Prevalence of primary dysmenorrhea and associated factors in adult women

A cross-sectional study was carried out with women aged between 19 and 49 years from a city of northeastern Brazil. Sociodemographic, gynecological, and obstetric variables were assessed by questionnaires and interviews. Dysmenorrhea was measured by self-report, and the Numerical Pain Rating Scale measured the intensity of pain. Statistical analyses included χ² test, ANOVA, and logistic regression.

RESULTS:

The average age was 33.2±9.1 years and the prevalence of primary dysmenorrhea was 56% for the whole sample. The average duration of symptoms was 2.7±1.8 days and the mean intensity was 6.1±2.6. The previous cesarean section was associated with a higher rate of primary dysmenorrhea (PR=2.33; 95%CI 1.11–4.90) when considering the whole sample. Women who aged 25–39 years and are insufficiently active had higher rates of primary dysmenorrhea (PR=5.24; 95%CI 1.08–27.31).

CONCLUSION:

Primary dysmenorrhea has a high prevalence in young adults, adults, and middle-aged women. Cesarean section and being physically inactive was associated with increased rates of dysmenorrhea among adult women.

KEYWORDS:
Cross-sectional studies; Dysmenorrhea; Epidemiology; Prevalence; Women’s health

Variables		Women
		Young adults (n=40)	Adults (n=96)	Middle-aged women (n=59)
		%
Family income^* * In 2016, the value of a minimum wage in Brazil was R$ 880.00.
	≤1 minimum wage	80.0	79.2	79.7
	>1 minimum wage	20.0	20.8	20.3
	Profess some religion	77.5	85.4	88.1
	Insufficiently physically active	17.5	21.9	13.6
Age of menarche
	≤11 years old	17.5	17.7	22.0
	≥12 years old	82.5	82.3	78.0
	Use any contraceptive method	60.0	49.5	55.2
Menstrual cycle length (n=172)
	28–35 days	68.6	76.2	71.7
	<28 days or >35days	31.4	23.8	28.3
	Constipation	37.5	29.2	44.1
	Urinary incontinence	15	16.7	30.5
	Stress urinary incontinence	7.5	6.3	16.9
	Urgency urinary incontinence	2.5	4.2	6.8
	Mixed urinary incontinence	5.0	6.3	6.8
	Sexual dysfunction	27.5	36.7	40.0
	Have children	75.0	82.3	81.4
	≥1 Cesarean section (n=146)	70.0	66.7	61.0
	≥1 Vaginal delivery (n=146)	67.5	76.0	69.5

	Intensity of pain (NPRS) Mean±SD	Duration of pain (days) Mean±SD
Total sample	6.14±2.55	2.68±1.83
Young adults	6.70±2.58	2.80±1.61
Adults	5.87±2.55	2.40±1.57
Middle-aged womens	6.22±2.56	3.03±2.22
ANOVA (p-value)	0.454	0.265
Young adults×adults (p-value)^* * p-value was calculated by the post hoc Tukey test. NPRS: Numeric Pain Rating Scale.	0.433	0.477
Young adults×middle-aged women (p-value)^* * p-value was calculated by the post hoc Tukey test. NPRS: Numeric Pain Rating Scale.	0.782	0.895
Adult×middle-aged women (p-value)^* * p-value was calculated by the post hoc Tukey test. NPRS: Numeric Pain Rating Scale.	0.798	0.247

Variables		All sample (n=195)					Young adults (n=40)		Adults (n=96)		Middle-aged women (n=59)
Variables		Crude PR (95%CI)	p	Adjusted PR (95%CI)	p	Adjusted PR (95%CI)	p	Adjusted PR (95%CI)	p	Adjusted PR (95%CI)	p
Profess some religion		0.59 (0.26–0.33) ref.	0.200	0.46 (0.17–1.21) ref.	0.116	–	–	–	–	–	–
	Yes
	No
Family income (R$ 880.00)		–	–	–	–	–	–	–	–	0.13 (0.14–1.31) ref.	0.084
	≤1 minimum wage
	>1 minimum wage
Age at menarche		–	–	–	–	–	–	1.18 (0.32–4.35) ref.	0.802	–	–
	≤11 years old
	≥12 years old
Menstrual cycle length		1.66 (0.81–3.41) ref.	0.168	2.05 (0.90–4.64) ref.	0.086	–	–	3.11 (0.87–10.91) ref.	0.076	–	–
	menstrual cycle >35 or <28 days
	28–35 days
Use of the contraceptive method		–	–	–	–	2.68 (0.58–12.31) ref.	0.206	–	–	–	–
	Yes
	No
Urinary incontinence		0.51 (0.25–1.02) ref.	0.058	0.84 (0.33–2.13) ref.	0.709	–	–	0.52 (0.11–2.54) ref.	0.418	–	–
	Yes
	No
Mixed urinary incontinence		0.24 (0.06–0.92) ref.	0.038	0.33 (0.46–2.35) ref.	0.267	–	–	0.15 (0.01–3.97) ref.	0.256	–	–
	Yes
	No
Insufficiently physically active		–	–	–	–	–	–	5.42 (1.08–27.31) ref.	0.040	–	–
	Yes
	No
Sexual dysfunction		0.57 (0.30–1.06) ref.	0.077	0.61 (0.29–1.24) ref.	0.172	–	–	–	–	0.38 (0.09–1.59) ref.	0.185
	Yes
	No
Have children		0.60 (0.29–1.25) ref.	0.174	1.00 (0.38–2.66) ref.	0.997	0.22 (0.04–1.35) ref.	0.102	–	–	–	–
	Yes
	No
Cesarean section		1.99 (1.09–3.62) ref.	0.025	2.33 (1.11–4.90) ref.	0.026	2.94 (0.60–14.64) ref.	0.185	–	–	1.55 (0.32–7.51) ref.	0.587
	One or more
	None
Vaginal delivery						–	–	1.28 (0.39–4.23) ref.	0.683	0.15 (0.02–1.14) ref.	0.066
	One or more
	None

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[1] *Corresponding author: diego.sdantas@ufpe.br