Primary Dysmenorrhea: Therapeutic Approaches and Quality of Life among Adolescents in the City of Douala (Cameroon)

Introduction: Primary dysmenorrhea is one of the most common gynecological disorders among adolescents. Beyond the pain, its impact on academic performance, social life, and psychological well-being makes it a significant public health concern. There is a lack of local data in Douala, despite the high student density and inequalities in access to healthcare. This study aimed to describe therapeutic approaches and assess the impact of dysmenorrhea on the quality of life of adolescents. Methods: This was an analytical cross-sectional study conducted from October 2023 to April 2024 in five high schools in Douala. Included were consenting menstruating adolescents under 20 years old, with parental consent. A total of 1045 adolescents were recruited, of whom 800 had dysmenorrhea. Data collected included sociodemographic characteristics, therapeutic approaches (pharmacological, traditional, non-pharmacological), and quality of life, which was assessed using the EQ-5D-5L tool. Statistical analyses included multivariate regressions. Results: The average age was 17.0 ± 1.3 years. Access to healthcare remained limited: only 13.5% of adolescents had consulted a doctor. Therapeutic strategies were dominated by modern medications (58%), followed by traditional practices (17.2%) and non-pharmacological methods (12.9%). Nearly 82.2% reported a decrease in academic performance, 39.7% reported absenteeism, and 46.5% suffered from anxiety related to pain. The EQ-5D-5L scale showed that 23% had mobility problems, 8% had self-care issues, 29% had problems with daily activities, and 46.5% experienced anxiety/depression. Multivariate analysis revealed strong associations: mobility (OR = 28.8; 95% CI: 7.0 - 118.5), daily activities (OR = 12.9; 95% CI: 4.6 - 42.7), autonomy (OR = 7.1; 95% CI: 1.7 - 29.8), and anxiety/depression (OR = 3.5; 95% CI: 2.2 - 5.9). Conclusion: Primary dysmenorrhea is extremely prevalent and profoundly affects the quality of life of adolescents in Douala, impacting academic performance, social life, and psychological well-being. These results highlight the need to integrate menstrual health into school programs, improve access to healthcare, and promote appropriate management strategies, combining pharmacological treatments and non-pharmacological interventions.