Int J Clin Exp Med 2020;13(9):6496-6505 www.ijcem.com /ISSN:1940-5901/IJCEM0115365 Original Article The prevalence of dysmenorrhea and its effects on female university students’ quality of life: what can we do in primary care? Aclan Ozder * , Zeyneb Salduz * Department of Family Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. * Equal contribu- tors. Received May 31, 2020; Accepted July 28, 2020; Epub September 15, 2020; Published September 30, 2020 Abstract: This study aimed to estimate the prevalence of dysmenorrhea among Turkish university students studying in the feld of health sciences and to evaluate the effects of the students’ socio-demographic characteristics on the condition. A cross-sectional survey of 658 students was conducted by questionnaire at a health sciences univer- sity in Turkey. A structured questionnaire was used to collect data on dysmenorrhea. Health related quality of life (HRQoL) was assessed using the generic 36-Item Short Form Health Survey (SF-36), and depressive symptoms were assessed with the BDI included in the survey. A visual analogue scale was used to assess the severity of dysmenor- rhea. Data were analyzed using chi-square tests and logistic regression analysis. The prevalence of dysmenorrhea was 79.7% (524 out of 658 students). Age of menarche (P = 0.001), menstrual fow (P = 0.000), drinking coffee (P = 0.001) and having a family history of dysmenorrhea were signifcantly associated with dysmenorrhea in a multivari- able analysis. Furthermore, 42.7% of the students with dysmenorrhea missed at least one day of school and 5.3% missed at least one exam. The high prevalence of dysmenorrhea among Turkish university students is a signifcant health problem requiring attention, and the need for on-the-job training of primary care physicians on the manage- ment of primary dysmenorrhea should be considered. Keywords: Dysmenorrhea, quality of life, SF-36, BDI, depression Introduction The medical term “dysmenorrhea” is defned as painful menstruation in the absence of a pelvic pathology [1]. There are two types of dysmenor- rhea: “primary” and “secondary”. Primary dys- menorrhea involves common menstrual cram- ps that are recurrent and are not due to other diseases. The pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt in the lower abdomen, back, or thighs. The pain can range from mild to severe, it typi- cally lasts 12 to 72 hours, and many individuals suffer from accompanying nausea and vomit- ing, fatigue, and even loose, watery stools called diarrhea [2]. Secondary dysmenorrhea is pain that is caused by an underlying disorder such as endometrio- sis, ovarian cysts, adenomyosis, pelvic infam- matory disease, or pelvic adhesions. So, the clinical onset of secondary dysmenorrhea var- ies a lot, since the condition may be caused by a number of gynecological pathologies. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea [3]. The burden of dysmenorrhea is greater than any other gyne- cological complaint [4]. Having cramping during menstruation is one of the most common, an- noying parts of a woman’s period. The effects extend beyond individual women to society, resulting in an important loss of productivity [5]. The pain experienced by adolescents with dysmenorrhea is the most common gynecologi- cal complaint and the leading cause of recur- rent school or work absenteeism among ado- lescents and young adults [6]. In the literature, studies have shown that women with dysmen-