Comparison of Pain, Physical, and Psychosocial Parameters in Women With and Without Primary Dysmenorrhea

Comparison of Women With andWithout Primary Dysmenorrhea in Terms of Pain Threshold, Joint Mobility, PhysicalActivity Habit Level, Respiratory Muscle Strength, Menstruation Attitudes andDepressive Symptoms

Dysmenorrhea is a common gynecological condition that negatively affects women's physical, psychological, and social well-being. Primary dysmenorrhea (PD) has been associated with reduced pain thresholds in various body regions; however, evidence regarding its relationship with joint mobility, respiratory muscle strength, and psychosocial factors remains limited. In addition, the influence of menstrual attitudes, physical activity habits, and depressive symptoms in women with PD has not been sufficiently explored. Therefore, this study aims to compare women with and without primary dysmenorrhea in terms of pain threshold, joint mobility, physical activity level, respiratory muscle strength, menstrual attitudes, and depressive symptoms. Identifying the parameters affected by PD is essential for developing effective management strategies and may contribute to increased awareness and improved clinical approaches for primary dysmenorrhea.

Dysmenorrhea is a very common gynecological problem among women during the menstrual period and is defined as "painful menstruation." The pain is most commonly experienced in the abdominal and lumbar regions and is typically described as cramping and colicky in nature. Symptoms such as nausea, vomiting, headache, and leg pain may accompany the pain in dysmenorrhea. Dysmenorrhea leads to decreased work productivity, increased tension in social life, and absenteeism from school or work. Dysmenorrhea is classified into two types: primary and secondary.

In women with primary dysmenorrhea (PD), pressure, heat, and electrical pain thresholds in the abdominal, paravertebral, and extremity regions have been shown to decrease during the menstrual phase. However, research on painful pelvic floor regions in women with PD is still in its early stages. There is very limited published data in the literature addressing the optimal management of women with hypermobility and abnormal uterine bleeding. Therefore, it is necessary to determine the relationship between joint mobility and PD. Similarly, no studies have been found examining PD and respiratory muscle strength. On the other hand, positive or negative beliefs related to menstruation and cultural factors may also influence menstrual attitudes. Although a positive relationship between dysmenorrhea and depression is assumed, the evidence remains controversial and limited.

In light of this information, it is of interest to investigate how all these parameters differ in women with PD compared to women without PD. Therefore, the aim of this study is to compare women with and without primary dysmenorrhea in terms of pain threshold, joint mobility, physical activity level, respiratory muscle strength, menstrual attitudes, and depressive symptoms. Identifying which parameters are affected in PD is important for clinicians and researchers in order to determine effective management strategies for primary dysmenorrhea. Thus, it is believed that this study will contribute to the literature by increasing awareness on this topic.

Inclusion Criteria:

• Be between 18 and 35 years of age
• Have a history of menstrual pain since the first few years after menarche
• Have a menstrual pain intensity of 4 or higher on the VAS in the last 6 months
• Have no pelvic or uterine pathology (e.g., cysts, infections, fibroids)
• Have a regular menstrual cycle
• Be willing to voluntarily participate in the study

Exclusion Criteria:

• Having a neurological, orthopedic, rheumatologic, cardiac, or pulmonary disease
• Being pregnant or suspected of pregnancy
• Having given birth
• Having undergone abdominal, pelvic, or spinal surgery within the past year
• Having a malignant disease