Prevalence and Coping Mechanism of Dysmenorrhea Among Female University Students in Ghana.

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Adjoa Enyidado Hackman, Augustine Kumah, Christine Ahiale, Emmanuel Obot, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4622110/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Among young women, dysmenorrhea is known to be a prevalent condition that poses serious consequences for the quality of their daily lives. This study aimed to determine the prevalence and coping mechanism of dysmenorrhea among female students in Ghana. Method A cross-sectional descriptive study was conducted among 211 female health science students at Kwame Nkrumah University of Science and Technology from 14th January 2023 to 26th January 2023. The participants were selected using a convenient sampling technique. A structured questionnaire was used to collect data from the selected participants. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) programme IBM version 20. The results were presented in tables. Results The prevalence of dysmenorrhea was 97.2%. A more significant proportion of the students (99.02%) experienced pain in their lower abdomen. The predominant symptoms associated with dysmenorrhea were pimples (74.63%), mood swings (74.15%), and diarrhoea (70.73%). Among those who experienced dysmenorrhea, the frequently reported influences on their daily activities included withdrawal from activities (80%) and poor concentration (72.68%). More than half of the participants (50.2%) who experienced dysmenorrhea used medications, of which paracetamol (69.90%) was the most common. Self-medication (66.99%) was predominant among those who experienced dysmenorrhea. Most of the participants resorted to ignoring the pain (88.78%) and sleeping (83.41%) as their alternate interventions for coping with the pain. Conclusion This study establishes that dysmenorrhea is high among university students, and it negatively affects the daily activity of most of them. Sexual & Reproductive Medicine Dysmenorrhea Prevalence Coping Mechanism University Students Ghana Introduction Dysmenorrhea, though not life-threatening, is one of the common gynaecological problems usually experienced by young women 1 . The revised International Association of the Study of Pain (IASP) definition of pain describes it as “an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage” 2 . Dysmenorrhea, also known as menstrual pain, is referred to as “the presence of painful cramps of uterine origin that occur during menstruation” 3 . The prevalence of dysmenorrhea globally is high and has been estimated to range from 60% − 93%. 4 – 6 . Given that, it is a significant topic of public health concern as it has been seen to have a considerable impact on the lives of the affected young women. Based on the pathogenesis, dysmenorrhea can be classified as primary (absence of pelvic pathology) or secondary (presence of pelvic pathology) 7 . Endometriosis and adenomyosis are the leading causes of secondary dysmenorrhea among young women 8 . Studies show that dysmenorrhea occurs due to the increased production of prostaglandins, which results in concomitant increased contractility of the uterus 8 . The prostaglandin implicated in this pathology has been identified as PGF2a and PGE2 during the sloughing of the endometrial lining. This brings about increased sensitisation of the pain fibres and leads to dysmenorrhea. Increased concentrations of prostaglandins have been seen to be associated with women who present with dysmenorrhea as compared to eumenorrheic women 9 . Most young women usually have dysmenorrhea during the first two to three days of their menstrual flow 10 , 11 . Abdominal cramps, backache, weakness, and fatigue were some of the commonly associated symptoms of menstrual pain 12 . Dysmenorrhea has many repercussions on the quality of life, including absenteeism, poor concentration, altered sleep patterns, anorexia, and withdrawal from social activities 13 . Due to the impact of the pain, the affected young women resort to specific coping mechanisms to alleviate the pain. According to the American College of Obstetrics and Gynaecology (ACOG), the use of non-steroidal anti-inflammatory Drugs (NSAIDs) is the mainstay 14 . Physical exercise and applying warm compresses are alternate ways of alleviating the pain 3 , 8 . For females who saw the perception of pain as a typical female experience, they mainly chose to ignore or endure the pain 15 . Many young women have come to accept pain during menstruation as a normal part of the menstrual cycle and fail to seek appropriate treatments despite the impact on their lives. 3 Several studies have been conducted to identify certain biological and psychosocial factors of dysmenorrhea 16 . It has also been shown to be one of the significant causes of short-term absenteeism in schools and workplaces and generally impacts the quality of life of young females 17 , 18 . Despite its increasing prevalence globally and its impact on the quality of life among young women, data on dysmenorrhea is limited and has been overlooked here in Ghana 19 . Hence, proper measures have not been put in place to address dysmenorrhea, which is a significant public health issue. This study, therefore, aimed to determine the prevalence and coping mechanism of dysmenorrhea among female students in Ghana. Methods Study Design This study used a descriptive cross-sectional study design to determine the prevalence and coping mechanism of dysmenorrhea among female students at the Kwame Nkrumah University of Science and Technology (KNUST), Ghana, from 14th January 2023 to 26th January 2023. Study Population This study was conducted among 211 undergraduate female students in the College of Health Sciences at Kwame Nkrumah University of Science and Technology, Ghana. The College of Health Sciences comprises the Faculty of Allied Health Sciences, School of Medicine and Dentistry, School of Veterinary Medicine and School of Pharmacy and Pharmaceutical Sciences. Data Collection and Analysis. The participants were selected using a convenient sampling technique. A structured questionnaire was used to collect data from the selected participants. Data was collected on the Socio-demographic and menstrual characteristics of participants, Associated symptoms, severity, and sites of pain of dysmenorrhea amongst the female students, and the Effect of dysmenorrhea on the daily life of female university students at KNUST and the coping mechanisms in the management of dysmenorrhea amongst the university students. The severity of dysmenorrhea was assessed using the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS), which was obtained from previous literature 5 . Data was analyzed using the Statistical Package for the Social Sciences (SPSS) programme IBM version 20. A descriptive analysis was conducted, and the results were presented in tables showing frequency and percentages. Ethical Considerations. A departmental approval was sought from the College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST) and written consent was obtained from all respondents. Confidentiality and anonymity were ensured, and the data analyzed was stripped of participants’ details. Participation was voluntary, and respondents could withdraw at any stage without any penalty. Results Socio-demographic and menstrual characteristics The respondents’ ages ranged from 16–34, with a mean age of 22.45. Most participants, 167 (79%), were between the ages of 20 − 24. Also, 202 (95.7%) were Christians, and 151(71.6%) participants had a regular menstrual cycle. The mean menstrual cycle period length was 5.07 days. The mean age of those who could tell their menarche was 12.58. (Table 1 ) Table 1 Socio-demographic and menstrual characteristics VARIABLES FREQUENCY(N = 211) PERCENTAGE (%) Age • 16–19 23 11.0 • 20–24 167 79.0 • 25–29 15 7.0 • 30–34 6 3.0 Religion • Christian 202 95.7 • Muslim 9 4.3 Menarche in years • 9–11 51 24.1 • 12–14 134 63.5 • 15–18 23 10.9 • Can't remember 3 1.4 Length of cycle in days • 21–25 10 4.7 • 26–30 160 75.8 • 31–35 20 9.5 • 36–40 2 1 • Irregular 16 7.6 • Not sure 3 1.4 Length of period in days • 3 12 5.7 • 4 38 18 • 5 106 50.2 • 6 35 16.6 • 7 19 9 • 8 1 0.5 Regularity of Cycle • Yes 151 71.6 • No 60 28.4 Prevalence of dysmenorrhea The study found that the prevalence of dysmenorrhea among Female Students at the KNUST was 97.2%. Most of the respondents, 205 (97.2%), experienced dysmenorrhea during their menstruation. Only 6 (2.8%) respondents mentioned they had never experienced dysmenorrhea. (Table 2 ) Table 2 Prevalence of dysmenorrhea Personal experience of dysmenorrhea Frequency Percent (%) • Yes, every time during menstruation 100 47.4 • Yes, sometimes 105 49.8 • No 6 2.8 Associated symptoms, severity, and sites of the pain of dysmenorrhea amongst the female students. Symptoms associated