Determinants of menstrual pain severity among female medical students: a cross-sectional study
DOI:
https://doi.org/10.12928/jcp.v7i2.14095Keywords:
Body Mass Index, Dysmenorrhea, Exercise, mena, Menstrual PainAbstract
Dysmenorrhea, or menstrual pain, is one of the most common gynecological complaints among women of reproductive age, particularly among female students. Its impact extends beyond physical discomfort, affecting academic performance, psychological well-being, and overall quality of life. Despite its high prevalence, few studies have examined the determinants of menstrual pain severity among female medical students in Indonesia. This study aimed to identify the determinants of menstrual pain severity among female medical students at the Faculty of Medicine, Universitas Negeri Surabaya. A cross-sectional, descriptive quantitative study was conducted in November 2024, involving 112 participants selected through simple random sampling. Data were collected using a structured online questionnaire and analyzed with Spearman’s rho correlation and ordinal regression to assess associations between menstrual pain severity and independent variables, including body mass index (BMI), age at menarche, menstrual cycle characteristics, and exercise habits. Bivariate analysis indicated significant associations between menstrual pain severity and BMI (p = 0.004), age at menarche (p = 0.032), and exercise frequency (p = 0.038). However, in the adjusted multivariate regression model, only menstrual cycle length greater than 35 days remained significantly associated with increased pain severity (B = 1.143; p = 0.017). Other hypothesized predictors, including BMI, age at menarche, and exercise, did not retain independent effects after adjustment. In conclusion, irregular menstrual cycles—particularly very long cycles—were identified as the only independent determinant of increased menstrual pain severity among female students. These findings underscore the importance of considering menstrual cycle patterns when exploring risk factors for dysmenorrhea, while suggesting that commonly presumed predictors may not directly influence pain severity in this population.
References
Barcikowska Z, Wójcik-Bilkiewicz K, Sobierajska-Rek A, Grzybowska ME, Wąż P, Zorena K. Dysmenorrhea and Associated Factors among Polish Women: A Cross-Sectional Study. Pain Res Manag. 2020;2020. https://doi.org/10.1155/2020/6161536
Wang YL, Zhu HL. The prevalence and associated risk factors of primary dysmenorrhea among women in Beijing: a cross-sectional study. Sci Rep. 2025;15. https://doi.org/10.1038/s41598-025-89038-5
Molla A, Duko B, Girma B, Madoro D, Nigussie J, Belayneh Z, et al. Prevalence of dysmenorrhea and associated factors among students in Ethiopia: A systematic review and meta-analysis. Women’s Health. SAGE Publications Ltd; 2022;18. https://doi.org/10.1177/17455057221079443
Koçoğlu S, Şevgin Ö, Hoşbaş BD. Comparison of motor imagery focused pelvic floor exercises and relaxation exercises for treating dysmenorrhea: A randomized controlled study. Taiwan J Obstet Gynecol. 2025; 64: 671-7. https://doi.org/10.1016/j.tjog.2024.12.029
Zuhkrina Y, Martina. Determinan Faktor Penyebab Dismenore pada Remaja Putri di Desa Lubuk Sukon Kecamatan Ingin Jaya Kabupaten Aceh Besar Tahun 2022. Sehat Rakyat: Jurnal Kesehatan Masyarakat. 2023;2:123–30. https://doi.org/10.54259/sehatrakyat.v2i1.1504
Rizsya, Reality F, Aisyaroh N. External Factors that Cause Dysmenorrhea in Adolescent Girls: Literature Review. Media Publikasi Promosi Kesehatan Indonesia. Muhammadiyah Palu University; 2024. p. 2260–7. https://doi.org/10.56338/mppki.v7i9.5488
Singh D, Deo S, Solanki V, Kumari P, Singh S. Menstrual challenges and quality of life among medicals students - a cross sectional study. Clin Epidemiol Glob Health. 2025;34. https://doi.org/10.1016/j.cegh.2025.102100
Cameron L, Mikocka-Walus A, Stanley K, Payne LA, Druitt M, Grover S, et al. The relationship between menstrual pain in adolescence and mental health in adolescence and early adulthood. J Psychosom Res. 2025;192. https://doi.org/10.1016/j.jpsychores.2025.112122
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 Womens Health. 2021;21. https://doi.org/10.1186/s12905-021-01532-w
Mizgier M, Więckowska B, Sansoni V, Malvandi AM, Jarząbek-Bielecka G, Drejza M, et al. Risk Factors of Primary Dysmenorrhea in Female Adolescent Basketball Players Related to Dietary, Hormonal, and Immuno-Metabolic Factors and Disordered Eating Attitudes. Nutrients. 2025;17. https://doi.org/10.3390/nu17071190
Octariyana, Lestari D, Apriliani. Determinant Factors Of Primary Dysmenorrhea In Adolescent Girl In Aziziah Boarding School Of Palembang. Jurnal Surya Medika (JSM) [Internet]. 2022;8. https://doi.org/10.33084/jsm.v8i3.4518
Duman NB, Yıldırım F, Vural G. Risk factors for primary dysmenorrhea and the effect of complementary and alternative treatment methods: Sample from Corum, Turkey. Int J Health Sci (Qassim). 2022;16.
