This study shows a prevalence of dysmenorrhea at 80.1%, which is comparable to studies done in northern Ethiopia, Nigeria (7, 10), and Morocco(2, 7, 10) whereas the finding of this study was higher than those of the study done in eastern Ethiopia; 69.3%(23). Mekelle University; 71.8% (9) and Kenyan 68.1% (17). The finding of this study was lower than the finding of Kuwait University (24), Lithuania Vilnius University (13), and a study done in Turkey. (1). the variation is due to the assessment tool, method of data collection, and socio-cultural, ethnic, and lifestyle factors among females. Moreover, menstruation is considered a private issue in many cultures hence its associated complaints might be kept silently by most females
In this study, the prevalence of dysmenorrhea was 80% (277), using the Numeric Pain Rating Scale out of 277 students with dysmenorrhea 21.7% (60), 33.2% (92), 37.5%, (104), and 7.6% (26) of the respondents reporting the mild, moderate, severe and very severe intensity of pain, respectively. It is similar to one study where 47.4% of unmarried women reported severe and worst pain. (27).
According to the verbal multidimensional scoring system, 132 (38.1%) students had grade I, mild pain, and 110 (32.1%) females had grade II, moderate pain. Additionally, in 10.1% (35) of students, daily activity was inhibited by dysmenorrhea, and the effect of analgesics to give relief to the pain was insignificant (grade III, severe pain). This matches with the other findings in Ethiopia, In an Indian study, 55.26% of unmarried women reported that they use anti-pain on the second of menses(10, 27). So irrespective of the pain scoring methods, near to half of the female students were suffering from severe pain during menstruation.
Of the respondents with dysmenorrhea, 83% reported that the disorder interferes with their academic performance which was in line with the findings in northern Ethiopia and slightly lower than the study at Debre Brehan. (9, 10) but higher than finding Ghana and Turkey (1, 17). It may be due to socio-cultural differences, differences in pain tolerance between the populations as well as methodological differences. Additionally, this might be due to the questionnaire design on part of academic activities: ours had options (no affected, mildly affected, moderately affected, and severely affected), whereas the above Turkey and Ghana studies had Yes/No options. The student with mild negative effects might have chosen No in the Yes/No options.
Our finding was higher than the finding of the largest study so far to look into the impact of dysmenorrhea; 38% of all women reported dysmenorrhea interfering with their regular daily activities. (6). the difference may be due to the difference in the source population. Dysmenorrhea interfered with the concentration of 86.6% of females which was higher than the finding at Debre Brehan, Ghana, Australia (10, 17, 25). More than two-thirds 72.6%, reported dysmenorrhea had interfered with their relationship (mild in 39.4% and moderate to severe in 33.2%). Which was higher than the finding of the study at Debre Brehan, at Mekelle, Ghana Australia (9, 10, 17, 25).as well as lower than in Turkey where 92% reported personal relationship was negatively affected by dysmenorrhea. (1). this might be due to the questionnaire design on part of academic activities and differences in the study population. So due to the effect of dysmenorrhea personal relationships and concentration are significantly affected.
Almost half of the students with dysmenorrhea, 49.1% absent from class during the time of menses for 1–2 days. The common reason for class absence was pain intensity, reported at 80.1%. Our finding was higher than the finding of the study at Mekelle, Ghana, and Australia (9, 17, 25) as well as lower than the study at Debre Brehan and Gondar (8, 10).
Being sexually active was the determinant factor of dysmenorrhea. Sexually active female students are 70% less likely to develop dysmenorrhea compared to those who were not sexually active. This may be due to sexually active women being more likely to use hormonal contraception options, which are protective for dysmenorrhea.
A student whose mother and sister have a history of dysmenorrhea has an eight- and four-times increased risk to have dysmenorrhea compared to those whose mother had no dysmenorrhea. Most studies revealed that females who had a positive family history of dysmenorrhea were more likely to develop dysmenorrhea(8, 9) (16),(15). This study showed the presence of positive screening for depression were significantly associated with dysmenorrhea, participant with positive screening for depression were at a 5.7 times higher risk to have dysmenorrhea compared with those who had no history of depression. Mood disorders were associated with dysmenorrhea as this group has hypersensitivity to pain (11). Having depression was associated with a higher risk of dysmenorrhea (10). Furthermore, the strong effect of being depressed most of the time is associated with the risk of menstrual pain with an odds ratio of 13.3(26)
The study tried to assess the factors and impacts of dysmenorrhea in young females,
The study used two different scoring methods especially numerical pain scoring have not been used widely in the literature.
Limitation of the study
The other possible cause for secondary dysmenorrhea like endometriosis, PCOS (polycystic ovarian syndrome), and so on were not excluded since they need investigations
The cross-sectional study lacks cause and effect association