Menstrual Distress Questionnaire (MEDI-Q): a new tool to assess menstruation-related distress

Abstract

Research question: Menstruation is a physiological event often associated with subjective distress. Is there a tool that assesses and objectively evaluates the global distress experienced by women during their period?

Design: An observational cross-sectional study conducted between June 2019 and May 2020 at Careggi University Hospital, Florence, Italy. A new questionnaire, The Menstrual Distress Questionnaire (MEDI-Q), was developed and administered to a group of healthy women (n = 418) of fertile age (18-50 years), without known uterine, psychiatric disorders, or both. The MEDI-Q investigated 25 items, covering the following areas: pain, discomfort, psychic or cognitive changes, gastrointestinal symptoms and changes in physiological functions. MEDI-Q Total Score and the three sub-scales, Menstrual Symptoms (MS), Menstrual Symptoms Distress (MSD) and Menstrual Specificity Index (MESI) were evaluated. The validation of MEDI-Q was achieved by testing test-retest reliability and internal consistency, convergent and concurrent validity.

Results: The MEDI-Q produced reliable results with good internal consistency, convergent and concurrent validity. MEDI-Q Total Score, MS and MSD all positively correlated with general psychopathology and premenstrual symptoms. A receiver operating characteristic analysis was used to determine the cut-off value of 20 (inclusive) and to identify the women with clinically relevant menstrual distress (area under the curve 0.90, 95% CI 0.86 to 0.93; P < 0.001).

Conclusion: MEDI-Q is a new tool for evaluating menstruation-related distress, and provides a representative score of stress perception. MEDI-Q may be added to routine women's healthcare to help identify and adequately monitor menstruation-related disorders, and their effect on wellbeing, promptly.

Keywords: Distress; Dysmenorrhea; Menstruation; Pain; Psychopathology.