Dysmenorrhea and associated symptoms in Ethiopia: A systematic review and meta-analysis

Introduction: Dysmenorrhea is the most common gynecologic compliant and reproductive health problem among adolescents, young, and reproductive age group. Dysmenorrhea has psychological, physical, and behavioral impact on adolescent girls in different regions. Objective: This systematic review and meta-analysis aimed to assess the overall prevalence of dysmenorrhea, its pain intensity and associated symptoms in Ethiopia and compare with other countries. Methods: Literatures from PubMed, MEDLINE, EMABSE, CINHAL, SCOPUS, Hinari, Africa journals, and Google scholar were retrieved. Eligible cross-sectional studies were included for meta-analysis. I-2 statistics was calculated to check heterogeneity. Subgroup analysis based on outcome of interest was performed. Sensitivity analysis was undertaken to examine the level of heterogeneity. Results: The prevalence of overall and primary dysmenorrhea in Ethiopia was 72% (95%CI 68-77) and 72.27% (95%CI 69.8-75.33) respectively. Back pain 56.62% (95%CI 46.68-66.57) and fatigue 51.51% (95%CI 40.08-62.94) were more common than headache 29.15% (95%CI 18.16-40.14) whereas moderate pain 41.03% (95%CI 33.98-48.07) was more common than mild 31.83% (95%CI 21.61-42.05) and severe pain intensity 21.57% (95%CI 14.24-28.89). The prevalence between small and large samples, Northern and South/West Ethiopia, and school girls and university students were nearly similar. Positive family history (OR = 4.05; 95%CI 3.15-5.20), early menarche (OR = 2.91; 95%CI 2.00-4.24) and irregular monthly menstrual cycle (OR = 1.87, 95%CI 1.23-2.84) were the predictors of dysmenorrhea. Conclusion: Compared with other countries, the prevalence of dysmenorrhea in Ethiopia is moderate, presenting as mainly back pain and fatigue with moderate pain intensity. Positive family history, early menarche, and irregular menstrual cycle are the positive contributing factors.