Prevalence and Determinants of Primary Dysmenorrhea and Its Influence on Quality of Life among Female Medical University Students in Pakistan

Background: Dysmenorrhea, characterized by painful menstruation, is classified as primary or secondary. Primary dysmenorrhea commonly affects women under 25 years of age and is associated with absenteeism, reduced academic performance, and limitations in daily activities. However, research focusing specifically on female medical students remains limited, despite their exposure to unique academic and psychosocial stressors. Objective: To determine the frequency of primary dysmenorrhea among female medical students, assess its impact on quality of life and daily functioning, and identify the management practices used for symptom relief. Method: A descriptive cross-sectional study was conducted among 323 female medical students aged 18–25 years from six medical institutes in Pakistan between March and June 2024. Data were collected using a self-designed, structured, and validated questionnaire that was pilot-tested for clarity and reliability. Married students and those with secondary dysmenorrhea were excluded. Quality of life was assessed using functional indicators, including absence from academic activities, reduced concentration, inability to perform routine tasks, and limitation of physical activities. Data was analyzed using SPSS version 26. Descriptive statistics were used to calculate frequencies and percentages, and associations between dysmenorrhea severity and quality-of-life indicators were assessed using the chi-square test, with p < 0.05 considered statistically significant. Results: Primary dysmenorrhea was reported by 96.9% (n=313) of participants. Severity, assessed using the WaLIDD score (0–12), showed a statistically significant association with impaired quality of life and functional status (p < 0.05). Higher severity scores were associated with reduced working ability, increased absenteeism, and impaired academic performance. Specifically, 68.4% (n=221) reported difficulty concentrating, 30.3% (n=98) difficulty learning, 26.3% (n=85) difficulty memorizing, 19.8% (n=64) hesitancy in group participation, and 18% (n=58) absenteeism, while only 19.5% (n=63) reported no academic impact. Common coping strategies included bed rest (75.2%, n=243), hot compresses (49.8%, n=161), self-medication (48%, n=155), massage (16.4%, n=53), and herbal remedies (15.5%, n=50). Conclusion: Primary dysmenorrhea is highly frequent among female medical students and is significantly associated with impaired quality of life and daily functioning. Improved awareness and effective management strategies are needed to reduce its academic and functional burden.