Predictors of Dysmenorrhea and Its Impact on Quality of Life among Tribal Adolescent Girls in India


Sharvanan E Udayar
Devika P Jeeragyal
K Kruthika


Many girls are faced with the challenge of Dysmenorrhea during their adolescent years. Therefore, this study aimed at finding the prevalence of Dysmenorrhea, its risk factors, and its impact on quality of life among teenage girls residing in tribal welfare hostels.

After obtaining informed consent, a cross-sectional survey was conducted among 582 adolescent girls residing in tribal welfare hostels in southern India. Data was collected by purposive sampling technique, and the mean, standard deviation and percentages, and frequencies were applied for summarizing the continuous and quantitative variables. Additionally, multinominal regression analysis was performed to determine the factors associated with Dysmenorrhea.

The results indicated the prevalence of Dysmenorrhea was 58.4%, while 48.8% of participants reported physical premenstrual symptoms. Furthermore, there is a significant association between those experiencing moderate to severe pain and Dysmenorrhea (p<0.000). Association between factors such as prolonged menstrual duration [AOR,3.4(95%CI,1.49-7.81)], those having moderate [AOR,5.78(95% CI,1.96-17.02)] to severe menstrual bleeding [AOR, 5.1 (95% CI, 1.78-14.08)], family history [AOR, 3.5 (95%CI,2.30-5.54)]and somatic symptoms [AOR,2.03 (95%CI, 1.33-3.08] were statistically significant.

In conclusion, Dysmenorrhea had a significant impact on quality of life since the girls could not attend routine activities. Therefore, incorporating reproductive health issues in education programs will encourage treatment-seeking behavior among the girls.


Author Biographies

Sharvanan E Udayar, Department of Community Medicne Kodagu Institute of Medical Sciences Government of Karnataka, India


Devika P Jeeragyal, Department of Community Medicne Apollo Institute of Medical Sciences Chittoor - Andhra Pradesh India

Scopus ID: 57202642370

K Kruthika, Department of Community Medicine,Kodagu Institute of Medical Sciences Government of Karnataka India


How to Cite
Udayar, S. E., Jeeragyal, D. P., & Kruthika, K. (2022). Predictors of Dysmenorrhea and Its Impact on Quality of Life among Tribal Adolescent Girls in India. Unnes Journal of Public Health, 11(1), 23-32.