with dysmenorrhea The frequently reported symptoms experienced by the participants who experienced dysmenorrhea were pimples, 153 (74.63%), mood swings 152 (74.15%), diarrhoea, 145 (70.73%), bloating, 122 (59.51%) and breast pain, 113 (55.12%). The most common gastrointestinal symptoms were diarrhoea, 145 (70.73%), followed by bloating, 122 (59.51%). (Table 3 ) Table 3 Symptoms, severity, and site of dysmenorrhea on daily lives Characteristics Frequency(N = 205) Percent (%) Symptoms associated with dysmenorrhea • Vomiting 43 20.98 • Nausea 42 20.49 • Bloating 122 59.51 • Headache 90 43.90 • Breast pain 113 55.12 • Pimples 153 74.63 • Diarrhea 145 70.73 • Mood swings 152 74.15 • Palpitations 32 15.61 • Anorexia 97 47.32 • Others 17 8.29 Severity of pain • Grade 1 96 46.83 • Grade 2 75 36.59 • Grade 3 34 16.59 Severe day of pain • A day or two prior to menstruation 21 10.24 • First day of menstruation 129 62.93 • Second day of menstruation 20 9.76 • On the third day and beyond, excluding the last day of menstruation 6 2.93 • On the last day of menstruation 2 0.98 • Throughout the whole period 3 1.46 • Others 24 11.71 Site of pain • Lower abdomen 203 99.02 • Lower back 90 43.90 • Leg 44 21.46 • Thigh 38 18.54 • Others 14 6.83 The severity of pain The severity of dysmenorrhea was assessed using the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS). Grade 1 – Mild pain, which rarely interferes with daily activities, and analgesics are seldom needed. Grade 2 - Moderate pain inhibits day-to-day activities, and analgesics are needed for relief. Grade 3 – Severe pain, which is accompanied by symptoms such as vomiting and diarrhoea where daily activities are significantly impeded. Analgesics fail to provide relief. The study found that 96 females (46.8%) experienced Grade 1 pain, and Grade 2 pain, 75 (36.6%). Most of the respondents, 129 (62.93%), experienced dysmenorrhea on the first day of menstruation. (Table 3 ) Site of pain The majority, 203 (99.02%) of respondents, experienced pain in the lower abdomen, and 90 (24%) experienced pain in their lower back. (Table 3 ) Effect of dysmenorrhea on daily life female university students at KNUST. Among the female students who experienced dysmenorrhea, the frequently reported effects on their daily activities included withdrawal from school activities, 164 (80%), poor concentration, 149 (72.68%), changes in sleep pattern, 119 (58.05%) and school absenteeism, 68(33.17%). (Table 4 ) Table 4 Effects of dysmenorrhea on the daily life of female KNUST students Influence on daily life Frequency(N = 205) Percent (%) School absenteeism 68 33.17 Poor concentration 149 72.68 Change in sleep pattern 119 58.05 Withdrawal from activities 164 80.00 Depression 35 17.07 Lower self-esteem 38 18.54 Others 3 1.46 Coping mechanisms in the management of dysmenorrhea. Use of medications A proportion of the participants, 103 (50.2%), who experienced dysmenorrhea, used medications. For those who did not use medications, a proportion of 58 (56.86%) reported “the medication does not help” as their reason for not taking medications. Also, 20 (19.61%) respondents saw it as “a normal experience for females”; hence, there was no need to take drugs. The study found that participants used analgesics, antispasmodics, herbal medication, and hormonal contraceptives as a pharmacological means of managing dysmenorrhea. A proportion of 103(50.2%) of participants who resorted to the use of medications used paracetamol. Self-medication, 69 (66.99%), was predominant among participants who experienced dysmenorrhea. A proportion of 42(40.78%) of the participants took the medications once a day, and a proportion of 98(95.15%) reported the use of medications as effective. (Table 5 ) Table 5 Coping mechanisms used in the management of dysmenorrhea. Characteristics Frequency(N = 205) Percent Use of medications • Yes 103 50.2 • No 102 49.8 Reasons for no usage of medications for dysmenorrhea(N = 102) • A normal experience for females 20 19.61 • Allergic to the medication 1 0.98 • Fear of addiction to the drug 4 3.92 • Fear of altering the menstrual cycle 8 7.84 • Haven't visited the hospital yet 1 0.98 • The medications don’t help 58 56.86 • No knowledge of the appropriate drug for the pain 6 5.88 • The pain is minimal; hence it can be endured 4 3.92 Names of medications used • Diclofenac 44 42.72 • Paracetamol 72 69.90 • Ibuprofen 37 35.92 • Hormonal contraceptive 9 8.74 • Herbal 8 7.77 • Mefenamic acid 8 7.77 • Buscopan 2 1.94% • Spasfon 1 0.97% • Others 6 6.79% Persons who prescribed or recommended the medications (N = 103) • Doctor 30 29.13 • Nurse 11 10.68 • Mother 32 31.07 • Siblings 18 17.48 • Friends 43 41.75 • Teacher 4 3.88 • Media 11 10.68 • Self 69 66.99 • Aunt 1 0.97 • Pharmacist 2 1.94 Timing of taking the medication(N = 103) • Once a day 42 40.78 • Two times a day 38 36.89 • Thrice a day 13 12.62 • When the pain intensifies 10 9.71 Effectiveness of medication(N = 103) • Yes 46 44.66 • No 5 4.85 • Sometimes 52 50.49 Alternate interventions used in managing dysmenorrhea (N = 205) • Ignore or endure 182 88.78 • Sleep 171 83.41 • Exercise 34 16.59 • Discuss pain 40 19.51 • Diet change 70 34.15 • Warm compresses 87 42.44 Effectiveness of alternate interventions in the management of dysmenorrhea(N = 205) • Yes 57 27.80 • No 29 14.15 • Sometimes 119 58.05 Alternate interventions used in the management of dysmenorrhea. Most of the participants resorted to ignoring the pain, 182(88.78%), sleeping, 171(83.41%), and applying warm compresses, 87(42.44%) as their alternate interventions in coping with the pain. Also, most respondents, 176(85.85%), reported that the alternate interventions were effective. (Table 5 ) Discussion Prevalence of dysmenorrhea This study showed a very high prevalence of dysmenorrhea of 97.2% among university students at KNUST. This finding is consistent with other cross-sectional studies done in other countries: 94.4% in Upper Egypt, 94% in Oman, 92.9% in Egypt, 92.9% in France, and 92.5% in Taiwan 5 , 20 – 23 . This goes on to augment the fact that dysmenorrhea is an issue of public health concern, and the appropriate interventions need to be put in place to ensure females can go through it with less impact on their daily activities. However, centrally to the findings of this study, other studies revealed a relatively lower prevalence of dysmenorrhea: 83.6% in Ghana, 80.9% in Lebanon, 78.4% in Romania, 73% in Nigeria and 68.1% in Ghana 1 , 10 , 11 , 24 , 25 . A sharp contrast was seen in a study conducted in India, which revealed a prevalence of 22.4% 26 . The variation in the different prevalence rates could be accounted for by varying study populations, different study areas, different age groups, lack of standardised methods for defining and evaluating dysmenorrhea, and the impact of cultural influences on how pain is perceived subjectively. Associated Symptoms, Severity of Pain, and Site of Pain Dysmenorrhea usually comes along with other symptoms, and the severity, together with the site of pain, tends to vary from one individual to the other. The result from this study revealed that pimples, mood swings, diarrhoea, bloating, and breast pain were the topmost reported symptoms by the respondents who experienced dysmenorrhea. Some of these symptoms were similar to findings from other studies 5 , 10 , 23 . The predominant symptom associated with dysmenorrhea in this study was pimples, whereas another study done in Ghana reported breast changes 10 . Also, a study conducted in Ghana showed restlessness and headache as the predominantly associated symptoms with dysmenorrhea 27 . The most typical gastrointestinal symptom found in this study was diarrhoea. However, this differed from other studies 5 , 24 , where the leading gastrointestinal symptoms were bloating and increased appetite. This shows that apart from the well-known menstrual cramps, other associated symptoms are experienced; hence, there should be a holistic approach to the management of dysmenorrhea instead of just focusing on the menstrual cramps. Regarding the localization of the pain, most participants reported experiencing pain in their lower abdomen and back. This is similar to other findings in Ethiopia 12 , 28 . In another study by Gebeyehu et al., lower abdominal pain was seen as the most typical site of pain, concurring with this study’s findings 12 . This study showed that the pain experienced by the participants was that of Grade 1(mild with no need for analgesics) and Grade 2(moderate where analgesics may be needed for pain relief), with Grade 1 being the most reported. However, in a study in France, where the assessment method of pain severity was the same, the results were the opposite, where Grade 2 pain was the most reported 5 . These findings could result from the different populations used in the respective studies. Other studies employed the use of mild to severe as a