Prevalence of Dysmenorrhea and Its Association with Body Mass Index among Female College Students in Sulaymaniyah: A Cross-Sectional Survey Study

Abstract

Background: Dysmenorrhea is a periodic, cramping pain sensation, typically experienced in the lower abdomen before or during menstruation. It is among the most common gynecologic issues affecting female students. It is a frequent cause of college absence in this age group and can negatively affect academic performance. In addition, overweight and obesity are common health concerns among females. Objectives: The purpose of this study was to investigate the relationship between body mass index (BMI) and dysmenorrhea. Although previous studies suggest a possible association, the evidence remains inconclusive due to existing gaps in knowledge. Therefore, this study aims to determine the prevalence and severity of dysmenorrhea among female college students in Sulaymaniyah across different BMI categories and to evaluate the association between BMI, dysmenorrhea intensity, and related risk factors. Methodology: A cross-sectional study was conducted from January 2024 to March 2024 among female college students aged 18–24 years (n = 362) from eight universities in Sulaymaniyah. Participants were assessed using a self-administered questionnaire to determine BMI, dysmenorrhea prevalence, intensity, and associated risk factors, with pain severity evaluated using the Visual Analog Scale (VAS). BMI levels and associated risk factors were compared according to the dysmenorrhea presence and severity. Results: The overall prevalence of dysmenorrhea among participants was 91.2%. Regarding pain severity, 14.7% reported mild pain, 41.4% reported moderate pain, and 35.1% reported severe pain, while 8.8% reported no dysmenorrhea. The mean BMI demonstrated a decreasing trend with increasing pain severity. Participants with severe dysmenorrhea had the lowest mean BMI (22.57 ± 4.05 kg/m²; n = 150), followed by those with moderate dysmenorrhea (22.95 ± 3.78 kg/m²; n = 177) and mild dysmenorrhea (23.21 ± 3.76 kg/m²; n = 24). In contrast, participants without dysmenorrhea had the highest mean BMI (24.08 ± 3.89 kg/m²; n = 11). Statistical analysis revealed no significant association between BMI and the presence or severity of dysmenorrhea. However, significant associations were identified between dysmenorrhea (and its severity) and menstrual irregularity, heaviness of menstrual blood loss, and positive family history (p < 0.05). Conclusion: Dysmenorrhea is highly prevalent among female college students in Sulaymaniyah, with greater severity observed in individuals with menstrual irregularities, heavy bleeding, or a positive family history. Body mass index (BMI) was not significantly associated with dysmenorrhea, suggesting that it may not be a major contributing factor. These findings highlight the importance of routine screening and targeted reproductive health education, and further research is needed to investigate other biological, genetic, and lifestyle contributors to menstrual pain.