Original scientific paper

Iva Rrugia¹ , Daniela Shukova Stojmanovska² , Georgi Georgiev²

https://doi.org/10.46733/PESH25142103r

Abstract

Primary dysmenorrhea is a prevalent gynecological condition that significantly impacts women’s physical and emotional well-being. This study investigates the correlation between regular physical activity and the occurrence and severity of primary dysmenorrhea. A cross-sectional design was used, involving 401 menstruating females aged 16 to 50 years, who completed an online questionnaire assessing menstrual symptoms and physical activity habits.The results indicate a trend toward a lower prevalence of dysmenorrhea among individuals who engage in regular, long-term, and higher-intensity physical activity. Although statistical significance was not reached in most comparisons, women who exercised daily or had more than five years of experience with physical activity reported less frequent and less severe menstrual pain. These findings support the growing evidence that physical activity may serve as a non-pharmacological strategy for managing primary dysmenorrhea. The study underscores the importance of promoting active lifestyles among women as part of broader public health efforts to enhance menstrual health and reduce reliance on medication. Further longitudinal and intervention-based research is recommended to confirm causality and develop targeted exercise guidelines

Key words: Primary dysmenorrhea, Physical activity, Menstrual health, Non-pharmacological management

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References

Adib-Rad, H., Kheirkhah, F., Faramarzi, M., Omidvar, S., Basirat, Z., & Haji Ahmadi, M. (2022). Primary dysmenorrhea associated with psychological distress in medical sciences students in the north of Iran: A cross-sectional study. International Journal of Fertility and Sterility, Online First. https://doi.org/10.22074/ijfs.2022.542056.1216

Alkhatib, A., Alshikh Ahmad, H., Zhang, C., Peng, W., & Li, X. (2024). Impact of traditional Chinese Baduanjin exercise on menstrual health among international female students studying in China: a randomized controlled trial. Frontiers in public health, 12, 1259634. https://doi.org/10.3389/fpubh.2024.1259634

Arif Fadli, Rustanti, M., & Yoga Handita Windiastoni. (2024). Efektivitas Program Latihan Aerobik pada Penurunan Nyeri Dismenore Primer: Meta-analysis. Jurnal Kesehatan Vokasional/Jurnal Kesehatan Vokasional, 9(1), 26–26. https://doi.org/10.22146/jkesvo.92667

Armour, M., Ee, C. C., Naidoo, D., Ayati, Z., Chalmers, K. J., Steel, K. A., De Manincor, M. J., & Delshad, E. (2019). Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2019(9). https://doi.org/10.1002/14651858.CD004142.pub4

Buchanan-Smith, L. I. M., Pang, A. H., Yeshitila, N. K., Parsons, E. N., & Blodgett, J. M. (2025). Physical Activity and Menstrual Health Symptoms and Characteristics: A Systematic Review and Meta-Analysis of Observational Studies. Journal of women’s health (2002), 34(12), 1535–1547. https://doi.org/10.1177/15409996251365804

Carroquino-Garcia, P., Jiménez-Rejano, J. J., Medrano-Sanchez, E., de la Casa-Almeida, M., Diaz-Mohedo, E., & Suarez-Serrano, 1380 (2019). Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. Physical Therapy, 99(10), 1371–1380. https://doi.org/10.1093/ptj/pzz101

Celenay, S. T., Özgül, S., Demirtürk, F., Gürşen, C., Baran, E., & Akbayrak, T. (2021). Comparison of Physical Activity, Quality of Life and Menstrual Symptoms by Menstrual Pain Intensity in Turkish Women With Primary Dysmenorrhea. Konuralp Tıp Dergisi, 13(2), 334–340. https://doi.org/10.18521/ktd.774059

De Sanctis, V., Soliman, A., Bernasconi, S., Bianchin, L., Bona, G., Bozzola, M., Buzi, F., De Sanctis, C., Tonini, G., Rigon, F., & Perissinotto, E. (2015). Primary Dysmenorrhea in Adolescents: Prevalence, Impact and Recent Knowledge. Pediatric Endocrinology Reviews: PER, 13(2), 512–520.

