Menstrual health and health-related quality of life in Spain: a multicenter cross-sectional study.

Abstract

Introduction: Menstrual health plays a crucial role in health-related quality of life (HRQoL). However, there is a gap addressing HRQoL in relation to broader aspects of menstrual health definition. This study aims to analyse the relationship between menstrual health and self-reported health-related quality of life in women and people who menstruate (PWM) ≥ 18 years in five regions of Spain (Andalusia, Basque Country, Canary Islands, Catalonia, and Galicia).

Methods: A cross-sectional survey-based study with gender perspective was conducted. Thirty-two healthcare centres took part in the study across five regions of Spain between May and September 2023. Participants were women and PWM aged 18 or over with at least one menstruation in the last 6 months. Self-reported sociodemographic, menstrual health and HRQoL variables (using EQ-5D-5 L scale) were collected. Descriptive statistics and linear regression models were performed. EQ-VAS scale was employed to perform sensitivity analyses.

Results: A total of 1,381 women and PWM were included (Mean age = 34.63, SD = 10.06). The mean of EQ-5D-5 L index was 0.88 (SD = 0.13) and EQ-VAS was 73.63 (SD = 22.60). Several menstrual health variables were significantly associated with lower HRQoL. The strongest associations were observed for high frequency of premenstrual symptoms (β= -0.144; 95%CI= -0.139 to -0.090), high impact of premenstrual symptoms (β= -0.071; 95%CI= -0.102 to -0.040), high impact on social participation during menstruation (β= -0.104; 95%CI= -0.128 to -0.080), moderate frequency of menstrual poverty (β= -0.054; 95%CI= -0.078 to -0.029) and menstrual pain intensity (β= -0.047; 95%CI= -0.068 to -0.025).

Conclusions: These findings highlight the substantial impact of menstrual health on HRQoL, particularly in some EQ-5D-5 L domains (usual activities, anxiety/depression, and pain/discomfort). From a public health perspective, it is important to recognise menstrual health as a relevant component of overall well-being of women and PWM. Specifically paying greater attention to menstrual health relation to general pain, emotional health and participation in daily activities when designing health promotion and primary healthcare interventions.