Silent struggles: association between primary dysmenorrhea and health-related quality of life among adolescent girls in Lusaka District, Zambia

Primary dysmenorrhea is a common gynecological disorder among females of reproductive age characterized by painful menstrual cramps without any underlying conditions; however, this condition is under-recognised in clinical and educational settings. Primary dysmenorrhea significantly impacts quality of life and thus affects the daily activities, academic performance and overall wellbeing of affected individuals. In Zambia, particularly in Lusaka District, the impact of this condition on adolescents’ daily lives has not been thoroughly examined. The objective of this study was to assess the association between primary dysmenorrhea and QoL of school-going adolescent girls in Zambia, Lusaka District. In this descriptive cross-sectional study, 400 adolescent girls aged 10–19 years were recruited from 8 secondary schools. Health-related quality of life (HRQL) data were collected between June 2023 and August 2023 via the 36-item Short-Form (SF-36) questionnaire, which consists of eight subscales, physical functioning, role-physical functioning, bodily pain, general health, vitality, social functioning, role-emotional functioning, and mental health, summarized into two domains: the physical (PCS) and mental (MCS) component summary measures. The data were analysed via STATA 18 version 18 SE (Stata Corp, College Station, TX, USA), which summarizes sociodemographic characteristics and SF-35 scores. Generalized linear models were used to assess the impact of primary dysmenorrhea on quality of life and adjust for clustering. Compared with adolescent girls without primary dysmenorrhea, adolescent girls with primary dysmenorrhea experienced significantly lower quality of life across several components. The key findings included a median physical functioning score of 20 for dysmenorrhea sufferers versus 80 for those without; role physical scores were predominantly 0 for the affected group, reflecting severe limitations. An adjusted odds ratio of 8.52 confirms the strong association between primary dysmenorrhea and poor QoL. This study confirms the need for targeted interventions and support systems to help reduce primary dysmenorrhea and enhance the QoL for adolescent girls, addressing both physical and mental health aspects.