measurement of the severity of pain; hence, it averted the use of those studies to draw any relevant comparisons with the results of my study. Furthermore, this study revealed that the pain was most severe on the first day of menstruation, and this finding was in line with other studies 9 , 11 . Effect of dysmenorrhea on the lives of young women. Although dysmenorrhea does not pose as a life-threatening disorder, the recurrence of the symptoms every month shows a substantial morbidity that has a significant debilitating effect on the lives of students 27 , 29 . In this study, it was revealed that among those who experienced dysmenorrhea, a proportion of them had withdrawn from activities. In contrast, others experienced poor concentration, changes in sleep patterns, and school absenteeism, respectively. The influence of dysmenorrhea on the lives of the students seems profound, considering they were at their most productive age. Some studies have denoted a link between poor concentration and dysmenorrhea, which aligns with our findings 1 , 30 . This study showed that university students with dysmenorrhea reported a history of poor concentration during menstruation. This percentage is consistent with another study at Hong Kong University, which revealed a 75% poor concentration 30 . This poor concentration could decrease academic performance, especially if they are to take an exam or test within that period. This goes on to suggest that dysmenorrhea may have a detrimental effect on cognitive function. It was shown that dysmenorrhea has been associated with the leading causes of recurring short-term absenteeism 31 . This study showed a prevalence rate of 33.17% for school absenteeism. This finding is similar to previous studies that found that 19–34% of females were absent from school due to the impact of dysmenorrhea 4 , 11 , 32 , 33 . Another study in Romania also found that school absenteeism was reported at 34% but was lower than 7% in Ghana 1 , 11 . This study found that a proportion of university students reported withdrawal from activities as a result of dysmenorrhea. A study by Armour et al. showed that dysmenorrhea also frequently affected other activities directly related to school (like sports) or social activities. However, the finding from this study was significantly higher when compared to other studies where withdrawal from activities was shown to be 37% 4 . A strong association was found between changes in sleep patterns and dysmenorrhea 17 , 34 . Interestingly, a study by Araujo et al. showed no significant correlation between the impact of dysmenorrhea and changes in sleep patterns 35 . This study involved the use of age groups (25–48 years) higher than the ones used in the previous study and may explain why the result was so. Also, the varying assessment tools used to determine the changes in sleeping patterns may have accounted for that. This study revealed that university students experienced changes in their sleep patterns. This is similar to a study reported that 26% of students had changes in their sleep patterns. This finding is, however, lower than the result in this study 30 . Coping Mechanisms Used in Managing Dysmenorrhea In this study, we found that pharmacological and non-pharmacological means were used to alleviate the pain associated with menstruation. This study found that analgesics, antispasmodics, hormonal contraceptives, and herbal medications were the mainstay. Less than half of the participants mentioned they do not take any medications for the pain. The reasons cited included “the medications do not help” and “a normal experience for females”. These reasons were similar to those found in a study conducted in Ghana 36 . It could be that the medications do not help because of a negative report they may have heard from another female counterpart or a personal experience that may have stemmed from not consulting appropriate healthcare professionals for the proper dosage of the drugs; hence, it would be deemed ineffective. This is a misconception that must be tackled through education about the appropriate interventions available for the management of dysmenorrhea. These misconceptions may have also been passed down in their societies 24 . Pharmacological interventions Concerning health-seeking practices, this study was in congruence with the results of other studies where females resorted to consulting the media, the internet, and family relatives instead of seeking medical advice from healthcare professionals 10 , 24 . Notably, self-medication was prevalent in this study, similar to other findings 1 , 5 , 13 . However, a prevalence of 78.2% was revealed in a study among University Health Science students, which was higher than the one in this study, which was observed to be 66.99% 28 . This high prevalence of self-medication could be due to exposure to knowledge about several medications in their curriculum as health science students and, hence, do not see the need to go to the appropriate professionals for the prescription. Among the health professionals, doctors were the ones who were predominantly consulted, followed by nurses and pharmacists, according to this study. This differed from a previous study where pharmacists were mostly consulted 24 . Regarding the choice of medications, our findings were consistent with a study in Ethiopia, where the notable drugs used were paracetamol, diclofenac, and ibuprofen 37 . Paracetamol was found to be the drug of choice by most of the respondents, and this was similar in other studies as well 10 , 37 . However, this study showed more females who preferred paracetamol than other studies 10 . On the contrary, Karout et al. observed NSAIDs as the predominant medication used by females who experienced dysmenorrhea 24 . Although paracetamol is less potent than NSAIDs and much safer and suitable for use in the management of dysmenorrhea for those who may have been diagnosed with peptic ulcer or any other disease where NSAIDs are considered unsafe 38 . This study found that university students also used diclofenac. This finding, however, differed from some studies where ibuprofen and mefenamic acid were seen as the common NSAIDs used 12 , 24 . This study revealed that hyoscine was the most frequently used antispasmodic, similar to a study by Ameade et al. 10 . Karout et al. also documented hyoscine and phloroglucinol/trimethyl phloroglucinol combination as the common antispasmodics used, consistent with this study 24 . Hormonal contraceptives were also adopted for use by a few participants in this study. Interestingly, a sharp contrast was seen when compared to a study where none of the females used hormonal contraceptives for the alleviation of the pain 24 . This is because hormonal contraceptives are perceived to be taboo for unmarried women in Lebanon 24 . This shows that some misconceptions still exist about the choice of medication for dysmenorrhea, and the public needs to be sensitized on these issues. Furthermore, other participants in this study opted for the use of herbal medications for the management of dysmenorrhea. This was in congruence with other studies done in Ghana 1 , 15 . Regarding the timing of medications, this study showed that most participants took them once daily, and very few took them only when the pain intensified. More than half of the participants said the medications produced their desired effects only on some occasions. Some medications, like NSAIDs, are recommended to be taken prior to the onset of the pain, and one may not get the desired effect if this recommendation is not adhered to 39 . This may account for why some experienced partial relief from taking the medications. Non-pharmacological interventions Most of the participants resorted to ignoring the pain, sleeping, and applying warm compresses as their alternate or complementary interventions for coping with the pain. In a study by Ameade et al., their findings were in line with this study, where it was observed that the majority of the female university students either ignored the pain or slept as their coping mechanism for the pain 10 . Also, compared to this study, the proportion of females who resorted to sleeping was higher than that of other studies, which reported 76.3% 5 . Most females, 66.7%, adopted the application of warm compresses in France compared to this study 5 . It was also observed that the females used exercise to alleviate the pain associated with dysmenorrhea. This was observed in several other studies 12 , 30 . This might be because the students, who are health science students, have some knowledge of the non-pharmacological management of dysmenorrhea. Limitations The study is limited to only one university in Ghana, potentially limiting the generalisation of findings to Ghana’s student population. Conclusion This study establishes that dysmenorrhea is high among university students of KNUST, and it negatively affects the daily activity of the majority of them. In the face of the ever-increasing prevalence of dysmenorrhea, as seen in this study, more awareness needs to be created among university students and encouraged to seek the appropriate interventions from the right professionals. Declarations The study had an ethical approval from the KNUST Institutional Review Committee. Acknowledgement. 