Prevalence and Determinants of Primary Dysmenorrhea and Its Influence on Quality of Life among Female Medical University Students in Pakistan

Authors

  • Areeshah Mufti Shifa College of Medicine: Shifa Tameer-e-Millat University, Islamabad, Pakistan.
  • Areebah Mufti Shifa College of Medicine: Shifa Tameer-e-Millat University, Islamabad, Pakistan.
  • Tatheer Zahra Shifa College of Medicine: Shifa Tameer-e-Millat University, Islamabad, Pakistan.
  • Saira Lateef Mufti Federal Government Hospital Rawalpindi, Pakistan.
  • Maryam Amin Sheikh Shifa College of Medicine: Shifa Tameer-e-Millat University, Islamabad, Pakistan.
  • Zainab Riaz Shifa College of Medicine: Shifa Tameer-e-Millat University, Islamabad, Pakistan.

DOI:

https://doi.org/10.47489/szmc.v40i1.785

Keywords:

Dysmenorrhea, Quality of Life, Students, Medical, Pakistan

Abstract

Background: Dysmenorrhea, characterized by painful menstruation, is classified as primary or secondary. Primary dysmenorrhea commonly affects women under 25 years of age and is associated with absenteeism, reduced academic performance, and limitations in daily activities. However, research focusing specifically on female medical students remains limited, despite their exposure to unique academic and psychosocial stressors.

Objective: To determine the frequency of primary dysmenorrhea among female medical students, assess its impact on quality of life and daily functioning, and identify the management practices used for symptom relief.

Method: A descriptive cross-sectional study was conducted among 323 female medical students aged 18–25 years from six medical institutes in Pakistan between March and June 2024. Data were collected using a self-designed, structured, and validated questionnaire that was pilot-tested for clarity and reliability. Married students and those with secondary dysmenorrhea were excluded. Quality of life was assessed using functional indicators, including absence from academic activities, reduced concentration, inability to perform routine tasks, and limitation of physical activities. Data was analyzed using SPSS version 26. Descriptive statistics were used to calculate frequencies and percentages, and associations between dysmenorrhea severity and quality-of-life indicators were assessed using the chi-square test, with p < 0.05 considered statistically significant.

Results: Primary dysmenorrhea was reported by 96.9% (n=313) of participants. Severity, assessed using the WaLIDD score (0–12), showed a statistically significant association with impaired quality of life and functional status (p < 0.05). Higher severity scores were associated with reduced working ability, increased absenteeism, and impaired academic performance. Specifically, 68.4% (n=221) reported difficulty concentrating, 30.3% (n=98) difficulty learning, 26.3% (n=85) difficulty memorizing, 19.8% (n=64) hesitancy in group participation, and 18% (n=58) absenteeism, while only 19.5% (n=63) reported no academic impact. Common coping strategies included bed rest (75.2%, n=243), hot compresses (49.8%, n=161), self-medication (48%, n=155), massage (16.4%, n=53), and herbal remedies (15.5%, n=50).

Conclusion: Primary dysmenorrhea is highly frequent among female medical students and is significantly associated with impaired quality of life and daily functioning. Improved awareness and effective management strategies are needed to reduce its academic and functional burden.

References

Ikramullah, Ahmed Z, Shafiq-Ur-Rahman, Habib A, Gul B, Khan MA. Effects of dysmenorrhea on quality of life in young girls. Journal of Medical Sciences (Peshawar). 2016;24(2):77–80. Available from: https://jmedsci.com/index.php/Jmedsci/article/view/162

Jawad NK, Ali Z, Khail SK, Fozia A, Pervaiz N, Rehman F. Prevalence and predictors of dysmenorrhea, its effects and coping mechanism among adolescent. Pakistan Journal of Medical and Health Sciences. 2021;15(8):2472–6. https://doi.org/10.53350/pjmhs211582472

Armour M, Parry K, Manohar N, Holmes K, Ferfolja T, Curry C, et al. The prevalence and academic impact of dysmenorrhea in 21,573 young women: a systematic review and meta-analysis. Journal of Women’s Health. 2019;28:1161–71. https://doi.org/10.1089/jwh.2018.7615

McKenna KA, Fogleman CD. Dysmenorrhea. American Family Physician. 2021 Aug;104(2):164–70. Available from: https://pubmed.ncbi.nlm.nih.gov/34383437/

Ferries-Rowe E, Corey E, Archer JS. Primary dysmenorrhea: diagnosis and therapy. Obstetrics & Gynecology. 2020 Nov;136(5):1047–58. https://doi.org/10.1097/AOG.0000000000004096

Guimarães I, Póvoa AM. Primary dysmenorrhea: assessment and treatment. Revista Brasileira de Ginecologia e Obstetricia. 2020;42(8):501–7. https://doi.org/10.1055/s-0040-1712131

