Primary Dysmenorrhea and Functioning in adults women from Northeastern Brazil
Dysmenorrhea; Epidemiology; Prevalence; Cross-sectional study; Disability assessment; Women's health; International Classification of Functioning, Disability and Health.
Introduction: Dysmenorrhea is defined as colic pain in the hypogastrium that occurs during menstruation. In the literature, as far as we know, there are no studies that evaluate the functioning or deficiencies associated with primary dysmenorrhea (PD) in any age group. In addition, studies that address dysmenorrhea are restricted to adolescents or young adult women. Objective: This dissertation involves two studies that evaluated separately, the prevalence of primary dysmenorrhea and associated factors, and the association between primary dysmenorrhea and disability in adult women. Methodology: A cross-sectional study was carried out with adult women aged between 19 and 49 years. Sociodemographic, gynecological and obstetric aspects were investigated. Primary dysmenorrhea was measured using self-report; the Numerical Pain Rating Scale measured the intensity of pain; the World Health Disability Assessment Schedule 2.0 (WHODAS 2.0) assessed disability; the International Physical Activity Questionnaire (IPAQ), short version, evaluated the level of physical activity. The statistical analysis involved descriptive and inferential analysis. In the inferential analysis, logistic regression test, median difference tests, effect size measures were used. The level of statistical significance established was p <0.05. Results: The study that assessed the prevalence of primary dysmenorrhea and associated factors, found a prevalence of PD of 55.9% for the entire sample. Prevalence of PD was 50% among young adults, 55% adults, and 61% for middle-aged women. Cesarean delivery was associated with greater chances of PD (p = 0.026) when considering the entire sample, and women between 25 and 39 years old, insufficiently active, had higher chances of PD (p = 0.040). In the study that analyzed the association between primary dysmenorrhea and disability, PD pain lasted an average of three days or more (66%) with average pain intensity, in the crisis period of 6.10 ± 2.57, on the numerical scale of pain. Serious painful complaints were associated with greater difficulties in the domains of mobility (p = 0.003; η2 = 0.115), participation (p = 0.030; η2 = 0.063) and total WHODAS score (p = 0.012; η2 = 0.086), with size of moderate effect for all variables. Conclusion: The present study found a high prevalence of PD among adult women, where cesarean section and insufficient physical activity were factors that were associated with a higher risk of developing PD. Dysmenorrhea was also associated with impairment in functioning, in which women with severe pain intensity have greater disabilities in the domains of mobility and participation when compared to women who presented mild or moderate pain.