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Obstet Gynecol Int . ;2019. 10.1155/2019/8059471 Yesuf TA, Eshete NA, Sisay EA (2018) Dysmenorrhea among University Health Science Students, Northern Ethiopia: Impact and Associated Factors. Int J Reprod Med . ;2018. 10.1155/2018/9730328 Pitangui ACR, Gomes MR, de Lima A, Schwingel AS, Albuquerque PA, de Araújo AP (2013) RC. Menstruation Disturbances: Prevalence, Characteristics, and Effects on the Activities of Daily Living among Adolescent Girls from Brazil. J Pediatr Adolesc Gynecol . ;26(3). 10.1016/j.jpag.2012.12.001 Chia CF, Lai JHY, Cheung PK et al (2013) Dysmenorrhoea among Hong Kong university students: Prevalence, impact, and management. Hong Kong Med J 19(3). 10.12809/hkmj133807 Nwankwo TO, Aniebue UU, Aniebue PN (2010) Menstrual Disorders in Adolescent School Girls in Enugu, Nigeria. J Pediatr Adolesc Gynecol 23(6). 10.1016/j.jpag.2010.04.001 Samani RO, Hashiani AA, Razavi M et al (2018) The prevalence of menstrual disorders in iran: A systematic review and meta-analysis. Int J Reprod Biomed. ;16(11) Jaiprakash H, Myint K, Chai L, Nasir B (2016) Prevalence of Dysmenorrhea and Its Sequel among Medical Students in a Malaysian University. Br J Med Med Res 16(9). 10.9734/bjmmr/2016/25135 Baker FC, Colrain IM (2010) Daytime sleepiness, psychomotor performance, waking EEG spectra and evoked potentials in women with severe premenstrual syndrome. J Sleep Res . ;19(1 PART. 2). 10.1111/j.1365-2869.2009.00782.x Araujo P, Hachul H, Santos-Silva R, Bittencourt LRA, Tufik S, Andersen ML (2011) Sleep pattern in women with menstrual pain. Sleep Med 12(10). 10.1016/j.sleep.2011.06.011 Aziato L, Dedey F, Clegg-Lamptey JNA (2014) The experience of dysmenorrhoea among Ghanaian senior high and university students: Pain characteristics and effects. Reprod Health 11(1). 10.1186/1742-4755-11-58 Azagew AW, Kassie DG, Walle TA (2020) Prevalence of primary dysmenorrhea, its intensity, impact and associated factors among female students’ at Gondar town preparatory school, Northwest Ethiopia. BMC Womens Health 20(1). 10.1186/s12905-019-0873-4 Graham GG, Davies MJ, Day RO, Mohamudally A, Scott KF (2013) The modern pharmacology of paracetamol: Therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings. Inflammopharmacology 21(3). 10.1007/s10787-013-0172-x Coco AS Primary Dysmenorrhea - American Family Physician. American Academy of Family Physicians . Published online 1999 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4622110","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":317686272,"identity":"b6b00f43-1d40-451c-beb5-abc1e635b7da","order_by":0,"name":"Adjoa Enyidado Hackman","email":"","orcid":"","institution":"Department of Obstetrics \u0026 Gynecology, Kumasi South Municipal Hospital - Kumasi, Ghana","correspondingAuthor":false,"prefix":"","firstName":"Adjoa","middleName":"Enyidado","lastName":"Hackman","suffix":""},{"id":317686273,"identity":"10057712-03f4-4f6b-adb2-947d28d852c7","order_by":1,"name":"Augustine Kumah","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAklEQVRIiWNgGAWjYPACCQYGHiDF2GADIhsPENaRANeSBiaJ0cIA03IYzMerhX9G+jXJnz8s8vh5zphu+LnjvN3a9sNAW2psonF64kZOmTRPgkSxZG+P2c3eM7eTt51JBGo5lpbbgEvPjZw0aaBfEjec5zG7wdt2O9nsAFAL0IU4tcgDtUj+AGrZD9Ry82/buWSz8w/xazG4kX5MggdkC2+P2W3etgN2ZjcI2GJ45g2zNU+aROKMM8fKbsu2JSeY3QDakoDHL3LH0x/e/GFTl9jfk7zt5ts2O3uz8+kPH3yoscHtfQYeAxRuIlhlAk7lIMD+AIVrj1fxKBgFo2AUjEgAAGg7Z+o273m9AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-9408-2152","institution":"Nyaho Healthcare Limited, Accra - Ghana","correspondingAuthor":true,"prefix":"","firstName":"Augustine","middleName":"","lastName":"Kumah","suffix":""},{"id":317686274,"identity":"d7e86f03-5b95-4e24-b06b-568dee003a70","order_by":2,"name":"Christine Ahiale","email":"","orcid":"","institution":"Emergency Department, Ga North Municipal Hospital, Accra - Ghana","correspondingAuthor":false,"prefix":"","firstName":"Christine","middleName":"","lastName":"Ahiale","suffix":""},{"id":317686275,"identity":"5f4e59fc-4f3d-4cc3-8be9-40bf96bb2322","order_by":3,"name":"Emmanuel Obot","email":"","orcid":"","institution":"Department of Anesthesia, 37 Military Hospital, Accra – Ghana","correspondingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"","lastName":"Obot","suffix":""},{"id":317686276,"identity":"cd95190f-a209-490d-ac1c-92fd46f13646","order_by":4,"name":"Stephen Henry Afakorzi","email":"","orcid":"","institution":"Africa Centre of Excellence in Public Health and Toxicological Research, University of Port Harcourt, River State, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Stephen","middleName":"Henry","lastName":"Afakorzi","suffix":""},{"id":317686277,"identity":"92f80437-d57a-433b-b576-252eb61291ac","order_by":5,"name":"Mac Dzodzodzi","email":"","orcid":"","institution":"Department of Health and Wellbeing, Leeds Beckett University, UK","correspondingAuthor":false,"prefix":"","firstName":"Mac","middleName":"","lastName":"Dzodzodzi","suffix":""}],"badges":[],"createdAt":"2024-06-22 13:34:43","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":true,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":true},"doi":"10.21203/rs.3.rs-4622110/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4622110/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":59189003,"identity":"6e3a93cb-81ba-4725-b42d-957a6e93ef1d","added_by":"auto","created_at":"2024-06-27 12:45:04","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":990937,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4622110/v1/739d606a-e84f-4025-a278-fb75286e90f4.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePrevalence and Coping Mechanism of Dysmenorrhea Among Female University Students in Ghana.\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDysmenorrhea, though not life-threatening, is one of the common gynaecological problems usually experienced by young women \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. The revised International Association of the Study of Pain (IASP) definition of pain describes it as \u0026ldquo;an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage\u0026rdquo; \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Dysmenorrhea, also known as menstrual pain, is referred to as \u0026ldquo;the presence of painful cramps of uterine origin that occur during menstruation\u0026rdquo; \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. The prevalence of dysmenorrhea globally is high and has been estimated to range from 60% \u0026minus;\u0026thinsp;93%. \u003csup\u003e\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Given that, it is a significant topic of public health concern as it has been seen to have a considerable impact on the lives of the affected young women. Based on the pathogenesis, dysmenorrhea can be classified as primary (absence of pelvic pathology) or secondary (presence of pelvic pathology) \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Endometriosis and adenomyosis are the leading causes of secondary dysmenorrhea among young women \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Studies show that dysmenorrhea occurs due to the increased production of prostaglandins, which results in concomitant increased contractility of the uterus \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. The prostaglandin implicated in this pathology has been identified as PGF2a and PGE2 during the sloughing of the endometrial lining. This brings about increased sensitisation of the pain fibres and leads to dysmenorrhea. Increased concentrations of prostaglandins have been seen to be associated with women who present with dysmenorrhea as compared to eumenorrheic women \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eMost young women usually have dysmenorrhea during the first two to three days of their menstrual flow \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Abdominal cramps, backache, weakness, and fatigue were some of the commonly associated symptoms of menstrual pain \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Dysmenorrhea has many repercussions on the quality of life, including absenteeism, poor concentration, altered sleep patterns, anorexia, and withdrawal from social activities \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Due to the impact of the pain, the affected young women resort to specific coping mechanisms to alleviate the pain. According to the American College of Obstetrics and Gynaecology (ACOG), the use of non-steroidal anti-inflammatory Drugs (NSAIDs) is the mainstay \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Physical exercise and applying warm compresses are alternate ways of alleviating the pain \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. For females who saw the perception of pain as a typical female experience, they mainly chose to ignore or endure the pain \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eMany young women have come to accept pain during menstruation as a normal part of the menstrual cycle and fail to seek appropriate treatments despite the impact on their lives.