Dysmenorrhea and its impact on the health-related quality of life of adolescent girls.

Dysmenorrhea, more commonly known as period-related pelvic pain, is a highly prevalent complaint among adolescent girls. Previous research has shown that up to 92% of adolescent girls (<18 years) report some form of menstrual pain, which is often poorly managed. Although evidence suggests that dysmenorrhea can have a profound negative impact on many aspects of adolescents’ lives, research on this topic is still in its infancy. This work summarises the findings from one systematic review, two empirical qualitative studies conducted with adolescents and mothers, and one quantitative questionnaire study developed to address the gap in the current literature. In-depth, individual interviews were conducted with 20 adolescents (aged 12-18 years) experiencing dysmenorrhea, and 20 mothers of daughters with dysmenorrhea. This explorative research demonstrated that dysmenorrhea can have a profound negative impact on all aspects of the adolescents’ health-related quality of life (HRQoL). The adolescents interviewed reported that dysmenorrhea had a negative impact on their psychological, social, physical and school functioning, and well-being. Mothers also reported that dysmenorrhea had a negative impact on many aspects of family functioning, including increased tensions within households and financial implications (e.g., mothers taking time off of work to care for their daughters). Exploratory qualitative methods allowed the adolescents and their mothers to provide detailed accounts of their experiences in their own voices. As a result, several novel findings came from these studies including that, for some adolescents, there was a perceived positive impact of dysmenorrhea. In addition, both sets of interviews showed that there were a variety of misconceptions about the causes and treatments of dysmenorrhea. The findings from the review of the existing literature and two qualitative studies informed the development of a working model whereby psychosocial factors influenced quality of life (QoL) outcomes among adolescent girls experiencing dysmenorrhea. The final, quantitative study of 333 adolescent girls aged 13-18 years showed that perception of other bodily symptoms (β=-.314, p=.000), levels of anxiety (β= -.194, p=.004) and depression (β= -.165, p=.005), usual severity of menstrual pain (β= -.152, p=.013), and pain coping (β= -.103, p=.035) significantly predicted QoL outcomes among adolescents experiencing dysmenorrhea. Family functioning and pain severity of the most recent menstruation did not significantly predict QoL outcomes. As predicted, psychological factors predicted QoL outcomes over and above the severity of pain. These findings can be used to inform the development of psychological interventions to improve QoL outcomes among adolescent girls experiencing dysmenorrhea. The final chapter of this thesis explores the implications of these findings for adolescent girls, their families, health care professionals, and future research