Background: The incidence and severity of primary dysmenorrhea are influenced by various factors. The aim of the present study was to review nutritional factors influencing primary dysmenorrhea. Methods: Academic databases including Web of Science, EMBASE, Scopus, and PubMed (including Medline) were searched using keywords of nutrition, diet, and primary dysmenorrhea. In this study, observational studies that were published in English from 1990 to April 2018, which focused on nutritional factors affecting primary dysmenorrhea, were selected. The evaluation of studies was performed using a modified STROBE checklist with 10 items. Results: Out of 5,814 retrieved studies, 38 articles met inclusion criteria and were included for final data synthesis. The increased consumption of fruits and vegetables as the sources of vitamins and minerals, as well as fish and milk and dairy products have positive associations with less menstrual pain. Inconsistent results were reported on the consumption of other nutritional groups. Studies showed negative associations of meal skipping and following diet to lose weight with severity of dysmenorrhea. Conclusion: A few studies showed inconclusive findings due to methodological heterogeneities for assessing nutritional habits and different methods of measuring dysmenorrhea pain. Therefore, further analysis and future interventional studies with stronger methodologies are required.

1.
Iacovides S, Avidon I, Baker FC: What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update 2015; 21: 762–778.
2.
Jonatan S, Berek J: Novak’s Gynecology: 14th. New York, Lippincott Williams and Wilkins Publishers, 2012.
3.
Chuamoor K, Kaewmanee K, Tanmahasamut P: Dysmenorrhea among Siriraj nurses; prevalence, quality of life, and knowledge of management. J Med Assoc Thai 2012; 95: 983–991.
4.
Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF: Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996; 87: 321–327.
5.
Shewte MK, Sirpurkar MS: Dysmenorrhoea and quality of life among medical and nursing students: a cross-sectional study. Nat J Comm Med 2016; 7: 474–479.
6.
Gagua T, Tkeshelashvili B, Gagua D: Primary dysmenorrhea: prevalence in adolescent population of Tbilisi, Georgia and risk factors. J Turk Ger Gynecol Assoc 2012; 13: 162–168.
7.
Haidari F, Akrami A, Sarhadi M, Mohammad Shahi M: Prevalence and severity of primary dysmenorrhea and its relation to anthropometric parameters. Tums Hayat 2011; 17: 70–77.
8.
Ju H, Jones M, Mishra G: The prevalence and risk factors of dysmenorrhea. Epidemiol Rev 2014; 36: 104–113.
9.
Burnett MA, Antao V, Black A, Feldman K, Grenville A, Lea R, et al: Prevalence of primary dysmenorrhea in Canada J Obstet Gynaecol Can 2005; 27: 765–770.
10.
Latthe P, Mignini L, Gray R, Hills R, Khan K: Factors predisposing women to chronic pelvic pain: systematic review. BMJ 2006; 332: 749–755.
11.
Nohara M, Momoeda M, Kubota T, Nakabayashi M. Menstrual cycle and menstrual pain problems and related risk factors among Japanese female workers. Ind Health 2011; 49: 228–234.
12.
Ohde S, Tokuda Y, Takahashi O, Yanai H, Hinohara S, Fukui T: Dysmenorrhea among Japanese women. Int J Gynaecol Obstet 2008; 100: 13–17.
13.
Patel V, Tanksale V, Sahasrabhojanee M, Gupte S, Nevrekar P: The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, India. BJOG 2006; 113: 453–463.
14.
Pawłowski B: Prevalence of menstrual pain in relation to the reproductive life history of women from the Mayan rural community. Ann Hum Biol 2004; 31: 1–8.
15.
Santer M, Warner P, Wyke S: A scottish postal survey suggested that the prevailing clinical preoccupation with heavy periods does not reflect the epidemiology of reported symptoms and problems. J Clin Epidemiol 2005; 58: 1206–1210.
16.
Tavallaee M, Joffres MR, Corber SJ, Bayanzadeh M, Rad MM: The prevalence of menstrual pain and associated risk factors among Iranian women. J Obstet Gynaecol Res 2011; 37: 442–451.
17.
Weissman AM, Hartz AJ, Hansen MD, Johnson SR: The natural history of primary dysmenorrhoea: a longitudinal study. BJOG 2004; 111: 345–352.
18.
Osayande AS, Mehulic S: Diagnosis and initial management of dysmenorrhea. Am Fam Physician 2014; 89: 341–346.
19.
Marjoribanks J, Proctor M, Farquhar C, Derks RS: Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev 2015; 7:CD001751.
20.
Proctor M, Farquhar C: Diagnosis and management of dysmenorrhoea. BMJ 2006; 332: 1134–1138.
21.