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Several studies have been conducted to identify certain biological and psychosocial factors of dysmenorrhea \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. It has also been shown to be one of the significant causes of short-term absenteeism in schools and workplaces and generally impacts the quality of life of young females \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. Despite its increasing prevalence globally and its impact on the quality of life among young women, data on dysmenorrhea is limited and has been overlooked here in Ghana \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Hence, proper measures have not been put in place to address dysmenorrhea, which is a significant public health issue. This study, therefore, aimed to determine the prevalence and coping mechanism of dysmenorrhea among female students in Ghana.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis study used a descriptive cross-sectional study design to determine the prevalence and coping mechanism of dysmenorrhea among female students at the Kwame Nkrumah University of Science and Technology (KNUST), Ghana, from 14th January 2023 to 26th January 2023.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population\u003c/h2\u003e \u003cp\u003eThis study was conducted among 211 undergraduate female students in the College of Health Sciences at Kwame Nkrumah University of Science and Technology, Ghana. The College of Health Sciences comprises the Faculty of Allied Health Sciences, School of Medicine and Dentistry, School of Veterinary Medicine and School of Pharmacy and Pharmaceutical Sciences.\u003c/p\u003e \u003cp\u003e \u003cb\u003eData Collection and Analysis.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe participants were selected using a convenient sampling technique. A structured questionnaire was used to collect data from the selected participants. Data was collected on the Socio-demographic and menstrual characteristics of participants, Associated symptoms, severity, and sites of pain of dysmenorrhea amongst the female students, and the Effect of dysmenorrhea on the daily life of female university students at KNUST and the coping mechanisms in the management of dysmenorrhea amongst the university students.\u003c/p\u003e \u003cp\u003eThe severity of dysmenorrhea was assessed using the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS), which was obtained from previous literature \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) programme IBM version 20. A descriptive analysis was conducted, and the results were presented in tables showing frequency and percentages.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEthical Considerations.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e A departmental approval was sought from the College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST) and written consent was obtained from all respondents. Confidentiality and anonymity were ensured, and the data analyzed was stripped of participants\u0026rsquo; details. Participation was voluntary, and respondents could withdraw at any stage without any penalty.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic and menstrual characteristics\u003c/h2\u003e \u003cp\u003eThe respondents\u0026rsquo; ages ranged from 16\u0026ndash;34, with a mean age of 22.45. Most participants, 167 (79%), were between the ages of 20 \u0026minus;\u0026thinsp;24. Also, 202 (95.7%) were Christians, and 151(71.6%) participants had a regular menstrual cycle. The mean menstrual cycle period length was 5.07 days. The mean age of those who could tell their menarche was 12.58. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic and menstrual characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVARIABLES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFREQUENCY(N\u0026thinsp;=\u0026thinsp;211)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePERCENTAGE (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 16\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 25\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 30\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Christian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Muslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMenarche in years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 9\u0026ndash;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 12\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 15\u0026ndash;18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Can't remember\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength of cycle in days\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 21\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 26\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 31\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 36\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Irregular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Not sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength of period in days\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; 8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegularity of Cycle\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of dysmenorrhea\u003c/h2\u003e \u003cp\u003eThe study found that the prevalence of dysmenorrhea among Female Students at the KNUST was 97.2%. Most of the respondents, 205 (97.2%), experienced dysmenorrhea during their menstruation. Only 6 (2.8%) respondents mentioned they had never experienced dysmenorrhea. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of dysmenorrhea\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal experience of dysmenorrhea\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Yes, every time during menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Yes, sometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eAssociated symptoms, severity, and sites of the pain of dysmenorrhea amongst the female students.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSymptoms associated with dysmenorrhea\u003c/strong\u003e \u003cp\u003eThe frequently reported symptoms experienced by the participants who experienced dysmenorrhea were pimples, 153 (74.63%), mood swings 152 (74.15%), diarrhoea, 145 (70.73%), bloating, 122 (59.51%) and breast pain, 113 (55.12%). The most common gastrointestinal symptoms were diarrhoea, 145 (70.73%), followed by bloating, 122 (59.51%). (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSymptoms, severity, and site of dysmenorrhea on daily lives\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency(N\u0026thinsp;=\u0026thinsp;205)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eSymptoms associated with dysmenorrhea\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Vomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Nausea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Bloating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Headache\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Breast pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Pimples\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Diarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Mood swings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Palpitations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Anorexia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSeverity of pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Grade 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Grade 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Grade 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSevere day of pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; A day or two prior to menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; First day of menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Second day of menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; On the third day and beyond, excluding the last day of menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; On the last day of menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Throughout the whole period\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSite of pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Lower abdomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e203\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Lower back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Leg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Thigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eThe severity of pain\u003c/strong\u003e \u003cp\u003eThe severity of dysmenorrhea was assessed using the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eGrade 1\u003c/b\u003e \u0026ndash; Mild pain, which rarely interferes with daily activities, and analgesics are seldom needed.