Factors Associated with Increased Pain in Primary Dysmenorrhea: Analysis Using a Multivariate Ordered Logistic Regression Model

Study Objective: In the literature about primary dysmenorrhea (PD), either a pain gradient has been studied just in women with PD or pain was assessed as a binary variable (presence or absence). Accordingly, we decided to carry out a study in young women to determine possible factors associated with intense pain. Design: A cross-sectional observational study. Setting: A Spanish University in 2016. Participants: A total of 306 women, aged 18-30 years. Interventions: A questionnaire was filled in by the participants to assess associated factors with dysmenorrhoea. Main Outcome Measures: Our outcome measure was the Andersch and Milsom scale (grade from 0 to 3). Definition: grade 0 (menstruation is not painful and daily activity is unaffected), grade 1 (menstruation is painful but seldom inhibits normal activity, analgesics are seldom required, and mild pain), grade 2 (daily activity affected, analgesics required and give relief so that absence from work or school is unusual, and moderate pain), and grade 3 (activity clearly inhibited, poor effect of analgesics, vegetative symptoms and severe pain). Results: Factors significantly associated with more extreme pain: a higher menstrual flow (odds ratio [OR], 2.11; P < .001), a worse quality of life (OR, 0.97; P < .001) and use of medication for PD (OR, 8.22; P < .001). Conclusion: We determined factors associated with extreme pain in PD in a novel way. Further studies are required to corroborate our results.