Introduction: Primary dysmenorrhea is the most frequent cause of pelvic pain in adolescent girls and constitutes a major public health problem. In Douala, its clinical characteristics and determinants of severity remain understudied. The objective of this study was to determine the prevalence, describe the clinical characteristics, and identify the factors associated with the severity of primary dysmenorrhea among school-going adolescent girls in Douala. Methods: A cross-sectional analytical study was conducted from October 2023 to April 2024 in five secondary schools in Douala. A total of 1,045 adolescent girls aged 13 - 19 years were randomly selected. Data, collected via a self-administered questionnaire, covered socio-demographic, gynecological, and clinical characteristics. Pain intensity was evaluated using a Visual Analog Scale (VAS). Associations between dysmenorrhea severity and menstrual characteristics were explored by logistic regression. Results: The prevalence of primary dysmenorrhea was 76.5% (800/1,045). The mean age at menarche was 12.9 ± 1.5 years. Pain most often occurred from the first day of menses (66.5%), lasted more than 24 hours in 56.8% of cases, and was localized to the lower abdomen (71.8%). Associated symptoms included headaches (39.7%), breast pain (35.2%), and nervousness (32.6%). Severe pain was significantly associated with irregular cycles (OR = 1.52; p = 0.017), prolonged menstruation ≥6 days (OR = 2.45; p < 0.001), heavy menstrual flow (OR = 2.31; p < 0.001), and pain occurring every cycle (OR = 2.04; p < 0.001). Conclusion: Primary dysmenorrhea affects more than three-quarters of adolescent girls in Douala. Its severity is associated with menstrual characteristics (irregularity, longer duration, and heavy flow of menses). These results underscore the need to integrate menstrual health education and psychological support into school programs to reduce its impact on young girls’ quality of life and schooling.
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