Acheampong et al. 2019. Prevalence and Predictors of Dysmenorrhea, its Effect, and Coping Mechanisms among Adolescents in Shai Osudoku District, Ghana. Obstetrics and Gynecology International, 1-7.
Agarwal, A.K. & Agarwal, A. 2010. A Study of Dysmenorrhea during Menstruation in Adolescent Girls. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 35 (1): 159–164.
Ahuja, A., Sharma, M.K. & Singh, A. 2016. Impact of Dysmenorrhea on Quality of Life of Adolescent Girls of Chandigarh. Journal of Child and Adolescent Behavior, 4 (3): 295. https://doi:10.4172/2375-4494.1000295.
Al-Kindi, R. & Al-Bulushi, A. 2011. Prevalence and Impact of Dysmenorrhoea among Omani High School Students. Sultan Qaboos University Medical Journal, 11 (4): 485–491.
American Chronic Pain Association. Quality of Life Scale. 2017. Available from: [Last accessed on 2020 Sep 01]
Andersch, B. & Milsom, I. 2012. An Epidemiologic Study of Young Women with Gysmenorrhea. American journal of Obstetrics and Gynecology, 144 (6): 655–660.
Anikwe, C.C., Mamah, J.E., Okorochukwu, B.C., Nnadozie, U.U., Obarezi, C.H. & Ekwedigwe, K.C. 2020. Age at Menarche, Menstrual Characteristics, and its Associated Morbidities among Secondary School Students in Abakaliki, Southeast Nigeria. Heliyon, 6 (5): e04018.
Armour, M., Parry, K., Manohar, N., Holmes, K., Ferfolja, T., Curry, C., MacMillan, F. & Smith, C.A. 2019. The Prevalence and Academic Impact of Dysmenorrhea in 21.573 Young Women: A Systematic Review and Meta-Analysis. Journal of Women’s Health, 28 (8): 1161-1171.
Azagew, A.W., Kassie, D.G. & Walle, T.A. 2020. Prevalence of Primary Dysmenorrhea, its Intensity, Impact and Associated Factors among Female Students at Gondar Town Preparatory School, Northwest Ethiopia. BMC Women's Health, 20 (1): 5.
Balbi, C., Musone, R., Menditto, A., di Prisco, L., Cassese, E., d'Ajello, M., Ambrosio, D. & Cardone, A. 2000. Influence of Menstrual Factors and Dietary Habits on Menstrual Pain in Adolescence Age. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 91 (2): 143–148.
Banikarim, C., Chacko, M.R. & Kelder, S.H. 2000. Prevalence and Impact of Dysmenorrheal on Hispanic Female Adolescents. JAMA Pediatrics: Archives of Pediatrics & Adolescent Medicine, 154 (12): 1226-1229.
Borjigen, A., Huang, C., Liu, M., Lu, J., Peng, H., Sapkota, C. & Sheng, J. 2019. Status and Factors of Menstrual Knowledge, Attitudes, and Their Correlation with Psylogical in Adolescent Girl. Journal of Pediatric & Adolescent Gynecology,32 (6):
Burnett, M.A., Antao, V., Black, A., Feldman, K., Grenville, A., Lea, R., Lefebvre, G., Pinsonneault, O. & Robert, M. 2005. Prevalence of Primary Dysmenorrhea in Canada. Journal of Obstetrics and Gynaecology Canada (JOGC=Journal d' Obstetrique et Gynecologie du Canada), 27 (8): 765–770.
Chan, S.R. & Desmawati. 2019. Effect of Abdominal Stretching of Menstrual Pain (Dysmenorrhea) in Adolescent at Junior High School 1 Depok. UPN Veteran Jakarta. Presented in International Conferences ICHD on Health Development.
Chandramouli, C. 2011. Population Enumeration Data (Final Population). India: Registrar General and Census Commissioner of India.
Chongpensuklert, Y., Kawrudee, S., Soontrapa, S. & Sakondhavut, C. 2008. Dysmenorrheal in Thai Secondary School Students Khonkaen, Thailand. Thai Journal of Obstetrics and Gynaecology, 16 (1): 47-53.
El-Gilany, A.H., Badawi, K. & El-Fedawy, S. 2005. Epidemiology of Dysmenorrhoea among Adolescent students in Mansoura, Egypt. Eastern Mediterranean Health Journal = La Revue de Sante de la Mediterranee Orientale = al-Majallah al-Sihhiyah li-Sharq al-Mutawassit, 11 (1-2): 155–163.
Femi-Agboola, D.M., Sekoni, O.O. & Goodman, O.O. 2017. Dysmenorrhea and its Effects on School Absenteeism and School Activities among Adolescents in Selected Secondary Schools in Ibadan, Nigeria. Nigerian Medical Journal: Journal of the Nigeria Medical Association, 58 (4): 143–148.
Fernández-Martínez, E., Onieva-Zafra, M.D. & Parra-Fernández, M.L. 2019. The Impact of Dysmenorrhea on Quality of Life among Spanish Female University Students. International Journal of Environmental Research and Public Health, 16 (5): 713.
Gagua, T., Tkeshelashvili, B. & Gagua, D. 2012. Primary Dysmenorrhea: Prevalence in Adolescent Population of Tbilisi, Georgia and Risk Factors. Journal of the Turkish German Gynecological Association, 13 (3): 162–168.
Giletew, A. & Bekele, W. 2019. Prevalence and Associated Factors of Primary Dysmenorrhea among Debre Tabor University Students, North Central Ethiopia. International Journal of Biomedical Engineering and Clinical Science, 4 (4): 70–74.
