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. 2024 Sep;25(9):104574.
doi: 10.1016/j.jpain.2024.104574. Epub 2024 May 22.

Social Determinants of Health and Dysmenorrhea: A Systematic Review

Chen X Chen  1 , Sarah K Rogers  2 , Rui Li  3 , Rachel J Hinrichs  4 , J Dennis Fortenberry  5 , Janet S Carpenter  6
Affiliations

Social Determinants of Health and Dysmenorrhea: A Systematic Review

Chen X Chen et al. J Pain. 2024 Sep.

Abstract

Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).

Keywords: Dysmenorrhea; health disparities; health equity; race factors; social determinants of health.

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Conflict of interest statement

Disclosures:

Drs. Chen, Fortenberry, and Carpenter were supported by R01HD110994 (PI: Chen) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health while preparing this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
PRISMA Flow Diagram
Figure 2.
Figure 2.. Risk of Bias of Included Articles (N = 166).
SDoH: Social Determinants of Health.
See this image and copyright information in PMC

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