Abbreviations: CI, confidence interval; OCP, oral contraceptive pill.
Epidemiol Rev. 2014;36:104-13. doi: 10.1093/epirev/mxt009. Epub 2013 Nov 26.
Dysmenorrhea is a common menstrual complaint with a major impact on women's quality of life, work productivity, and health-care utilization. A comprehensive review was performed on longitudinal or case-control or cross-sectional studies with large community-based samples to accurately determine the prevalence and/or incidence and risk factors of dysmenorrhea. Fifteen primary studies, published between 2002 and 2011, met the inclusion criteria. The prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain in 2%-29% of the women studied. Women's age, parity, and use of oral contraceptives were inversely associated with dysmenorrhea, and high stress increased the risk of dysmenorrhea. The effect sizes were generally modest to moderate, with odds ratios varying between 1 and 4. Family history of dysmenorrhea strongly increased its risk, with odds ratios between 3.8 and 20.7. Inconclusive evidence was found for modifiable factors such as cigarette smoking, diet, obesity, depression, and abuse. Dysmenorrhea is a significant symptom for a large proportion of women of reproductive age; however, severe pain limiting daily activities is less common. This review confirms that dysmenorrhea improves with increased age, parity, and use of oral contraceptives and is positively associated with stress and family history of dysmenorrhea.
痛经是一种常见的月经问题，对女性的生活质量、工作效率和医疗保健利用有重大影响。我们对具有大型社区样本的纵向或病例对照或横断面研究进行了全面回顾，以准确确定痛经的患病率和/或发病率和危险因素。15 项符合纳入标准的主要研究发表于 2002 年至 2011 年之间。育龄妇女的痛经患病率在 16%至 91%之间不等，研究中 2%至 29%的妇女有严重疼痛。妇女的年龄、产次和口服避孕药的使用与痛经呈负相关，而高压力会增加痛经的风险。效应大小通常为中等至中等程度，比值比在 1 至 4 之间变化。痛经的家族史强烈增加了其风险，比值比在 3.8 至 20.7 之间。对于可改变的因素，如吸烟、饮食、肥胖、抑郁和滥用，证据尚不明确。痛经是很大一部分育龄妇女的一个重要症状；然而，限制日常活动的严重疼痛则不那么常见。本综述证实，痛经随年龄增长、产次增加和口服避孕药的使用而改善，与压力和痛经家族史呈正相关。
