Prevalence of primary dysmenorrhea
In our study we found that the prevalence of PD was 90.9%. This implies that PD is a very important concern that should be given much attention as is being given to menstrual hygiene and this should be incorporated in to the most important components of menstrual health among the University students. The results of this study is similar to that of another study in Ireland which found the prevalence of primary dysmenorrhea to be equally alarmingly high at 91.5% [30]. However, the result of this study is not consistent with that of some other studies in other contexts which found out the prevalence of PD to be low. A study in china found the prevalence of PD to be 41.7% [31]. This could be because in their study, they used random sampling method and those that could have delivered could have been included in the study and yet delivery has been shown to lead to cessation of the symptoms of primary dysmenorrhea in some women. During data collection, the research assistants used in that study were all from the same class of the participants, this could have led to information biases by the study participants during answering of the questionnaires leading to the low results of the prevalence of primary dysmenorrhea.
Primary dysmenorrhea associated symptoms among study participants
We found out that depressed mood was one of the most commonly experienced dysmenorrhea associated symptoms among the study participants. More attention should be given to the component of mental health among the female university students when addressing menstrual health issues. The result of this study is consistent with other studies which showed that there was a relationship between dysmenorrhea and depression [32].
In our study, we also found that breast engorgement was another commonly experienced symptom associated with PD among our study participants. This implies that health workers should consider breast examination on females who experience breast engorgement during menstruation so as to rule out other causes of breast engorgement and the girls who experience dysmenorrhea should be equipped with the strategies to deal with the breast engorgement. The results of our study is consistent with that in other studies which also found breast engorgement as one of the most common dysmenorrhea associated symptoms [33].
In this study, we found that change in appetite was one of the most reported PD associated symptoms among the respondents (36.0%). This implies that the component of nutrition should be given due attention when handling the aspects of menstrual health. The results of this study is consistent with that of other studies on PD which found that gastrointestinal symptoms were the most reported symptoms associated with PD among the study participants [21, 34]
Management of primary dysmenorrhea associated symptoms among study participants
This study found out that the use of pain relievers were the most deployed management strategy for primary dysmenorrhea (PD). Of all the pain relievers, paracetamol was the most commonly used (29.8%). University female students should be given more knowledge regarding the medical management of PD and the most effective pain relievers so that they can use the best recommended drugs in the management of dysmenorrhea. The result of this study is similar to that of other studies on a similar topic which also found that pain relievers were among the most commonly used medical management strategy for PD and paracetamol was the most commonly used pain reliever (60.5%) [30].
We also found out that resting and relaxation were most commonly used none-drug management strategies in the management of PD among our study particpants. More attention should be put on educating the females on the most effective non-drug management strategies for PD and how to balance between productivity and management of PD. The result of this study is similar to that of other studies which also found that resting was among the most commonly used non-drug strategies in the management of PD [35].
In our study, we found that exercise was one of the most commonly used non-medical management strategy for the management of primary dysmenorrhea. Focus should be made to motivate the female undergraduate students to always exercise as it will be helpful for their general health. The result of this study is consistent with that of other studies which also found exercise to be one of the commonly used management strategies for primary dysmenorrhea[35, 36].
Study strengths and limitations
There was no screening for underlying pelvic pathology during data collection and so some of the participants who reported dysmenorrhea could have been having secondary dysmenorrhea
There could have been a recall bias among the study participants, however, we asked for the information about PD that has taken less than three months and so they could easily remember them. Since the research assistants that collected the data came from the respective faculties, there could have been social desirability bias, however, we ensured the informed consent process was properly conducted and so the participants were assured of their confidentiality. Additionally, a self-administered questionnaire was used to collect the data and the informed consent forms were separated from the questioner to ensure confidentiality.
The pain characteristics were verbally reported by the participants and therefore, there could have been some biasness or subjectivity in the responses. However, the term being used was clearly defined and so it was very easy for the participant to give an accurate estimate of the severity of the menstrual pain.