Recognizing the usage of analgesics among Saudi women with primary dysmenorrhea

Primary dysmenorrhea (PD) is defined as the pain that occurs during the menstrual cycle (MC) in the absence of a distinguishable reason. The purpose of this study was to investigate the application of analgesics during dysmenorrhea among Saudi women. This was a cross-sectional study that was carried out by distributing an electronic questionnaire to selected subjects between June 2022 and January 2023. The questionnaire consisted of three sections including 25 questions relating to subject demographics, the characteristics of dysmenorrhea, and the use of analgesics. In total, 1011 females were involved in this study, with a mean age of 23.5 ± 12.8 years. We found that a family history of dysmenorrhea was not associated with PD. In total, 37.9% of subjects reported that the pain began before MC while 58.1% of subjects reported that pain began during their cycle. In addition, 68.5% of females stated that the pain associated with dysmenorrhea affected their daily activities. Analysis showed that 76.2% of females used analgesics for dysmenorrhea while 23.8% did not use any analgesics. The majority of users reported taking Paracetamol, followed by Ibuprofen, and Diclofenac, while 9% used other drugs or herbs. With regards to the timing of analgesic administration, 89.7% of subjects stated that they used analgesics as needed, whereas 10.3% reported using analgesics before the pain began. Furthermore, 66.9% of subjects reported using analgesics after meals whereas 22.5% reported using analgesics before meals. However, 20% of subjects used analgesics after consulting healthcare personnel, including doctor/pharmacists. Our anlaysis revealed that females exhibited reluctance in pursuing medical assistance and preferred to consult family members, friends and internet resources, thus resulting in a lower efficacy of the analgesic drugs taken.

Dysmenorrhea; Analgesics; Quality of life; Women

[1] Cortes H, Hernández-Parra H, Bernal-Chávez SA, Caballero-Florán IH, Aguilar-Vázquez R, Del Prado-Audelo ML, et al. Current status of the therapeutic approach for dysmenorrhea. Cellular and Molecular Biology. 2023; 69: 52–63.

[2] Ma H, Li LY, Zhang BY, Chen J, Yuan S, Wang GZ, et al. Research progress on pathogenesis and treatment of primary dysmenorrhea. Advances in Obstetrics and Gynecology Research. 2023; 1: 20–30.

[3] Gutman G, Nunez AT, Fisher M. Dysmenorrhea in adolescents. Current problems in pediatric and adolescent health care. 2022; 52: 101186.

[4] Almanasef M, Alqarni H. Self-care strategies for the management of primary dysmenorrhea among young women in Asir region, Saudi Arabia: a cross-sectional study. European Review for Medical & Pharmacological Sciences. 2023; 27: 172–178.

[5] Al-Husban N, Odeh O, Dabit T, Masadeh A. The influence of lifestyle variables on primary dysmenorrhea: a cross-sectional study. International Journal of Women’s Health. 2022; 14: 545–553.

[6] Fitrianingsih ADR, Santanu AM. Primary dysmenorrhea risk based on characteristics, dietary habits, and types of exercise. Jurnal Ilmu Kesehatan Masyarakat. 2021; 12: 21–37.

[7] Karout S, Soubra L, Rahme D, Karout L, Khojah HMJ, Itani R. Prevalence, risk factors, and management practices of primary dysmenorrhea among young females. BMC Women’s Health. 2021; 21: 392.

[8] Kant A, Kannan J, Chandra S, Chandravati, kalra B, Mary H, et al. Unraveling prostaglandin and NLRP3 inflammasomemediated pathways of primary dysmenorrhea and the role of mefenamic acid and its combinations. Indian Journal of Clinical Practice. 2023; 33: 41–46.

[9] MacGregor B, Allaire C, Bedaiwy MA, Yong PJ, Bougie O. Disease burden of dysmenorrhea: impact on life course potential. International Journal of Women’s Health. 2023; 15: 499–509.

[10] Tsonis O, Gkrozou F, Barmpalia Z, Makopoulou A, Siafaka V. Integrating lifestyle focused approaches into the management of primary dysmenorrhea: impact on quality of life. International Journal of Women’s Health. 2021; 13: 327–336.