Dehnavi, Z. M., Jafarnejad, F., & Kamali, Z. (2018). The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. Journal of Education and Health Promotion, 7, 3. https://doi.org/10.4103/jehp.jehp_79_17

Fang, X. (2023). Scientific Knowledge Graph of Dysmenorrhea: A Bibliometric Analysis From 2001 to 2021. Journal of Pain Research, Volume 16, 2883–2897. https://doi.org/10.2147/jpr.s418602

Fuentes-Aparicio, L., Cuenca-Martínez, F., Muñoz-Gómez, E., Mollà-Casanova, S., Aguilar-Rodríguez, M., & Sempere-Rubio, N. (2023). Effects of therapeutic exercise in primary dysmenorrhea: an umbrella and mapping review. Pain medicine (Malden, Mass.), 24(12), 1386–1395. https://doi.org/10.1093/pm/pnad104

Hadjou, O.-K., Jouannin, A., Lavoue, V., Leveque, J., Esvan, M., & Bidet, M. (2022). Prevalence of dysmenorrhea in adolescents in France: Results of a large cross-sectional study. Journal of Gynecology Obstetrics and Human Reproduction, 51(3), 102302. https://doi.org/10.1016/j.jogoh.2021.102302

Heidarimoghadam, R., Abdolmaleki, E., Kazemi, F., Masoumi, S. Z., Khodakarami, B., & Mohammadi, Y. (2019). The Effect of Exercise Plan Based on FITT Protocol on Primary Dysmenorrhea in Medical Students: A Clinical Trial Study. Journal of research in health sciences, 19(3), e00456.

Huang, W. C., Chiu, P. C., & Ho, C. H. (2022). The Sprint-Interval Exercise Using a Spinning Bike Improves Physical Fitness and Ameliorates Primary Dysmenorrhea Symptoms Through Hormone and Inflammation Modulations: A Randomized Controlled Trial. Journal of sports science & medicine, 21(4), 595–607. https://doi.org/10.52082/jssm.2022.595

Imtiaz, I., & Riaz, H. (2022). Effects of high intensity aerobic training on symptomatology of primary dysmenorrhoea. JPMA. The Journal of the Pakistan Medical Association, 72(12), 2515–2518. https://doi.org/10.47391/JPMA.5158

International physical activity questionnaire – IPAQ (2003). https://youthrex.com/wp-content/uploads/2019/10/IPAQ-TM.pdf. Jaleel, G., Shaphe, M. A., Khan, A. R., Malhotra, D., Khan, H., Parveen, S., Qasheesh, M., Beg, R. A., Chahal, A., Ahmad, F., &

Ahmad, M. F. (2022). Effect of Exercises on Central and Endocrine System for Pain Modulation in Primary Dysmenorrhea. Journal of Lifestyle Medicine, 12(1), 15–25. https://doi.org/10.15280/jlm.2022.12.1.15

Kannan, P., Cheung, K.-K., Lau, B. W.-M., Li, L., Chen, H., & Sun, F. (2021). A mixed-methods study to evaluate the effectiveness and cost-effectiveness of aerobic exercise for primary dysmenorrhea: A study protocol. PLOS ONE, 16(8), e0256263. https://doi.org/10.1371/journal.pone.0256263

Li, X., Hao, X., Liu, J. H., & Huang, J. P. (2024). Efficacy of non-pharmacological interventions for primary dysmenorrhoea: a systematic review and Bayesian network meta-analysis. BMJ evidence-based medicine, 29(3), 162–170. https://doi.org/10.1136/bmjebm-2023-112434

MacGregor, B., Allaire, C., Yong, P. J., & Bougie, O. (2023). Disease Burden of Dysmenorrhea: Impact on Life Course Potential.

International Journal of Women S Health, Volume 15, 499–509. https://doi.org/10.2147/ijwh.s380006

McGovern, C. E., & Cheung, C. (2018). Yoga and Quality of Life in Women with Primary Dysmenorrhea: A Systematic Review.

Journal of Midwifery & Women’s Health, 63(4), 470–482. https://doi.org/10.1111/jmwh.12729

Menstrual Distress Questionnaire – MDQ (1975). National institutes of health. https://pubmed.ncbi.nlm.nih.gov/1237146/ Menstrual Symptom Questionnaire – MSQ (1968). Behaviour Research and Therapy 13(4):237-44. https://10.1016/0005-7967(75)90028-5.