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eGrade 2\u003c/b\u003e - Moderate pain inhibits day-to-day activities, and analgesics are needed for relief.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eGrade 3\u003c/b\u003e \u0026ndash; Severe pain, which is accompanied by symptoms such as vomiting and diarrhoea where daily activities are significantly impeded. Analgesics fail to provide relief.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe study found that 96 females (46.8%) experienced Grade 1 pain, and Grade 2 pain, 75 (36.6%). Most of the respondents, 129 (62.93%), experienced dysmenorrhea on the first day of menstruation. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSite of pain\u003c/strong\u003e \u003cp\u003eThe majority, 203 (99.02%) of respondents, experienced pain in the lower abdomen, and 90 (24%) experienced pain in their lower back. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eEffect of dysmenorrhea on daily life female university students at KNUST.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAmong the female students who experienced dysmenorrhea, the frequently reported effects on their daily activities included withdrawal from school activities, 164 (80%), poor concentration, 149 (72.68%), changes in sleep pattern, 119 (58.05%) and school absenteeism, 68(33.17%). (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEffects of dysmenorrhea on the daily life of female KNUST students\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfluence on daily life\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency(N\u0026thinsp;=\u0026thinsp;205)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchool absenteeism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor concentration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in sleep pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWithdrawal from activities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower self-esteem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eCoping mechanisms in the management of dysmenorrhea.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eUse of medications\u003c/strong\u003e \u003cp\u003eA proportion of the participants, 103 (50.2%), who experienced dysmenorrhea, used medications. For those who did not use medications, a proportion of 58 (56.86%) reported \u0026ldquo;the medication does not help\u0026rdquo; as their reason for not taking medications. Also, 20 (19.61%) respondents saw it as \u0026ldquo;a normal experience for females\u0026rdquo;; hence, there was no need to take drugs. The study found that participants used analgesics, antispasmodics, herbal medication, and hormonal contraceptives as a pharmacological means of managing dysmenorrhea. A proportion of 103(50.2%) of participants who resorted to the use of medications used paracetamol. Self-medication, 69 (66.99%), was predominant among participants who experienced dysmenorrhea. A proportion of 42(40.78%) of the participants took the medications once a day, and a proportion of 98(95.15%) reported the use of medications as effective. (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCoping mechanisms used in the management of dysmenorrhea.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency(N\u0026thinsp;=\u0026thinsp;205)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eUse of medications\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReasons for no usage of medications for dysmenorrhea(N\u0026thinsp;=\u0026thinsp;102)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; A normal experience for females\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Allergic to the medication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Fear of addiction to the drug\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Fear of altering the menstrual cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Haven't visited the hospital yet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; The medications don\u0026rsquo;t help\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No knowledge of the appropriate drug for the pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; The pain is minimal; hence it can be endured\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNames of medications used\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Diclofenac\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Paracetamol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Ibuprofen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Hormonal contraceptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Herbal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Mefenamic acid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Buscopan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.94%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Spasfon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.97%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.79%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePersons who prescribed or recommended the medications (N\u0026thinsp;=\u0026thinsp;103)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Doctor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Mother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Siblings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Teacher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Self\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Aunt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Pharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTiming of taking the medication(N\u0026thinsp;=\u0026thinsp;103)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Once a day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Two times a day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Thrice a day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; When the pain intensifies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEffectiveness of medication(N\u0026thinsp;=\u0026thinsp;103)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Sometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlternate interventions used in managing dysmenorrhea (N\u0026thinsp;=\u0026thinsp;205)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Ignore or endure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Sleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Exercise\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Discuss pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Diet change\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Warm compresses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEffectiveness of alternate interventions in the management of dysmenorrhea(N\u0026thinsp;=\u0026thinsp;205)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Sometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eAlternate interventions used in the management of dysmenorrhea.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eMost of the participants resorted to ignoring the pain, 182(88.78%), sleeping, 171(83.41%), and applying warm compresses, 87(42.44%) as their alternate interventions in coping with the pain. Also, most respondents, 176(85.85%), reported that the alternate interventions were effective. (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of dysmenorrhea\u003c/h2\u003e \u003cp\u003eThis study showed a very high prevalence of dysmenorrhea of 97.2% among university students at KNUST. This finding is consistent with other cross-sectional studies done in other countries: 94.4% in Upper Egypt, 94% in Oman, 92.9% in Egypt, 92.9% in France, and 92.5% in Taiwan \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan additionalcitationids=\"CR21 CR22\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. This goes on to augment the fact that dysmenorrhea is an issue of public health concern, and the appropriate interventions need to be put in place to ensure females can go through it with less impact on their daily activities. However, centrally to the findings of this study, other studies revealed a relatively lower prevalence of dysmenorrhea: 83.6% in Ghana, 80.9% in Lebanon, 78.4% in Romania, 73% in Nigeria and 68.1% in Ghana \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. A sharp contrast was seen in a study conducted in India, which revealed a prevalence of 22.4% \u003csup\u003e26\u003c/sup\u003e. The variation in the different prevalence rates could be accounted for by varying study populations, different study areas, different age groups, lack of standardised methods for defining and evaluating dysmenorrhea, and the impact of cultural influences on how pain is perceived subjectively.