Primary dysmenorrhea with and without premenstrual syndrome: variation in quality of life over menstrual phases
The majority of studies on quality of life (QoL) of women with menstrual disturbances have not taken menstrual cycle phase into account. We aimed to determine the size of changes in QoL score during perimenstrual week compared to those during late follicular phase in women suffering from dysmenorrhea with or without premenstrual syndrome (PMS) and also to compare the two groups.
In this observational analytical study, participants were selected purposively from among single students aged 18–30 years, who were residing at university dormitories in Tabriz, Iran, and had moderate or severe dysmenorrhea. They reported quality of their life during the past week using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) at two time points, days 3–4 and 11–12, of their menstrual cycle.
Among 52 participants with PMS and 64 without PMS, about half reported severe dysmenorrhea. The mean total quality score was significantly lower during perimenstrual week than during late follicular phase in both group with PMS [48 vs 79, mean difference − 31 (95% confidence interval − 37 to − 26)] and group without PMS [56 vs 78, − 1 (− 27 to − 18)]. The score was significantly lower in the group with PMS than in those without PMS during perimenstrual week [− 8 (− 13 to − 2)] but not during late follicular phase [2.1 (− 2.9 to 7.0)].
Dysmenorrhea with or without PMS significantly reduces QoL of women during perimenstrual week. The QoL is slightly lower in group with PMS during perimenstrual week but not during late follicular phase.
KeywordsPrimary dysmenorrhea Premenstrual syndrome Quality of life Pain Menstrual phase
This paper has been extracted from thesis of MSc student in Midwifery. Appreciation goes to research deputy of the Tabriz University of Medical Sciences for their financial support. This project was approved by ethics committee of the university (Ethical Code: TBZMED.rec.1394.881, Date 2016-01-04). We send our deep appreciation to all students who patiently participated in this study.
All of the authors contributed to the conception and design of the study. FQ recruited the participants, collected the data, and wrote the first draft of the paper. FQ and SMAC analyzed the data. SMAC and MM revised the manuscript. All the authors read and approved the final manuscript.
- 5.Latthe, P. M., Champaneria, R., & Khan, K. S. (2011). Dysmenorrhoea. BMJ Clinical Evidence, 2, 813.Google Scholar
- 6.Dawood, M. Y. (2006). Primary dysmenorrhea: advances in pathogenesis and management. Obstetrics & Gynecology, 108, 428–441. https://doi.org/10.1097/01.AOG.0000230214.26638.0c.CrossRefGoogle Scholar
- 9.Smith, R. P., & Kaunitz, A. M. (2018) Primary dysmenorrhea in adult women: Clinical features and diagnosis. In: Eckler K (Ed.). Retrieved July 4, 2018, from https://www.uptodate.com/contents/primary-dysmenorrhea-in-adult-women-clinical-features-and-diagnosis?search=primary%20dysmenorrhea&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
- 10.O’Brien, P. M., Backstrom, T., Brown, C., Dennerstein, L., Endicott, J., et al. (2011). Towards a consensus on diagnostic criteria, measurement and trial design of the premenstrual disorders: The ISPMD Montreal consensus. Archives of Women’s Mental Health, 14, 13–21. https://doi.org/10.1007/s00737-010-0201-3.CrossRefGoogle Scholar
- 12.Sahin, S., Ozdemir, K., & Unsal, A. (2014). Evaluation of premenstrual syndrome and quality of life in university students. Journal of Pakistan Medical Association, 64, 915–922.Google Scholar
- 15.Al-Jefout, M., Seham, A. F., Jameel, H., Randa, A. Q., Ola, A. M., et al. (2015). Dysmenorrhea: Prevalence and impact on quality of life among young adult Jordanian females. Journal of Pediatric and Adolescent Gynecology, 28, 173–185. https://doi.org/10.1016/j.jpag.2014.07.005.CrossRefGoogle Scholar
- 18.Heinemann, L. A., Minh, T. D., Heinemann, K., Lindemann, M., & Filonenko, A. (2012). Intercountry assessment of the impact of severe premenstrual disorders on work and daily activities. Health Care for Women International, 33, 109–124. https://doi.org/10.1080/07399332.2011.610530.CrossRefGoogle Scholar
- 19.Raval, C. M., Panchal, B. N., Tiwari, D. S., Vala, A. U., & Bhatt, R. B. (2016). Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among college students of Bhavnagar, Gujarat. Indian Journal of Psychiatry, 58, 164–170. https://doi.org/10.4103/0019-5545.183796.CrossRefGoogle Scholar
- 21.Endicott, J., Nee, J., Harrison, W., & Blumenthal, R. (1993). Quality of Life Enjoyment and Satisfaction Questionnaire: A new measure. Psychopharmacology Bulletin, 29, 321–326.Google Scholar
- 22.Baker, F. C., Sassoon, S. A., Kahan, T., Palaniappan, L., Nicholas, C. L., et al. (2012). Perceived poor sleep quality in the absence of polysomnographic sleep disturbance in women with severe premenstrual syndrome. Journal of Sleep Research, 21, 535–545. https://doi.org/10.1111/j.1365-2869.2012.01007.x.CrossRefGoogle Scholar
- 23.Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care and Research (Hoboken), 63(Suppl 11), S240–S252. https://doi.org/10.1002/acr.20543.CrossRefGoogle Scholar
- 24.The American College of Obestetricians and Gynecologists (2015) Premenstural syndrom (PMS). Retrieved January 14, 2016, from https://www.acog.org/-/media/For-Patients/faq057.pdf?dmc=1&ts=20180212T0642252466.
- 25.Stevanovic, D. (2011). Quality of Life Enjoyment and Satisfaction Questionnaire-short form for quality of life assessments in clinical practice: A psychometric study. Journal of Psychiatric and Mental Health Nursing, 18, 744–750. https://doi.org/10.1111/j.1365-2850.2011.01735.x.CrossRefGoogle Scholar
- 26.Lee, Y. T., Liu, S. I., Huang, H. C., Sun, F. J., Huang, C. R., et al. (2014). Validity and reliability of the Chinese version of the Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). Quality of Life Research, 23, 907–916. https://doi.org/10.1007/s11136-013-0528-0.CrossRefGoogle Scholar
- 27.Tagharrobi, Z., Sharifi, K., Sooky, Z., & Tagharrobi, L. (2012). Psychometric evaluation of the Iranian version of Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-QSF). Payesh, 11, 235–244.Google Scholar