Gulzar, S., Khan, S., Abbas, K., Arif, S., Husain, S.S., Imran, H.I. & Sommer, J. 2015. Prevalence, Perceptions and Effects of Dysmenorrhea in School Going Female Adolescents of Karachi, Pakistan. International Journal of Innovative Research & Development, 4 (2): 236–40.
Habibi, N., Huang, M.S., Gan, W.Y., Zulida, R. & Safavi, S.M. 2015. Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study. Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses, 16 (6): 855–861.
Helwa, H.A., Mitaeb, A.A., Hamshri, S.A. & Sweileh, W.M. 2018. Prevalence of Dysmenorrhea and Predictors of its Pain Intensity among Palestinian Female University Students. BMC Women’s Health, 18 (18): 1-11.
Jarrett, M., Cain, K.C., Heitkemper, M. & Levy, R.L. 1996. Relationship between Gastrointestinal and Dysmenorrheic Symptoms at Menses. Research in Nursing & Health, 19 (1): 45–51.<45::AID-NUR5>3.0.CO;2-L.
Kazama, M., Maruyama, K. & Nakamura, K. 2015. Prevalence of Dysmenorrhea and its Correlating Lifestyle Factors in Japanese Female Junior High School Students. The Tohoku Journal of Experimental Medicine, 236 (2): 107–113.
Khalid, M., Jamali, T., Ghani, U., Shahid, T., Ahmed, T. & Nasir, T. 2020. Severity and Relation of Primary Dysmenorrhea and Body Mass Index in Undergraduate Students of Karachi: A Cross-Sectional Survey. Journal of the Pakistan Medical Association, 1299-1303.
Kish, L. 1965. Survey Sampling. New York: John Wiley and Sons, Inc.
Kumar, K.S., Konjengbam, S. & Devi, H.S. 2016. Dysmenorrhea among Higher Secondary Schoolgirls of Imphal West District, Manipur: A Cross-Sectional Study. Journal of Medical Society, 30 (1): 38-43.
Mohamed, E.M. 2012. Epidemiology of Dysmenorrhea among Adolescent Students in Assiut City, Egypt. Life Science Journal, 9 (1): 348-53.
Munro, A.K., Hunter, E.C., Hossain, S.Z. & Keep, M. 2021. A Systematic Review of the Menstrual Experiences of the Menstrual Experiences of University Students and the Impacts on Their Education: A Global Perspective. Plos One, 16 (9): 1-28.
Nwankwo, T.O., Aniebue, U.U. & Aniebue, P.N. 2010. Menstrual Disorders in Adolescent School Girls in Enugu, Ethiopia. Journal of Pediatric and Adolescent Gynecology, 23 (6): 358-363.
Omidvar, S., Bakouei, F., Amiri, F.N. & Begum, K. 2016. Primary Dysmenorrhea and Menstrual Symptoms in Indian Female Students: Prevalence, Impact and Management. Global Journal of Health Science, 8 (8): 53632.
Ortiz, M.I. 2010. Primary Dysmenorrhea among Mexican University Students: Prevalence, Impact and Treatment. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 152 (1): 73–77.
Patel, V., Tanksale, V., Sahasrabhojane, M., Gupte, S. & Nevrekar, P. 2006. . The Burden and Determinants of Dysmenorrhoea: A Population‐Based Survey of 2262 Women in Goa, India. BJOG: An International Journal of Obstetrics and Gynaecology, 113 (4): 453-463.
Shah, M., Monga, A., Patel, S., Shah, M. & Bakshi, H. 2013. A Study of Prevalence of Primary Dysmenorrhea in Young Students. Healthline, 4 (2): 30–34.
Sharma, P., Malhotra, C., Taneja, D.K. & Saha, R. 2008. Problems Related to Menstruation amongst Adolescent Girls. Indian Journal of Pediatrics, 75 (2): 125–129.
Sidi, I., Hounkpatin, B., Obossou, A.A., Salifou, K., Vodouhe, M., Denakpo, J. & Perrin, R. 2016. Primary Dysmenorrhea in the Schools of Parakou: Prevalence, Impact and Therapeutic Approach. Gynecology & Obstetrics (Sunnyvale), 6 (5): 376.
Tadese, M., Kassa, A., Muluneh, A.A. & Altaye, G. 2021. Prevalence of Dysmenorrhaea, Associated Risk Factor and Its Relationship with Academic Performance among Graduating Female University Students in Ethiopia: A Cross Sectional Study. BMJ Open, 11 (3): 1-9.
Tangchai, K., Titapant, V. & Boriboonhirunsarn, D. 2004. Dysmenorrhea in Thai Adolescents: Prevalence, Impact and Knowledge of Treatment. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 87 (3): S69–S73.
Unsal, A., Ayranci, U., Tozun, M., Arslan, G. & Calik, E. 2010. Prevalence of Dysmenorrhea and its Effect on Quality of Life among a Group of Female University Students. Upsala Journal of Medical Sciences, 115 (2): 138–145.
Vashisht, A., Pathak, R., Agarwalla, R., Patavegar, B.N. & Panda, M. 2018. School Absenteeism during Menstruation amongst Adolescent Girls in Delhi, India. Journal of Family and Community Medicine, 25 (3): 163-168.
Weissman, A.M., Hartz, A.J., Hansen, M.D. & Johnson, S.R. 2004. The Natural History of Primary Dysmenorrhoea: a Longitudinal Study. BJOG: an International Journal of Obstetrics and Gynaecology, 111 (4): 345–352.
WHO Expert Consultation. 2004. Appropriate Body-mass Index for Asian Populations and its Implications for Policy and Intervention Strategies. Lancet, 363 (9403): 157–163.
World Health Organization. 2020. Adolescent Health – Health topics. Available from: [Last accessed on 2020 Sep 01].