Burden, impacts and management practices of dysmenorrhea among female students in Ethiopia: a systematic review and meta-analysis.

Abstract

Dysmenorrhea is a public health problem worldwide, and affects more than half of reproductive-age females in Ethiopia. Despite dysmenorrhea having being studied, this has not covered the impacts and management of dysmenorrhea. Therefore, this review aimed at critically appraising, synthesizing and presenting the evidence on the burden, impacts and management methods of dysmenorrhea among females in Ethiopia. International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google and Google Scholar) and lists of references were employed to search literature in Ethiopia. The overall burden of dysmenorrhea was presented using a random-effects model for the reported proportion by forest plot using STATA version 18. The heterogeneity of the studies was determined using p=0.05 for I2 statistics. In addition, sensitivity analyses were performed to examine the stability of pooled values in the presence of outliers. Furthermore, Egger's regression test and funnel plot were performed to check for potential publication bias. A total of 20 studies and a population of 8713 were included in the review. The overall burden of dysmenorrhea among females was 73% (95% CI 68 to 77%), with I2=96.04. Psychological problems (59.9%), poor concentration (42.3%) and absenteeism from the class (41.3%) were the common impacts of dysmenorrhea, and bed rest (54%), use of painkillers (41.5%) and hot drinks (41.3%) were commonly practiced treatments by participants. Around three out of four females experienced dysmenorrhea. Enhancing social support may reduce stress; and behavioral interventions such as mind-body awareness and relaxation training are believed to help decrease the risk of depression by alleviating dysmenorrhea. Both pharmacological and non-pharmacological therapy have played a crucial role in its management. But the literature offers controversial scientific proof, and imply that high-quality trials are needed to make conclusive recommendations for better management methods of dysmenorrhea.