The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, India


Dr V Patel, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E7HT, UK. Email:


Objective  To describe the prevalence and determinants of dysmenorrhoea, the most common menstrual complaint, in a community in India.

Design  Cross-sectional survey.

Setting  Catchment area of primary health centre in Goa, India.

Population  Three thousand women aged 18–45 years randomly selected. A total of 2494 women consented to participate (83.1%).

Methods  Eligible participants were asked standardised questions regarding menstrual complaints over the past 12 months, and socio-demographic, psychosocial and reproductive risk factors. Vaginal or urine specimens were collected for the diagnosis of reproductive tract infections.

Main outcome measures  Dysmenorrhoea of moderate to severe intensity.

Results  A total of 2262 women were eligible. More than half reported dysmenorrhoea; moderate to severe dysmenorrhoea was reported by 755 participants (33.4%, 95% CI 31.4–35.4). There was a linear association between severity of pain and impact (medication and taking rest) and the onset of pain (premenstrual onset associated with more severe pain). On multivariate analyses, the risk of moderate–severe dysmenorrhoea was associated with the experience of violence (OR 2.23, 95% CI 1.5–34); other somatic complaints (OR 3.67, 95% CI 2.7–4.9 for highest somatoform symptom score category compared with the lowest); gynaecological complaints (non-menstrual lower abdominal pain: OR 1.78, 95% CI 1.3–2.3; dysuria: OR 1.98, 1.4–2.7); menorrhagia (OR 1.92, 95% CI 1.4–2.6); and illiteracy (OR 1.32, 95% CI 1.0–1.7). Having had a pregnancy (OR 0.53, 95% CI 0.4–0.7), older age of menarche (OR 0.70, 95% CI 0.5–0.9, for age >14 compared with <13 years) and older age (OR 0.43, 0.3–0.6 for age 40–50, compared with 18–24 years) were protective.

Conclusions  The burden of dysmenorrhoea is greater than any other gynaecological complaint, and is associated with significant impact. Social disadvantage, co-morbidity with other somatic syndromes and reproductive factors are determinants of this complaint.