Primary Dysmenorrhea and Its Impact on Mental Health and Quality of Life Among Female Medical Students in Saudi Arabia: A Cross-Sectional Study

INTRODUCTION: Primary dysmenorrhea (PD), characterized by painful uterine contractions without pelvic pathology, is highly prevalent among women of reproductive age, particularly common among university students. Risk factors such as early menarche, prolonged menstrual duration, heavy bleeding, and psychological stress contribute to its burden, impairing academic performance, mental health, and quality of life (QoL). Despite its high prevalence in Saudi Arabia, limited research has examined the relationship between PD severity, mental health, and QoL among medical students. METHODS: A cross-sectional study was conducted at the College of Nursing and Health Sciences, Jazan, Saudi Arabia, among female students aged 18-25 years with PD. Data were collected between August and October 2025 using a self-administered questionnaire covering socio-demographics, menstrual history, WaLIDD score, DASS-21, WHOQOL-BREF, and NPRS for pain intensity. Participants were recruited through snowball sampling. Statistical analyses were performed in SPSS 28.0 using Spearman's correlation, Kruskal-Wallis, and Jonckheere-Terpstra, with significance of p < .05. RESULTS: Of the 191 participants, 59.7% reported severe PD. Stress levels were higher, while the lowest QoL scores were observed in physical health and social relations domains. Pain severity was significantly negatively correlated with physical health (ρ = -0.245, p = .001). Stress scores differed significantly across PD severity groups (p = .006), monotonic trends revealed worsening depression, anxiety, and stress with increasing severity. All QoL domains were significantly negatively correlated with mental health. CONCLUSION: PD significantly impacts mental health, QoL among female medical students. Targeted pain management, psychological support, and institutional wellness programs are essential to improve well-being and academic performance.