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eAssociated Symptoms, Severity of Pain, and Site of Pain\u003c/h2\u003e \u003cp\u003eDysmenorrhea usually comes along with other symptoms, and the severity, together with the site of pain, tends to vary from one individual to the other. The result from this study revealed that pimples, mood swings, diarrhoea, bloating, and breast pain were the topmost reported symptoms by the respondents who experienced dysmenorrhea. Some of these symptoms were similar to findings from other studies \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. The predominant symptom associated with dysmenorrhea in this study was pimples, whereas another study done in Ghana reported breast changes \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Also, a study conducted in Ghana showed restlessness and headache as the predominantly associated symptoms with dysmenorrhea \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe most typical gastrointestinal symptom found in this study was diarrhoea. However, this differed from other studies \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e, where the leading gastrointestinal symptoms were bloating and increased appetite. This shows that apart from the well-known menstrual cramps, other associated symptoms are experienced; hence, there should be a holistic approach to the management of dysmenorrhea instead of just focusing on the menstrual cramps. Regarding the localization of the pain, most participants reported experiencing pain in their lower abdomen and back. This is similar to other findings in Ethiopia \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. In another study by Gebeyehu et al., lower abdominal pain was seen as the most typical site of pain, concurring with this study\u0026rsquo;s findings \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study showed that the pain experienced by the participants was that of Grade 1(mild with no need for analgesics) and Grade 2(moderate where analgesics may be needed for pain relief), with Grade 1 being the most reported. However, in a study in France, where the assessment method of pain severity was the same, the results were the opposite, where Grade 2 pain was the most reported \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. These findings could result from the different populations used in the respective studies. Other studies employed the use of mild to severe as a measurement of the severity of pain; hence, it averted the use of those studies to draw any relevant comparisons with the results of my study. Furthermore, this study revealed that the pain was most severe on the first day of menstruation, and this finding was in line with other studies \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEffect of dysmenorrhea on the lives of young women.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAlthough dysmenorrhea does not pose as a life-threatening disorder, the recurrence of the symptoms every month shows a substantial morbidity that has a significant debilitating effect on the lives of students \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. In this study, it was revealed that among those who experienced dysmenorrhea, a proportion of them had withdrawn from activities. In contrast, others experienced poor concentration, changes in sleep patterns, and school absenteeism, respectively. The influence of dysmenorrhea on the lives of the students seems profound, considering they were at their most productive age. Some studies have denoted a link between poor concentration and dysmenorrhea, which aligns with our findings \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. This study showed that university students with dysmenorrhea reported a history of poor concentration during menstruation. This percentage is consistent with another study at Hong Kong University, which revealed a 75% poor concentration \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. This poor concentration could decrease academic performance, especially if they are to take an exam or test within that period. This goes on to suggest that dysmenorrhea may have a detrimental effect on cognitive function.\u003c/p\u003e \u003cp\u003eIt was shown that dysmenorrhea has been associated with the leading causes of recurring short-term absenteeism \u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. This study showed a prevalence rate of 33.17% for school absenteeism. This finding is similar to previous studies that found that 19\u0026ndash;34% of females were absent from school due to the impact of dysmenorrhea \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e. Another study in Romania also found that school absenteeism was reported at 34% but was lower than 7% in Ghana \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. This study found that a proportion of university students reported withdrawal from activities as a result of dysmenorrhea. A study by Armour et al. showed that dysmenorrhea also frequently affected other activities directly related to school (like sports) or social activities. However, the finding from this study was significantly higher when compared to other studies where withdrawal from activities was shown to be 37% \u003csup\u003e4\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA strong association was found between changes in sleep patterns and dysmenorrhea \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. Interestingly, a study by Araujo et al. showed no significant correlation between the impact of dysmenorrhea and changes in sleep patterns \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. This study involved the use of age groups (25\u0026ndash;48 years) higher than the ones used in the previous study and may explain why the result was so. Also, the varying assessment tools used to determine the changes in sleeping patterns may have accounted for that. This study revealed that university students experienced changes in their sleep patterns. This is similar to a study reported that 26% of students had changes in their sleep patterns. This finding is, however, lower than the result in this study \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eCoping Mechanisms Used in Managing Dysmenorrhea\u003c/h2\u003e \u003cp\u003eIn this study, we found that pharmacological and non-pharmacological means were used to alleviate the pain associated with menstruation. This study found that analgesics, antispasmodics, hormonal contraceptives, and herbal medications were the mainstay. Less than half of the participants mentioned they do not take any medications for the pain. The reasons cited included \u0026ldquo;the medications do not help\u0026rdquo; and \u0026ldquo;a normal experience for females\u0026rdquo;. These reasons were similar to those found in a study conducted in Ghana \u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. It could be that the medications do not help because of a negative report they may have heard from another female counterpart or a personal experience that may have stemmed from not consulting appropriate healthcare professionals for the proper dosage of the drugs; hence, it would be deemed ineffective. This is a misconception that must be tackled through education about the appropriate interventions available for the management of dysmenorrhea. These misconceptions may have also been passed down in their societies \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePharmacological interventions\u003c/h2\u003e \u003cp\u003eConcerning health-seeking practices, this study was in congruence with the results of other studies where females resorted to consulting the media, the internet, and family relatives instead of seeking medical advice from healthcare professionals \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Notably, self-medication was prevalent in this study, similar to other findings \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. However, a prevalence of 78.2% was revealed in a study among University Health Science students, which was higher than the one in this study, which was observed to be 66.99% \u003csup\u003e28\u003c/sup\u003e. This high prevalence of self-medication could be due to exposure to knowledge about several medications in their curriculum as health science students and, hence, do not see the need to go to the appropriate professionals for the prescription. Among the health professionals, doctors were the ones who were predominantly consulted, followed by