[11] Fuentes-Aparicio L, Cuenca-Martínez F, Muñoz-Gómez E, Mollà-Casanova S, Aguilar-Rodríguez M, Sempere-Rubio N. Effects of therapeutic exercise in primary dysmenorrhea: an umbrella & mapping review therapeutic exercise in primary dysmenorrhea. To be published in Pain Medicine. 2023. [Preprint].

[12] Choksey R, Mangal RK, Stead TS, Jones T, Flores R, Ganti L. Quantifying the impact of dysmenorrhea symptoms on quality-of-life and access to oral contraceptives by income. Health Psychology Research. 2023; 11: 74120.

[13] Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean Journal of Family Medicine. 2022; 43: 101–108.

[14] Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database of Systematic Reviews. 2015; 2015: CD001751.

[15] Alsaleem M. Dysmenorrhea, associated symptoms, and management among students at King Khalid University, Saudi Arabia: an exploratory study. Journal of Family Medicine and Primary Care. 2018; 7: 769–774.

[16] Mannasaheb BA, Alajlan SA, Alshahrani JA, Othman N, Alolayan SO, Alamrah MS, et al. Prevalence, predictors and point of view toward self-medication among residents of Riyadh, Saudi Arabia: a cross-sectional study. Frontiers in Public Health. 2022; 10: 862301.

[17] Daniel WW, Cross CL. Biostatistics: a foundation for analysis in the health sciences. 11th edn. Wiley: Michigan. 2018.

[18] Hassan SA, Moussa BA. Prevalence of dysmenorrhea and its impact on daily activities among women in Babylon city. Medical Journal of Babylon. 2022; 19: 680–690.

[19] Kahal F, Alshayeb S, Torbey A, Al Helwani O, Kadri S, Helwani A, et al. The prevalence of menstrual disorders and their association with psychological stress in Syrian students enrolled at health-related schools: a cross-sectional study. To be published in International Journal of Gynecology & Obstetrics. 2023. [Preprint].

[20] Hashim RT, Alkhalifah SS, Alsalman AA, Alfaris DM, Alhussaini MA, Qasim RS, et al. Prevalence of primary dysmenorrhea and its effect on the quality of life amongst female medical students at King Saud University, Riyadh, Saudi Arabia. Saudi Medical Journal. 2020; 41: 283–289.

[21] Abdel-Salam DM, Alnuman RW, Alrwuaili RM, Alrwuaili GA, Alrwuaili EM. Epidemiological aspects of dysmenorrhea among female students at Jouf University, Saudi Arabia. Middle East Fertility Society Journal. 2018; 23: 435–439.

[22] Bakhsh H, Algenaimi E, Aldhuwayhi R, AboWadaan M. Prevalence of dysmenorrhea among reproductive age group in Saudi Women. BMC Women’s Health. 2022; 22: 78.

[23] Ali A, Ali A, Alotaibi NS, Alsufyani MS, Alotaibi AJ, Almutairi MM, et al. Prevalence, impact, and management perception of dysmenorrhea among university students: a cross-sectional study. Brazilian Journal of Pharmaceutical Sciences. 2022; 58: e20458.

[24] Alhammadi MH, Albogmi AM, Alzahrani MK, Shalabi BH, Fatta FA, AlBasri SF. Menstrual cycle irregularity during examination among female medical students at King Abdulaziz University, Jeddah, Saudi Arabia. BMC Women’s Health. 2022; 22: 367.

[25] Sharghi M, Mansurkhani SM, Ashtary-Larky D, Kooti W, Niksefat M, Firoozbakht M, et al. An update and systematic review on the treatment of primary dysmenorrhea. JBRA Assisted Reproduction. 2019; 23: 51–57.

[26] Oksuz E, Sozen F, Kavas E, Arik EP, Akgun Y, Bingol P, et al. Usage of analgesics among young girls and dysmenorrhea. Konuralp Medical Journal. 2017; 9: 213–221.

[27] Ibrahim NK, AlGhamdi MS, Al-Shaibani AN, AlAmri FA, Alharbi HA, Al-Jadani AK, et al. Dysmenorrhea among female medical students in King Abdulaziz University: prevalence, predictors and outcome. Pakistan Journal of Medical Sciences. 2015; 31: 1312–1317.

