Date of Award

11-4-2024

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr Jai Das

Second Advisor

Ms. Arjumand Rizvi

Third Advisor

Dr. Unab Khan

Department

Community Health Sciences

Abstract

Introduction: Primary dysmenorrhea (PD) is a prevalent and multifactorial condition among adolescent girls worldwide. Despite its high prevalence, it remains under-researched in rural Pakistan. This study aims to assess the relationship between BMI, nutritional status, lifestyle factors, menstrual health, and PD in adolescent girls aged 10-19 years in TMK, Pakistan.
Methods: This representative cross-sectional household survey investigated associations between BMI, nutritional status, lifestyle factors, menstrual health, and PD in adolescent girls aged 10-19 years in TMK, Pakistan. Participants were recruited using multistage cluster sampling, and data were collected through validated questionnaires. BMI was measured using South Asian categories, and multivariable logistic regression with survey weights analyzed the relationships.
Results: The weighted prevalence of primary dysmenorrhea (PD) was 60.4% (95% CI: 54%-66%). Overweight/obese participants had lower odds of PD (AOR: 0.3, 95% CI: 0.1-0.9). Higher odds of PD were associated with being physically inactive, having inadequate sleep, and experiencing menarche after age 12, respectively (AOR: 1.8, 95% CI: 1.2-2.9; AOR: 2.4, 95% CI: 1.2-3.8; AOR: 1.0, 95% CI: 0.3-3.3). Changing pads more than every 6 hours and reusing cloth pads were also linked to higher PD odds (AOR: 2.3, 95% CI: 1.5-3.6; AOR: 1.9, 95% CI: 0.8-4.4). Being the eldest or middle child correlated with higher PD odds (AOR: 1.1, 95% CI: 0.6-1.9; AOR: 1.8, 95% CI: 1.0-3.3). Conversely, higher Vitamin B6 intake was protective (AOR: 0.97, 95% CI: 0.95-0.99), and increased carbohydrate intake was associated with higher PD risk (AOR: 1.02, 95% CI: 0.9-1.05).
Conclusion: This study highlights that overweight and obesity reduce primary dysmenorrhea (PD) odds, with key preventive factors being lower carbohydrate intake, higher vitamin B6, adequate sleep, physical activity, and good menstrual hygiene. Late menarche, delayed hygiene practices, and limited access to reusable pads increase PD risk. The potential role of age at menarche as a mediator between overweight and PD requires further Page 14 of 141 exploration. Targeted health interventions and policies are needed to improve menstrual health and support gender equality, aligning with SDG 5.

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Last Page

132

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