Patterns of menstrual cycle, menstrual pain and medication usage in young women from high- and middle-income countries

Abstract

Research question: Do patterns of the menstrual cycle, menstrual pain and the use of medication for menstrual pain differ between young women from high-income countries (HIC) and middle-income countries (MIC)? Design: A multinational, multicentre, cross-sectional study using pen-and-paper questionnaires was conducted between 2016 and 2021 to assess patterns of the menstrual cycle, menstrual pain and the use of medication for menstrual pain. Various parameters were evaluated to identify high-risk factors for severe menstrual pain in women from two HIC (n = 1550) and nine MIC (n = 7139). Results: From a total of 9114 young women, 4920 medical students (HIC n = 696, MIC n = 4224) and 3769 nursing students (HIC n = 854, MIC n = 2915) were included in this study. Compared with those from HIC, a significantly higher proportion of medical and nursing students from MIC reported cyclic pain (83.9% and 86.8%, respectively) and acyclic pain (33.8% and 31.9%, respectively) (both P < 0.001). Multivariate regression analysis revealed that low body mass index and early onset of menarche were independent risk factors for severe cyclic/acyclic pain among women from HIC, and a family history of menstrual pain was a risk factor for severe cyclic/acyclic pain among women from HIC and MIC. Conclusions: Differential patterns of the menstrual cycle, menstrual pain and use of medication for menstrual pain were found between young women from HIC and MIC. A proper educational programme may be necessary for these women and healthcare providers to understand the consequences of intractable cyclic/acyclic pain, in order to facilitate early detection and timely management of menstrual pain and its negative consequences, such as endometriosis.