Alotibi H, Zarban A, Jan R, Helal R, Kersh R, Almutairi W, et al. Non-pharmacological methods to relieve dysmenorrhea among students of health colleges in Saudi Arabia. International Journal of Novel Research in Healthcare and Nursing. Available from: https://www.noveltyjournals.com/upload/paper/paperpdf-1608018915.pdf

Gutman G, Nunez AT, Fisher M. Dysmenorrhea in adolescents. Current Problems in Pediatric and Adolescent Health Care. 2022;52(5):101186. https://doi.org/10.1016/j.cppeds.2022.101186

Ishikura IA, Hachul H, Tufik S, Andersen ML. Dysmenorrhea and sleep: a review. Sleep Medicine Clinics. 2023;18(4):449–61. https://doi.org/10.1016/j.jsmc.2023.06.006

Almanasef M, Alqarni H. Self-care strategies for the management of primary dysmenorrhea among young women in Asir region, Saudi Arabia: a cross-sectional study. European Review for Medical and Pharmacological Sciences. 2023;27(1):172–8. https://doi.org/10.26355/eurrev_202301_30869

Maqbool S, Manzoor I, Fatima N, Tahir S, Shahid H, Hanif MU, et al. Prevalence, impact, management practices and factors associated with dysmenorrhea among students of Akhtar Saeed Medical & Dental College Lahore. Pakistan Journal of Public Health. 2021;11(2):95–101. https://doi.org/10.32413/pjph.v11i2.722

Carroquino-Garcia P, Jiménez-Rejano JJ, Medrano-Sanchez E, De La Casa-Almeida M, Diaz-Mohedo E, Suarez-Serrano C. Therapeutic exercise in the treatment of primary dysmenorrhea: a systematic review and meta-analysis. Physical Therapy. 2019;99(10):1371–80. https://doi.org/10.1093/ptj/pzz101

Ullah A, Fayyaz K, Javed U, Usman M, Malik R, Arif N, et al. Prevalence of dysmenorrhea and determinants of pain intensity among university-age women. Pain Medicine. 2021;22(12):2851–62. https://doi.org/10.1093/pm/pnab273

Underrecognition of dysmenorrhea is an iatrogenic harm. AMA Journal of Ethics. 2022;24(8):E740–747. https://doi.org/10.1001/amajethics.2022.740

Kim YS, Kim JW. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean Journal of Family Medicine. 2022;43(2):101–108. https://doi.org/10.4082/kjfm.21.0103

Teherán AA, Piñeros LG, Pulido F, Mejía Guatibonza MC. WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students. International Journal of Women’s Health. 2018;10:35. https://doi.org/10.2147/IJWH.S143510

Jamil A, Sheraz M, Ashraf S, Akram S. Association of dysmenorrhea with mental health and academic performance among university students. Journal of University College of Medicine and Dentistry. 2024;3(1):13–7. https://doi.org/10.51846/jucmd.v3i1.2752

Karout S, Soubra L, Rahme D, Karout L, Khojah HMJ, Itani R. Prevalence, risk factors, and management practices of primary dysmenorrhea among young females. BMC Women’s Health. 2021;21(1):1–14. https://doi.org/10.1186/s12905-021-01532-w

Unnisa H, Annam P, Gubba NC, Begum A, Thatikonda K. Assessment of quality of life and effect of non-pharmacological management in dysmenorrhea. Annals of Medicine and Surgery. 2022;81:104407. https://doi.org/10.1016/j.amsu.2022.104407

Woretaw Azagew A, Kassie G, Walle TA. Prevalence of primary dysmenorrhea, its intensity, impact and associated factors among female students at Gondar town preparatory school, Northwest Ethiopia. https://doi.org/10.1186/s12905-019-0873-4

Bakro RM, Farrukh MJ, Rajagopal M, Kristina SA, Ramatillah DL, Ming LC, et al. Assessment of prevalence, knowledge and health-related practices of dysmenorrhea among Malaysian women in Kuala Lumpur: a cross-sectional survey. Annals of Medicine. 2023;55(2):2281655. https://doi.org/10.1080/07853890.2023.2281655

Durand H, Monahan K, McGuire BE. Prevalence and impact of dysmenorrhea among university students in Ireland. Pain Medicine. 2021;22(12):2835–45. https://doi.org/10.1093/pm/pnab122

Published

2026-04-02

How to Cite

1.
Mufti A, Mufti A, Zahra T, Mufti SL, Sheikh MA, Riaz Z. Prevalence and Determinants of Primary Dysmenorrhea and Its Influence on Quality of Life among Female Medical University Students in Pakistan. Proceedings S.Z.M.C [Internet]. 2026 Apr. 2 [cited 2026 Sep. 14];40(1):25-31. Available from: https://proceedings-szmc.org.pk/index.php/szmc/article/view/785