Quantifying the Impact of Dysmenorrhea Symptoms on Quality-of-Life and Access to Oral Contraceptives by Income.

Dysmenorrhea, or painful menstrual periods, is one of the most common gynecological complaints. Most reports of uterine contractions range between moderate to severe pain, and patients often elect to cope with their discomfort without assistance from a physician. In the process, women experiencing dysmenorrhea are more likely to report absenteeism from work and school.

This study measures the reported impact of dysmenorrhea on patients’ lives and elucidates a relationship between income and access to oral contraceptives.

Two hundred women completed a survey about their symptoms, level of pain, treatments, and the extent to which dysmenorrhea affected day-to-day obligations. Most questions were multiple-choice while others permitted several answer selections or were free response. The data was analyzed using JMP statistical software.

Eighty-four percent of respondents reported moderate to severe pain during menstruation. This discomfort has caused 65.5% of the cohort to miss work and 68% to avoid participating in social gatherings. Pain relief medications are most often used as treatment - 143 respondents took ibuprofen, 93 took acetaminophen, and 51 took naproxen. 29.5% of respondents are prescribed birth control for cramps and blood flow. Income (p = 0.049), age (p = 0.002), and education (p = 0.002) were significant predictors for oral contraceptive pill (OCP) use. The lowest income groups were found to use OCPs at less than half the rate as the highest income respondents.

Dysmenorrhea affected most participants in the cohort with an impact that extends beyond professional obligations. Income was found to be positively correlated with increased OCP use, whereas education level was inversely correlated. Clinicians should consider how patients’ backgrounds influence their access to OCP options. An improvement on this study’s findings would be to establish a causal relationship between these demographic factors and access to OCPs. 1. Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;6(1):177. doi:10.1186/1471-2458-6-177 2. Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ. 2006;332(7550):1134-1138. doi:10.1136/bmj.332.7550.1134 3. Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014;89(5):341-346. 4. Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. Am J Epidemiol. 2004;160(8):784-796. doi:10.1093/aje/kwh275 5. Gauthier A, Upmalis D, Dain MP. Clinical evaluation of a new triphasic oral contraceptive: norgestimate and ethinyl estradiol. Acta Obstet Gynecol Scand Suppl. 1992;71(s156):27-32. doi:10.3109/00016349209156512 6. Wong CL, Farquhar C, Roberts H, Proctor M. Oral contraceptive pill as treatment for primary dysmenorrhoea. Cochrane Database Syst Rev. 2009;2009(4). doi:10.1002/14651858.cd002120.pub2 7. Dmitrovic R, Kunselman AR, Legro RS. Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial. Obstet Gynecol. 2012;119(6):1143-1150. doi:10.1097/aog.0b013e318257217a 8. Dennis A, Grossman D. Barriers to Contraception and Interest In Over-the-Counter Access Among Low-Income Women: A Qualitative Study. Perspectives on Sexual and Reproductive Health. 2012;44(2):84-91. doi:10.1363/4408412 9. Grossman D, Fernández L, Hopkins K, Amastae J, Potter JE. Perceptions of the safety of oral contraceptives among a predominantly Latina population in Texas. Contraception. 2010;81(3):254-260. doi:10.1016/j.contraception.2009.09.009