[28] Donayeva A, Amanzholkyzy A, Nurgaliyeva R, Gubasheva G, Saparbayev S, Ayaganov D, et al. The impact of primary dysmenorrhea on the adolescents’ activities and school attendance. Research Square. 2023. [Preprint].

[29] Wildayani D, Lestari W, Ningsih WL, Sujendri S. The relationship between physical activity level and dysmenorrhoea in young women. The Medical Journal of Malaysia. 2023; 78: 495–499.

[30] Durand H, Monahan K, McGuire BE. Prevalence and impact of dysmenorrhea among university students in Ireland. Pain Medicine. 2021; 22: 2835–2845.

[31] Zaman AY, Alameen AM, Alreefi MM, Kashkari ST, Alnajdi SA, Shararah AA, et al. Comparison of herbal medicines and pain relief medications in the treatment of primary dysmenorrhoea among female medical students at Taibah University. Journal of Taibah University Medical Sciences. 2023; 18: 455–460.

[32] Nie W, Xu P, Hao C, Chen Y, Yin Y, Wang L. Efficacy and safety of over-the-counter analgesics for primary dysmenorrhea: a network meta-analysis. Medicine. 2020; 99: e19881.

[33] Xuan Y, Zhang H, Liu D, Huang Y, Li L, Cao Q, et al. The efficacy and safety of simple-needling for the treatment of primary dysmenorrhea compared with ibuprofen: a systematic review and meta-analysis. Medicine. 2022; 101: e28919.

[34] Syed N, Waliwitiya T. Evaluating the effectiveness of NSAIDs and vasopressin receptor antagonists as primary dysmenorrhea treatments. The Meducator. 2022; 1: 17–19.

[35] Hewitt GD, Gerancher KR. ACOG committee opinion No. 760 summary: dysmenorrhea and endometriosis in the adolescent. Obstetrics and Gynecology. 2018; 132: 1517–1518.

[36] Dong Y, Li MJ, Hong YZ, Li WJ. Insight into dysmenorrhea research from 1992 to 2022: a bibliometric analysis. Journal of Pain Research. 2023; 16: 3591–3611.

[37] Proctor ML, Farquhar CM. Dysmenorrhoea. BMJ clinical evidence. 2007; 2007: 0813.

[38] Ribeiro H, Rodrigues I, Napoleão L, Lira L, Marques D, Veríssimo M, et al. Non-steroidal anti-inflammatory drugs (NSAIDs), pain and aging: adjusting prescription to patient features. Biomedicine & Pharmacotherapy. 2022; 150: 112958.

[39] Oladosu FA, Tu FF, Hellman KM. Nonsteroidal antiinflammatory drug resistance in dysmenorrhea: epidemiology, causes, and treatment. American Journal of Obstetrics and Gynecology. 2018; 218: 390–400.

[40] Abdel-Salam DM, Albahlol IA, Almusayyab RB, Alruwaili NF, Aljared MY, Alruwaili MS, et al. Prevalence, correlates, and barriers of contraceptive use among women attending primary health centers in aljouf region, Saudi Arabia. International Journal of Environmental Research and Public Health. 2020; 17: 3552.

[41] Al-Husban N, Odeh O, Dabit T, Masadeh A. The influence of lifestyle variables on primary dysmenorrhea: a cross-sectional study. International journal of women’s health. 2022; 14: 545–553.

[42] Al-Matouq S, Al-Mutairi H, Al-Mutairi O, Abdulaziz F, Al-Basri D, Al-Enzi M, et al. Dysmenorrhea among high-school students and its associated factors in Kuwait. BMC Pediatrics. 2019; 19: 80.

[43] Ameade EPK, Amalba A, Mohammed BS. Prevalence of dysmenorrhea among university students in Northern Ghana; its impact and management strategies. BMC Women’s Health. 2018; 18: 39.

[44] Ramos-Pichardo JD, Ortega-Galán ÁM, Iglesias-López MT, Abreu-Sánchez A, Fernández-Martínez E. Why do some Spanish nursing students with menstrual pain fail to consult healthcare professionals? International Journal of Environmental Research and Public Health. 2020; 17: 8173.

[45] Teherán AA, Piñeros LG, Pulido F, Mejía Guatibonza MC. WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students. International Journal of Women’s Health. 2018; 10: 35–45.