Liu J, Wang Y, Wu L, Wang L, Fang H. Study on the influencing factors of primary dysmenorrhea in female college students: Systematic review and meta-analysis. Medicine (United States). Lippincott Williams and Wilkins; 2024. p. e40906. https://doi.org/10.1097/MD.0000000000040906
Mitsuhashi R, Sawai A, Kiyohara K, Shiraki H, Nakata Y. Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. MDPI; 2023;20:1. https://doi.org/10.3390/ijerph20010569
Adane Y, Ambelu A, Yenesew MA, Mekonnen Y, Kassahun T. Effect of menstruation on school attendance of girls along with water, sanitation, and hygiene services in Northwest Ethiopia. Pan African Medical Journal . 2025;50. https://doi.org/10.11604/pamj.2025.50.28.45413
Shah V, Nabwera H, Sonko B, Bajo F, Faal F, Saidykhan M, et al. Effects of Menstrual Health and Hygiene on School Absenteeism and Drop-Out among Adolescent Girls in Rural Gambia. Int J Environ Res Public Health. 2022;19. https://doi.org/10.3390/ijerph19063337
Islami IMR. Dysmenorrhea in adolescent girls: Does body mass index play a role? Science Midwifery [Internet]. 2024;12:2721–9453. Available from: www.midwifery.iocspublisher.orgJournalhomepage:www.midwifery.iocspublisher.org
Wu L, Zhang J, Tang J, Fang H. The relation between body mass index and primary dysmenorrhea: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. John Wiley and Sons Inc; 2022. p. 1364–73. https://doi.org/10.5114/pm.2023.131314
Donayeva A, Amanzholkyzy A, Nurgaliyeva R, Gubasheva G, Abdelazim IA, Samaha II. The relation between primary dysmenorrhea in adolescents and body mass index. Przeglad Menopauzalny. 2023;22:126–9. https://doi.org/10.5114/pm.2023.131314
Talahatu AH, Bewa MMI, Boeky D La. Nutrition, BMI and Dysmenorrhea in Adolescent Girls at Lembata’s Senior High School 1: A Cross-Sectional Study. Jurnal Pangan Gizi dan Kesehatan [Internet]. 2025;14. https://doi.org/10.51556/ejpazih.v14i1.426
Rusydi R, Fitri SA, Agustina FR. Relationship Between Body Mass Index With Menstrual Pain Scale At Senior High School 9 Padang. Journal of Nutrition Science. 2023;4:88. https://doi.org/10.35308/jns.v4i2.8587
Khan KN. Patterns of menstrual cycle, menstrual pain and medication usage in young women from high- and middle-income countries [Internet]. 2024;49:2. https://doi.org/10.1016/j.rbmo.2024.103942
Takata K, Kotani K, Umino H. The Relationship Between Body Mass Index and Dysmenorrhea in the General Female Population. J Clin Med Res. 2023;15:239–42. https://doi.org/10.14740/jocmr4893
Liu S, Yoneoka D, Suzuki H, Sasayama K, Saito E, Naraoka Y, et al. Prevalence of menstrual pain and symptoms and their association with age and BMI among Japanese female app users. Sci Rep. 2025;15. https://doi.org/10.1038/s41598-025-02459-0
Nyirenda T, Nyagumbo E, Murewanhema G, Mukonowenzou N, Kagodora SB, Mapfumo C, et al. Prevalence of dysmenorrhea and associated risk factors among university students in Zimbabwe. Women’s Health. 2023;19. https://doi.org/10.1177/17455057231189549
Tsai IC, Hsu CW, Chang CH, Lei W Te, Tseng PT, Chang KV. Comparative Effectiveness of Different Exercises for Reducing Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Network Meta-analysis of Randomised Controlled Trials. Sports Med Open. Springer Science and Business Media Deutschland GmbH; 2024;10:63. https://doi.org/10.1186/s40798-024-00718-4
Rejeki S, Pratama FY, Ernawati E, Yanto A, Soesanto E, Pranata S. Abdominal stretching as a therapy for dysmenorrhea. Open Access Maced J Med Sci. 2021;9:180–3. https://doi.org/10.3889/oamjms.2021.6711
Haryono IR, Sudarman JP, Prastowo NA, Lilis. The effect of Hatha Yoga on pain intensity in severe primary dysmenorrhea among students: A randomized controlled trials. Indonesian Journal of Nursing and Midwifery [Internet]. 2023;11. https://doi.org/10.21927/jnki.2023.11(1).95-105
Damayanti GAMN, Irnawati Y. The Decrease In The Intensity Of Menstrual Pain Before And After The Application Of Yoga In Class VIII Students At SMPN 1 Tanjung Bintang. Jurnal eduhealth [Internet]. 2023;14:2023. https://doi.org/10.54209/jurnaleduhealth.v14i01.1209
Syamsudi NA, Mayasari NR, Solihah LA. Stress, Physical Activity, And Dietary Intake Are Associated With Dysmenorrhea Among Female Students. Indonesian Midwifery and Health Sciences Journal. 2024;8:289–99. https://doi.org/10.20473/imhsj.v8i3.2024.289-299
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