Association of Psychological Distress with Primary Dysmenorrhea among Adolescents Living in West Bengal, India

Background: Primary dysmenorrhea, a painful uterine cramp without any pelvic pathology that occur before or during menstruation among reproductive women. Objective: The objective of this study was to compare the psychological distress between adolescent female students with dysmenorrhea and without dysmenorrhea and also to examine relationship between psychological distress and dysmenorrhea. Methods: This is a cross sectional questionnaire based study conducted among 1646 adolescent female having age limit 14-19 years. Only unmarried adolescent females were included in the study however, females with gynecological, psychological or other medical problems were excluded from the study. It used validated and reliable questionnaire such as VAS for pain rating scale and DASS-21 for assessment of depression, anxiety, stress. Then, the descriptive data analysis and chi-square test were used to explore the relationship between psychological distress and dysmenorrhea. t-test was used to compare psychological distress between dysmenorrhea and non-dysmenorrhea. P<0.05 was considered as significant. Results: Mean age of the adolescent female was 15.91+ 1.27 years. Prevalence of dysmenorrhea was 88.94%. Among dysmenorrhea 22.40% was severe, 28.89% was under moderate and   48.71% was under mild dysmenorrhea. There was significant difference of psychological distress indices scores between dysmenorrhea and non-dysmenorrhea (p<0.001). Majority of dysmenorrheic females had severe to extreme severe levels of anxiety, depression and stress in contrast to non-dysmenorrheic females who have mild to moderate level. Significant association was noted between depression, anxiety, mental irritability and mood swing with primary dysmenorrhea (p<0.001). Conclusion: The present study suggested that dysmenorrhea is associated with psychological distress including anxiety, depression, mental irritation and mood swing. Psychological interventions and counselling are important for young women with primary dysmenorrhea to lessen the severity of menstrual pain.