• V Patel, V Tanksale, M Sahasrabhojanee, S Gupte, and P Nevrekar.
• London School of Hygiene & Tropical Medicine, London, UK. vikram.patel@lshtm.ac.uk
• BJOG. 2006 Apr 1;113(4):453-63.

ObjectiveTo describe the prevalence and determinants of dysmenorrhoea, the most common menstrual complaint, in a community in India.DesignCross-sectional survey.SettingCatchment area of primary health centre in Goa, India.PopulationThree thousand women aged 18-45 years randomly selected. A total of 2494 women consented to participate (83.1%).MethodsEligible 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 MeasuresDysmenorrhoea of moderate to severe intensity.ResultsA 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.ConclusionsThe 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.

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