The prevalence and academic impact of dysmenorrhea in 21,573 young women : a systematic review and meta-analysis

Introduction: Dysmenorrhea (period pain) and associated symptoms are very common in young women <25 years. This time corresponds with a significant stage in adolescents and young women's academic lives at both school and in higher education. Dysmenorrhea may cause absenteeism from class or result in reduced classroom concentration and performance. Owing to cultural and economic differences, any impact may vary by country. This systematic review and meta-analysis examines the prevalence of dysmenorrhea in young women and explores any impact it has on their academic performance and other school-related activities. Materials and Methods: A search in Medline, PsychINFO, EMBASE, and Cumulative Index to Nursing and Allied Health Literature was carried out in June 2018. Results: Thirty-eight studies including 21,573 young women were eligible and included in the meta-analysis. Twenty-three studies were from low-, lower middle-, or upper middle-income countries, and 15 studies were from high-income countries. The prevalence of dysmenorrhea was high 71.1% (N = 37, n = 20,813, 95% confidence interval [CI] 66.6–75.2) irrespective of the economic status of the country. Rates of dysmenorrhea were similar between students at school (N = 24, 72.5%, 95% CI 67.5–77.0) and at university (N = 7, 74.9%, 95% CI 62.9–84.0). Academic impact was significant, with 20.1% reporting absence from school or university due to dysmenorrhea (N = 19, n = 11,226, 95% CI 14.9–26.7) and 40.9% reporting classroom performance or concentration being negatively affected (N = 10, n = 5126, 95% CI 28.3–54.9). Conclusions: The prevalence of dysmenorrhea was high, irrespective of country, with dysmenorrhea having a significant negative impact on academic performance both at school and during higher education.