Abdul-Razzak KK, Ayoub NM, Abu-Taleb AA, Obeidat BA: Influence of dietary intake of dairy products on dysmenorrhea. J Obstet Gynaecol Res. 2010; 36: 377–383.
22.
Proctor ML, Murphy PA: Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2001; 3: CD002124.
23.
Sidani M, Campbell J: Gynecology: select topics. Prim Care 2002; 29: 297–321.
24.
Pattanittum P, Kunyanone N, Brown J, Sangkomkamhang US, Barnes J, Seyfoddin V, et al: Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev 2016; 3: CD002124.
25.
Zhu X, Proctor M, Bensoussan A, Wu E, Smith CA: Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev 2008; 2:CD005288.
26.
Di Cintio E, Parazzini F, Tozzi L, Luchini L, Mezzopane R, Marchini M, et al: Dietary habits, reproductive and menstrual factors and risk of dysmenorrhoea. Eur J Epidemiol 1997; 13: 925–930.
27.
Balbi C, Musone R, Menditto A, Di Prisco L, Cassese E, D’Ajello M, et al: Influence of menstrual factors and dietary habits on menstrual pain in adolescence age. Eur J Obstet Gynecol Reprod Biol 2000; 91: 143–148.
28.
Unsal A, Ayranci U, Tozun M, Arslan G, Calik E: Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Ups J Med Sci 2010; 115: 138–145
29.
Ozerdogan N, Sayiner D, Ayranci U, Unsal A, Giray S: Prevalence and predictors of dysmenorrhea among students at a university in Turkey. Int J Gynaecol Obstet 2009; 107: 39–43.
30.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med.2009; 6: e1000097.
31.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP: The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med 2007; 4:e296.
32.
Fujiwara T, Nakata R: Skipping breakfast may induce dysmenorrhea and irregular menstruation in post-adolescent women in Japan. Ann Nutr Metab 2013; 63: 668.
33.
Abdul-Razzak KK, Obeidat BA, Al-Farras MI, Dauod AS: Vitamin D and PTH status among adolescent and young females with severe dysmenorrhea. J Pediatr Adolesc Gynecol. 2014; 27: 78–82.
34.
Deutch B: Menstrual pain in Danish women correlated with low n-3 polyunsaturated fatty acid intake. Eur J Clin Nutr 1995; 49: 508–516.
35.
Montero P, Bernis C, Fernandez V, Castro S: Influence of body mass index and slimming habits on menstrual pain and cycle irregularity. J biosoc Sci. 1996; 28: 315–323.
36.
Fujiwara T: Skipping breakfast is associated with dysmenorrhea in young women in Japan. Int J Food Sci Nutr 2003; 54: 505–509.
37.
Wang L, Wang X, Wang W, Chen C, Ronnennberg AG, Guang W, et al: Stress and dysmenorrhoea: a population based prospective study. Occup Environ Med 2004; 61: 1021–1026.
38.
Chung FF, Yao CC, Wan GH: The associations between menstrual function and life style/working conditions among nurses in Taiwan. J Occup Health 2005; 47: 149–156.
39.
Nagata C, Hirokawa K, Shimizu N, Shimizu H: Associations of menstrual pain with intakes of soy, fat and dietary fiber in Japanese women. Eur j clin nutr 2005; 59: 88–92.
40.
Fujiwara T, Sato N, Awaji H, Sakamoto H, Nakata R: Skipping breakfast adversely affects menstrual disorders in young college students. Int J Food Sci Nutr 2009; 60: 23–31.
41.
Fujiwara T, Nakata R: Skipping breakfast is associated with reproductive dysfunction in post-adolescent female college students. Appetite 2010; 55: 714–717.
42.
Venkata RS, Kiran VR, Vijayasree M: Oxidative stress and antioxidant status in primary dysmenorrhea. J Clin Diagn Res 2011 5: 509–511.
43.
Bin Mahmoud AZ, Makhdoom AN, Mufti LA, Alreheli RS, Farghal RG, Aljaouni SE: Association between menstrual disturbances and habitual use of caffeine. J Taibah University Med Sci 2014; 9: 341–344.
44.
Grandi G, Ferrari S, Xholli A, Cannoletta M, Palma F, Romani C, et al: Prevalence of menstrual pain in young women: what is dysmenorrhea? J Pain Res. 2012; 5: 169–174.
45.
Seven M, Guvenc G, Akyuz A, Eski F: Evaluating dysmenorrhea in a sample of Turkish nursing students. Pain Manag Nurs 2013; 15: 664–671.
46.
Vani R, Veena S, Subitha L, Hemanth Kumar R, Bupathy A: Menstrual abnormalities in school going girls – are they related to dietary and exercise pattern? J Clin Diagn Res 2013; 7: 2537–2540.
47.