Najafi, N., Khalkhali, H., Moghaddam Tabrizi, F., & Zarrin, R. (2018). Major dietary patterns in relation to menstrual pain: A

nested case control study. BMC Women’s Health, 18(1), 69. https://doi.org/10.1186/s12905-018-0558-4

Omidvar, S., Bakouei, F., Amiri, F. N., & Begum, K. (2015). Primary Dysmenorrhea and Menstrual Symptoms in Indian Female Students: Prevalence, Impact and Management. Global Journal of Health Science, 8(8), 135. https://doi.org/10.5539/gjhs.v8n8p135

Parra-Fernández, M. L., Onieva-Zafra, M. D., Abreu-Sánchez, A., Ramos-Pichardo, J. D., Iglesias-López, M. T., & Fernández-Martínez, E. (2020). Management of Primary Dysmenorrhea among University Students in the South of Spain and Family Influence. International Journal of Environmental Research and Public Health, 17(15), 5570. https://doi.org/10.3390/ijerph17155570

Rafique, N., & Al-Sheikh, M. H. (2018). Prevalence of primary dysmenorrhea and its relationship with body mass index. Journal of Obstetrics and Gynaecology Research, 44(9), 1773–1778. https://doi.org/10.1111/jog.13697

Rigal P, Bonnet S, Vieira Á, Carvalhais A, Lopes S. Therapeutic Physical Exercise for Dysmenorrhea: A Scoping Review. Journal of Functional Morphology and Kinesiology. 2025; 10(1):10. https://doi.org/10.3390/jfmk10010010

Rigal, P., Bonnet, S., Vieira, Á., Carvalhais, A., & Lopes, S. (2024). Therapeutic Physical Exercise for Dysmenorrhea: A Scoping Review. Journal of Functional Morphology and Kinesiology, 10(1), 10. https://doi.org/10.3390/jfmk10010010

Sahin, N., Kasap, B., Kirli, U., Yeniceri, N., & Topal, Y. (2018). Assessment of anxiety-depression levels and perceptions of quality of life in adolescents with dysmenorrhea. Reproductive Health, 15(1), 13. https://doi.org/10.1186/s12978-018-0453-3

Shukova Stojmanovska D., Aleksovska Velichkovska L., Gontarev S., Georgiev G., & Pluncevic Gligoroska J. (2023). Differences in the Mediterranean diet index, smoking and regular physical activity among students on university “ss. Cyril and Methodius”. Journal of Hygienic engineering and design, vol. 44. https://keypublishing.org/jhed/jhed-volumes/volume-44/

Triwahyuningsih, R. Y., Rahfiludin, M. Z., Sulistiyani, S., & Widjanarko, B. (2024). Role of stress and physical activity on primary dysmenorrhea: A cross-sectional study. Narra J, 4(1), e685. https://doi.org/10.52225/narra.v4i1.685

Tsai, I. C., Hsu, C. W., Chang, C. H., Lei, W. T., Tseng, P. T., & Chang, K. V. (2024). Comparative Effectiveness of Different Exercises for Reducing Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Sports medicine – open, 10(1), 63. https://doi.org/10.1186/s40798-024-00718-4

Tsai, I. C., Hsu, C. W., Chang, C. H., Lei, W. T., Tseng, P. T., & Chang, K. V. (2024). Comparative Effectiveness of Different Exercises for Reducing Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Sports medicine – open, 10(1), 63. https://doi.org/10.1186/s40798-024-00718-4

Wang, L., Yan, Y., Qiu, H., Xu, D., Zhu, J., Liu, J., & Li, H. (2022). Prevalence and Risk Factors of Primary Dysmenorrhea in Students: A Meta-Analysis. Value in Health, 25(10), 1678–1684. https://doi.org/10.1016/j.jval.2022.03.023

Zheng, Q., Huang, G., Cao, W., & Zhao, Y. (2024). Comparative effectiveness of exercise interventions for primary dysmenorrhea: A systematic review and network meta-analysis. BMC Women’s Health, 24(1), 610. https://doi.org/10.1186/s12905-024-03453-w