Prevalence of dysmenorrhea and predictors of its pain intensity among Palestinian female university students

Abstract

BackgroundFew studies on gynaecological problems of young females in Arab countries were published. The aim of this study was to determine the prevalence of dysmenorrhea and predictors of its pain among university students in Palestine.MethodsA cross – sectional study was carried out on a randomly selected sample of An-Najah National University female students. A pre-designed questionnaire, which included questions regarding menstrual cycle, pain during menstruation, life style, nutritional habits, and symptoms associated with menstrual pain, was used. Pain intensity was measured using visual analogue scale.ResultsA total of 956 female students were involved in the study. Of the total study sample, 846 (85.1%) reported having pain during menstruation; i.e. dysmenorrhea. Dysmenorrhea was significantly [(p = 0.027); OR = 1.5, 95% CI (1.05–2.19)] associated with age at menarche. The mean score of pain among dysmenorrhic females was 6.79 ± 2.64. The majority (654; 80.34%) of dysmenorrhic females reported having moderate/ severe pain. Univariate analysis using Chi-square test for factors associated with moderate/severe pain among dysmenorrhic females were irregular cycle [(p = 0.015); OR = 1.57, 95% CI = (1.09–2.30)], skipping breakfast [(p < 0.001); OR = 1.93, 95% CI = (1.33–2.79)], academic specialization [(p = 0.03; OR = 2.2, 95% CI = (1.21–3.98)] for medical specialization with reference to students in humanities), high stress level [(p = 0.036; OR = 1.53, 95% CI = (1.03–2.28)], and living in dormitories [(p = 0.034); OR = 1.72, 95% CI = (1.04–2.86)]. Multivariate analysis using binary logistic regression enter method showed that medical specialization [(p = 0.045); OR = 1.92, 95% CI = (1.02–3.64)] for medical students with reference to students in humanities), skipping breakfast [(p = 0.001); OR = 1.96, 95% CI = (1.35–2.86)], and irregular cycle [(p = 0.022); OR = 1.56, 95% CI = (1.07–2.29)] were the only significant predictors of moderate/severe dysmenorrhic pain.ConclusionThere is a high proportion of dysmenorrhea among Palestinian female university students. Skipping breakfast was the strongest predictor for moderate/severe dysmenorrhea. Increased awareness regarding factors that might influence the intensity of dysmenorrhic pain is needed.

Nutrition as a Potential Factor of Primary Dysmenorrhea: A Systematic Review of Observational Studies

“…Di Cintio et al [26] reported that women with dysmenorrhea consumed eggs more frequently than healthy controls, but Balbi et al [27] reported that women with dysmenorrhea consumed significantly less eggs compared to healthy controls. Other studies did not find significant results concerning the association between dysmenorrhea and the consumption of meat and its alternatives [16,26,27,39,52,55].…”

“…It developed a significantly higher risk of dysmenorrhea in women consuming excessive amount of sugar [6,29,60]. Inconsistently, Tavallaee et al [16], Grandi et al [44], Mohamadirizi and Kordi [52], Abu Helwa et al [55] found no association between the intake of sugar and dysmenorrhea. B) Fats: Fat consumption was reported by 2 studies.…”

“…In some studies, some forms of caffeinated drinks were assessed separately such as tea, coffee, Nescafe, but others studies assessed this group as whole. Seven studies [16,29,38,44,48,52,55] did not find any significant association between caffeine intake and dysmenorrhea, but Faramarzi and Salmalian [49], Pejčić and Jankovic [57], and Hailemeskel et al [56] found significant associations between caffeine consumption and higher intensity of menstrual pain. Drinking tea did not have a significant association with dysmenorrhea in 4 studies [28,43,45,60], but Wang et al [37] reported more tea consumption among women with dysmenorrhea.…”

“…One study reported a higher prevalence of dysmenorrhea in women with moderate or excessive intake of salt compared with those with a minimal intake [29]. Two other studies did not report a significant association between a high salt intake and dysmenorrhea [44,55]. D) Caffeine Consumption: Caffeine consumption was the most studied nutrient including coffee, tea, Nescafe, carbonated soft drinks, chocolate, and hot chocolate.…”

“…Fruits and Vegetables: The association between the consumption of fruits and vegetables were investigated in 4 studies, but Di Cintio et al [26] and Abu Helwa et al [55] found no associations. However, Tavallaee et al [16] and Balbi et al [27] reported that fruit consumption had negative associations with the level of menstrual pain.…”