I'm tired of pretending that nothing's wrong: A mixed-methods study of financial barriers for individuals living with primary dysmenorrhea.

BACKGROUND

Primary dysmenorrhea (PD), or pain in the abdomen experienced during menstruation, remains under-recognised, leading to poorer financial outcomes for those affected.

AIM: The current study aimed to explore individual perspectives of financial burden relating to PD, while also examining the impact of biopsychosocial factors on reported financial barriers.

METHOD: Participants completed an online survey between May and July 2019 measuring pain, symptoms of depression, anxiety, and stress, fatigue, perceived social support, sociodemographic information, days of work or school missed, and number of GP or specialist visits due to pain per year. Open-ended questions relating to financial impact of PD and suggested workplace supports were included in a two-year follow-up survey. Template thematic analysis was conducted, and themes were then entered as outcome measures in binary logistic regression models, using biopsychosocial variables as predictors.

RESULTS

Australian women who experienced PD, measured by a numeric rating scale for period pain, were recruited (n = 140). Three themes were developed: Burden of Healthcare and Financial Disempowerment, Reduced Workplace Participation and Stigma and Prejudice. Pain (OR = 1.568, 95 % CI = 1.195-2.058), fatigue (OR = 1.050, 95 % CI = 1.013-1.089) and perceived family support (OR = 0.715, 95 % CI = 0.522-0.980) significantly predicted Stigma and Prejudice.

CONCLUSION

Increased pain or fatigue severity and reduced perceived family support may be associated with Stigma and Prejudice as a financial barrier for those with PD. Improved recognition of the impact of PD at a governmental level may help to address stigma, thus reducing the financial burden for those affected and society as a whole.