Association of Primary Dysmenorrhea with Stress and Sleep Quality Among Adolescent Girls: A Cross-Sectional Study

Abstract

Background: Primary dysmenorrhea is a highly prevalent reproductive health problem among adolescent girls and may affect not only physical well-being but also psychological stress and sleep quality. Persistent menstrual pain may trigger stress responses and sleep disturbances through neuroendocrine and behavioral mechanisms.
Objective: This study aimed to examine the association between primary dysmenorrhea severity, perceived stress, and sleep quality among adolescent girls.
Methods: An observational cross-sectional study was conducted among 222 adolescent girls residing in an Islamic boarding school in Surakarta, Indonesia. Primary dysmenorrhea severity was assessed using the Numeric Rating Scale (NRS), stress levels were measured using the Perceived Stress Scale–10 (PSS-10), and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using Spearman’s rank correlation test with a significance level of 0.05.
Results: Most participants reported severe primary dysmenorrhea (64.4%), high stress levels (54.5%), and poor sleep quality (84.2%). Primary dysmenorrhea severity showed a significant positive correlation with stress level (r = 0.571; p < 0.001), indicating a moderate-to-strong association. A significant moderate association was also observed between primary dysmenorrhea severity and sleep quality (r = 0.440; p < 0.001).
Conclusion: Primary dysmenorrhea is significantly associated with increased stress levels and poorer sleep quality among adolescent girls. These findings underscore the importance of incorporating psychological stress management and sleep-related strategies into holistic, non-pharmacological approaches for managing primary dysmenorrhea in adolescents.