Primary dysmenorrhea magnitude, associated risk factors, and its effect on academic performance: evidence from female university students in Ethiopia.
BACKGROUND
Primary dysmenorrhea (PD) is the most common gynecologic compliant among adolescent females. There is a wide variation in the estimate of PD, which ranges from 50% to 90%, and the disorder is the most common cause of work and school absenteeism in adolescent females.


OBJECTIVE
To assess the prevalence and associated risk factors of PD among female university students and understand its effects on students' academic performance.


METHODS
A cross-sectional study was employed in 440 research participants. A multistage stratified sampling technique was employed to select the study units. Structured and pretested self-administered questionnaires were used and weight and height measurements were conducted. The severity of dysmenorrheal pain was assessed by using a verbal multidimensional scoring system and visual analog scale. The data were double entered in Epi Info version 3.1 and analyzed using SPSS version 17. Descriptive statistics, chi-square test, and logistic regression analysis were performed.


RESULTS
A total of 440 students participated in this study. The prevalence of PD was 368 (85.4%). Of these, 123 (28.5%) had mild, 164 (38.1%) moderate, and 81 (18.8%) severe primary dysmenorrheal pain. Among students with PD, 88.3% reported that PD had a negative effect on their academic performance. Of these, 80% reported school absence, 66.8% reported loss of class concentration, 56.3% reported class absence, 47.4% reported loss of class participation, 37.8% reported limited sport participation, 31.7% reported limitation in going out with friends, and 21% reported inability to do homework. Based on the multivariate logistic regression, PD was statistically significant with those who had lower monthly stipends, a history of attempt to lose weight, a history of depression or anxiety, disruption of social network of family, friends or people they love, who consumed more than four glasses of tea per day, who drunk one or more Coca-Cola or Pepsi per day, in nullipara, and students with a family history of dysmenorrhea.


CONCLUSIONS
PD is more prevalent among female students attending university. It has a significant negative impact on students' academic performance. Thus, it needs medical attention. There are various identified associated risk factors and considering them in the management of the disorder is fundamental. It is also wise to recommend future studies to better identify risk factors for PD and lighten its effect on students' academic performance at a larger scale in the country.
Department of Midwifery, College of Health Science, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
Solomon
S
Hailemeskel
Department of Nursing and Midwifery, School of Allied Health Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Asrate
A
Demissie
Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Nigussie
N
Assefa
Ethiopia; academic performance; adolescents; dysmenorrhea; higher institution; risk factors; young
Ann Epidemiol. 2007 Nov;17(11):882-8
17728147
Int J Gynaecol Obstet. 2006 Mar;92(3):221-7
16430896
Indian J Community Med. 2010 Jan;35(1):63-6
20606922
Contraception. 2003 Sep;68(3):183-8
14561538
Am J Obstet Gynecol. 1978 Apr 1;130(7):833-47
25021
Paediatr Drugs. 2008;10(1):1-7
18162003
Eur J Obstet Gynecol Reprod Biol. 2000 Aug;91(2):143-8
10869786
Coll Antropol. 2003 Dec;27(2):707-11
14746162
Am J Obstet Gynecol. 1982 Nov 15;144(6):655-60
7137249
BJOG. 2006 Apr;113(4):453-63
16489934
J Adolesc Health. 2009 Mar;44(3):237-43
19237109
J Obstet Gynaecol Can. 2005 Aug;27(8):765-70
16287008
BMJ. 2006 Apr 1;332(7544):749-55
16484239
Indian J Physiol Pharmacol. 2008 Oct-Dec;52(4):389-97
19585756
BMC Womens Health. 2009 Oct 05;9:29
19804623
J Pediatr Adolesc Gynecol. 2001 Feb;14(1):3-8
11358700
Eur J Obstet Gynecol Reprod Biol. 2010 Sep;152(1):73-7
20478651
Minerva Pediatr. 2002 Dec;54(6):525-38
12388941
Res Nurs Health. 1990 Aug;13(4):227-36
2197679
Med Hypotheses. 2009 Jul;73(1):90-1
19254828
Clin Obstet Gynecol. 1990 Mar;33(1):168-78
2178834
Pediatrics. 1981 Nov;68(5):661-4
7312467
Ups J Med Sci. 2010 May;115(2):138-45
20074018
Int J Gynaecol Obstet. 2009 Oct;107(1):39-43
19539288
Arch Pediatr Adolesc Med. 2000 Dec;154(12):1226-9
11115307
J Reprod Med. 1985 Mar;30(3):154-67
3158737
Am J Med. 1988 May 20;84(5A):23-9
3287908
J Womens Health (Larchmt). 2008 Jun;17(5):879-91
18537489