Gangwar V, Kumar D, Gangwar RS, Arya M, Banoo H: Prevalence of primary dysmenorrhea among the undergraduate medical students and its impact on their performance in study. Int J Physiol 2014; 2: 14.
48.
Sahin S, Ozdemir K, Unsal A, Arslan R: Review of frequency of dysmenorrhea and some associated factors and evaluation of the relationship between dysmenorrhea and sleep quality in university students. Gynecol Obstet Invest 2014; 78: 179–185.
49.
Faramarzi M, Salmalian H: Association of psychologic and nonpsychologic factors with primary dysmenorrhea. Iran Red Crescent Med J 2014; 16:e16307.
50.
Jeon GE, Cha NH, Sok SR: Factors influencing the dysmenorrhea among korean adolescents in middle school. J Phys Ther Sci 2014; 26: 1337–1343.
51.
Kazama M, Maruyama K, Nakamura K: Prevalence of dysmenorrhea and its correlating lifestyle factors in Japanese female junior high school students. Tohoku J Exp Med 2015; 236: 107–113.
52.
Mohamadirizi S, Kordi M: The relationship between food frequency and menstrual distress in high school females. Iran J Nurs Midwifery Res 2015; 20: 689–693.
53.
Pramanik P, Banerjee SB, Saha P: Primary dysmenorrhea in school going adolescent girls – is it related to deficiency of antioxidant in diet? Int J Life Sci Pharma Res 2015; 5:L54–L63.
54.
Bavil DA, Dolatian M, Mahmoodi Z, Baghban AA: Comparison of lifestyles of young women with and without primary dysmenorrhea. Electron Physician 2016; 8: 2107–2114.
55.
Abu Helwa HA, Mitaeb AA, Al-Hamshri S, Sweileh WM: Prevalence of dysmenorrhea and predictors of its pain intensity among Palestinian female university students. BMC Womens Health 2018; 18: 18.
56.
Hailemeskel S, Demissie A, Assefa N: Primary dysmenorrhea magnitude, associated risk factors, and its effect on academic performance: evidence from female university students in Ethiopia. Int J Womens Health 2016; 8: 489–496.
57.
Pejčić A, Jankovic S: Risk factors for dysmenorrhea among young adult female university students. Ann Ist Super Sanita 2016; 52: 98–103.
58.
Shinde GR, Laddad M: Overview of adolescent menstrual problems and its relation to bmi, eating habits and physical activity. J Evolution Med Dental Sci 2016; 5: 6757–6761.
59.
Karacin O, Mutlu I, Kose M, Celik F, Kanat-Pektas M, Yilmazer M: Serum vitamin D concentrations in young Turkish women with primary dysmenorrhea: a randomized controlled study. Taiwan J Obstet Gynecol 2018; 57: 58–63.
60.
Muluneh AA, Nigussie TS, Gebreslasie KZ, Anteneh KT, Kassa ZY: Prevalence and associated factors of dysmenorrhea among secondary and preparatory school students in Debremarkos town, North-West Ethiopia. BMC Womens Health 2018; 18: 57.
61.
Fujiwara T: Diet during adolescence is a trigger for subsequent development of dysmenorrhea in young women. Int J Food Sci Nutr 2007; 58: 437–444.
62.
Mehrpooya M, Eshraghi A, Rabiee S, Larki-Harchegani A, Ataei S: Comparison the effect of fish-oil and calcium supplementation on treatment of primary dysmenorrhea. Rev Recent Clin Trials 2017; 12: 148–153.
63.
Sadeghi N, Paknezhad F, Rashidi Nooshabadi M, Kavianpour M, Jafari Rad S, Khadem Haghighian H: Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: a double-blind, randomized clinical trial. Gynecol Endocrinol 2018: 34: 804–808.
64.
Zafari M, Tofighi M, Aghamohammady A, Behmanesh F, Rakhshaee Z: Comparison of the effect of acupressure, fish oil capsules and ibuprofen on treatment of primary dysmenorrhea. Afr J Pharm Pharmacol 2011; 5: 1115–1119.
65.
Saini RK, Nile SH, Park SW: Carotenoids from fruits and vegetables: chemistry, analysis, occurrence, bioavailability and biological activities. Food Res Int. 2015; 76: 735–750.
66.
Moini A, Ebrahimi T, Shirzad N, Hosseini R, Radfar M, Bandarian F, et al: The effect of vitamin D on primary dysmenorrhea with vitamin D deficiency: a randomized double-blind controlled clinical trial. Gynecol Endocrinol 2016; 32: 502–505.
67.
Zarei S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Javadzadeh Y, Effati-Daryani F: Effects of calcium-vitamin D and calcium-alone on pain intensity and menstrual blood loss in women with primary dysmenorrhea: a randomized controlled trial. Pain Med 2017; 18: 3–13.
You do not currently have access to this content.