepal. Kathmandu Univ Med J. 2023;81(1):46-51.

27 Shrestha DB, Shrestha S, Dangol D, Aryal BB, Shrestha S, Sapkota B, Rai S. Premenstrual Syndrome in Students of a Teaching Hospital. J Nepal Health Res Counc. 2019 Aug 4;17(2):253-257. doi: 10.33314/jnhrc.v0i0.1213. PMID: 31455944.

28. De Sanctis V, Soliman A, Bernasconi S, Bianchin L, Bona G, Bozzola M, Buzi F, De Sanctis C, Tonini G, Rigon F, Perissinotto E. Primary Dysmenorrhea in Adolescents: Prevalence, Impact and Recent Knowledge. Pediatr Endocrinol Rev. 2015 Dec;13(2):512-20. PMID: 26841639.

29. Rusydi R, Tamtomo DG, Kartikasari LR. Relationship Between Age of Menarche with Primary Dysmenorrhea in Adolescents . International Journal of Human and Health Sciences. 2022 Feb; 6 (1) : 123-126

30. Pakniat H, Jahanian S , Hemmati N , Ranjkesh F. The Association of Anhtropometric Indices with Dysmenorrhea in High School Students : A Cross-sectional Study. International Journal of School Health. 2019 January ; 6(1): e80870. Doi: 10.5812/intjsh.80870

31. Haidari F, Akrami A, Sarhadi M, Mohammad Shahi M. Prevalence and Severity of Primary Dysmenorrhea and its Relation to Anthropometric Parameters . Journal of Hayat 2011; 17 (1) :70-77

32 . Chauhan M, Kala J. Relation between dysmenorrhea and body mass index in adolescents with rural versus urban variation. J ObstetGynaecol India. 2012 Aug;62(4):442-5. doi: 10.1007/s13224-012-0171-7. Epub 2012 Jun 1. PMID: 23904707; PMCID: PMC3500946.

33. Takata K, Kotani K, Umino H. The Relationship Between Body Mass Index and Dysmenorrhea in the General Female Population. J Clin Med Res. 2023 Apr;15(4):239-242. doi: 10.14740/jocmr4893. Epub 2023 Apr 28. PMID: 37187713; PMCID: PMC10181351.

34. Gebeyehu MB, Mekuria AB, Tefera YG, Andarge DA, Debay YB, Bejiga GS, Gebresillassie BM. Prevalence, Impact, and Management Practice of Dysmenorrhea among University of Gondar Students, Northwestern Ethiopia: A Cross-Sectional Study. Int J Reprod Med. 2017;2017:3208276. doi: 10.1155/2017/3208276. Epub 2017 May 14. PMID: 28589173; PMCID: PMC5446888.

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Published

2025-06-09

How to Cite

Malla, N., Mahotra, N., Shrestha, S. M., & Chaudhary, S. (2025). Risk Factors of Primary Dysmenorrhea among Undergraduate Students of a Medical Institution of Nepal. Nepal Journal of Public Health, 2(1), 35–40. https://doi.org/10.70280/njph(2025)v2i1.26

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Original Research Articles