Worldwide prevalence of dysmenorrhea: a systematic review and meta-analysis across 70 countries.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational prevalence studies
PubMed 41031966 · doi:10.1097/j.pain.0000000000003768
What was done
Systematic review and meta-analysis of 6 databases (2000–2024) without language restrictions to estimate the worldwide prevalence of dysmenorrhea, primary dysmenorrhea (PD), and secondary dysmenorrhea (SD). Risk of bias was evaluated with the Joanna Briggs Institute tool, heterogeneity with I2, and certainty of evidence with GRADE modified for prevalence studies.
What was found
Across 336 included studies (49.4% from Asia), the pooled worldwide prevalence was 71.3% (95% CI 68.7%-73.8%) for dysmenorrhea overall, 73% (95% CI 68%-78%) for PD, and 35% (95% CI 19%-56%) for SD. Prevalence was highest in Central America (89.6%), Sri Lanka (97.7%), among adults (73.3%), and in university settings (78.4%). Heterogeneity was extreme across all subgroup analyses (I2 = 99.5%-100%) with very low certainty of evidence.
Why it matters
It aggregates data across 70 countries to show that dysmenorrhea affects approximately 70% of menstruating individuals worldwide, establishing a benchmark for global health prioritization.
Limits
Certainty of evidence was rated very low by GRADE due to extreme between-study heterogeneity (I2 = 99.5%-100%). Nearly half of all studies were conducted in Asia, and differences in diagnostic definitions or self-reporting instruments were not detailed in the abstract.