nurses and pharmacists, according to this study. This differed from a previous study where pharmacists were mostly consulted \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eRegarding the choice of medications, our findings were consistent with a study in Ethiopia, where the notable drugs used were paracetamol, diclofenac, and ibuprofen \u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. Paracetamol was found to be the drug of choice by most of the respondents, and this was similar in other studies as well \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. However, this study showed more females who preferred paracetamol than other studies \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. On the contrary, Karout et al. observed NSAIDs as the predominant medication used by females who experienced dysmenorrhea \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Although paracetamol is less potent than NSAIDs and much safer and suitable for use in the management of dysmenorrhea for those who may have been diagnosed with peptic ulcer or any other disease where NSAIDs are considered unsafe \u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. This study found that university students also used diclofenac. This finding, however, differed from some studies where ibuprofen and mefenamic acid were seen as the common NSAIDs used \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. This study revealed that hyoscine was the most frequently used antispasmodic, similar to a study by Ameade et al. \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Karout et al. also documented hyoscine and phloroglucinol/trimethyl phloroglucinol combination as the common antispasmodics used, consistent with this study \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHormonal contraceptives were also adopted for use by a few participants in this study. Interestingly, a sharp contrast was seen when compared to a study where none of the females used hormonal contraceptives for the alleviation of the pain \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. This is because hormonal contraceptives are perceived to be taboo for unmarried women in Lebanon \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. This shows that some misconceptions still exist about the choice of medication for dysmenorrhea, and the public needs to be sensitized on these issues. Furthermore, other participants in this study opted for the use of herbal medications for the management of dysmenorrhea. This was in congruence with other studies done in Ghana \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eRegarding the timing of medications, this study showed that most participants took them once daily, and very few took them only when the pain intensified. More than half of the participants said the medications produced their desired effects only on some occasions. Some medications, like NSAIDs, are recommended to be taken prior to the onset of the pain, and one may not get the desired effect if this recommendation is not adhered to \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e. This may account for why some experienced partial relief from taking the medications.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eNon-pharmacological interventions\u003c/h2\u003e \u003cp\u003eMost of the participants resorted to ignoring the pain, sleeping, and applying warm compresses as their alternate or complementary interventions for coping with the pain. In a study by Ameade et al., their findings were in line with this study, where it was observed that the majority of the female university students either ignored the pain or slept as their coping mechanism for the pain \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Also, compared to this study, the proportion of females who resorted to sleeping was higher than that of other studies, which reported 76.3% \u003csup\u003e5\u003c/sup\u003e. Most females, 66.7%, adopted the application of warm compresses in France compared to this study \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. It was also observed that the females used exercise to alleviate the pain associated with dysmenorrhea. This was observed in several other studies \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. This might be because the students, who are health science students, have some knowledge of the non-pharmacological management of dysmenorrhea.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe study is limited to only one university in Ghana, potentially limiting the generalisation of findings to Ghana\u0026rsquo;s student population.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study establishes that dysmenorrhea is high among university students of KNUST, and it negatively affects the daily activity of the majority of them. In the face of the ever-increasing prevalence of dysmenorrhea, as seen in this study, more awareness needs to be created among university students and encouraged to seek the appropriate interventions from the right professionals.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe study had an ethical approval from the KNUST Institutional Review Committee.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement.\u003c/h2\u003e \u003cp\u003eWe acknowledge Dr Yeetey Enuameh for all his technical and professional guidance and all the study participants for their time and participation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAcheampong K, Baffour-Awuah D, Ganu D et al (2019) Prevalence and predictors of dysmenorrhea, its effect, and coping mechanisms among adolescents in Shai Osudoku district, Ghana. \u003cem\u003eObstet Gynecol Int\u003c/em\u003e. ;2019. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2019/5834159\u003c/span\u003e\u003cspan address=\"10.1155/2019/5834159\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaja SN, Carr DB, Cohen M et al (2020) The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. 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Published online 1999\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dysmenorrhea, Prevalence, Coping Mechanism, University Students, Ghana","lastPublishedDoi":"10.21203/rs.3.rs-4622110/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4622110/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eAmong young women, dysmenorrhea is known to be a prevalent condition that poses serious consequences for the quality of their daily lives. This study aimed to determine the prevalence and coping mechanism of dysmenorrhea among female students in Ghana.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eA cross-sectional descriptive study was conducted among 211 female health science students at Kwame Nkrumah University of Science and Technology from 14th January 2023 to 26th January 2023. The participants were selected using a convenient sampling technique. A structured questionnaire was used to collect data from the selected participants. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) programme IBM version 20. The results were presented in tables.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe prevalence of dysmenorrhea was 97.2%. A more significant proportion of the students (99.02%) experienced pain in their lower abdomen. The predominant symptoms associated with dysmenorrhea were pimples (74.63%), mood swings (74.15%), and diarrhoea (70.73%). Among those who experienced dysmenorrhea, the frequently reported influences on their daily activities included withdrawal from activities (80%) and poor concentration (72.68%). More than half of the participants (50.2%) who experienced dysmenorrhea used medications, of which paracetamol (69.90%) was the most common. Self-medication (66.99%) was predominant among those who experienced dysmenorrhea. Most of the participants resorted to ignoring the pain (88.78%) and sleeping (83.41%) as their alternate interventions for coping with the pain.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis study establishes that dysmenorrhea is high among university students, and it negatively affects the daily activity of most of them.\u003c/p\u003e","manuscriptTitle":"Prevalence and Coping Mechanism of Dysmenorrhea Among Female University Students in Ghana.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-27 12:36:56","doi":"10.21203/rs.3.rs-4622110/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"874eeb11-4c80-4b6b-9ccb-d2c01202ec11","owner":[],"postedDate":"June 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":33594449,"name":"Sexual \u0026 Reproductive Medicine"}],"tags":[],"updatedAt":"2024-06-27T12:36:57+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-27 12:36:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4622110","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4622110","identity":"rs-4622110","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}