Neurocognitive function, psychosocial characteristics, and occupational performance across menstrual phases in young adults with and without primary dysmenorrhea


Karakus A., Inanc S., AKYÜREK G.

European Journal of Obstetrics and Gynecology and Reproductive Biology, vol.318, 2026 (SCI-Expanded, Scopus) identifier identifier

Abstract

Objective: To examine phase-related variations in cognitive, emotional, and occupational functioning among women with and without primary dysmenorrhea (PD). Study design: A repeated-measures case-control study was conducted at a university-based research laboratory and hospital outpatient unit. Participants: Seventy-nine women with PD and fifty-nine asymptomatic women aged 17-25 years participated. Main outcome measures: Menstrual pain intensity (Visual Analog Scale), menstrual attitudes (Menstrual Attitudes Questionnaire), body awareness (Body Awareness Questionnaire), occupational performance and satisfaction (Canadian Occupational Performance Measure), and self-esteem (Rosenberg Self-Esteem Scale) were assessed across three menstrual phases. Cognitive functions (attention, processing speed, and executive control) were evaluated using the Stroop Test and the Paced Auditory Serial Addition Test. Mann-Whitney U and Friedman tests were used for between- and within-group analyses, and regression models identified predictors of occupational performance and self-esteem. Results: Women with PD reported higher pain intensity (p<0.001), lower BMI (p=0.022), and a more frequent family history of dysmenorrhea (p = 0.016). They also had more negative and proactive menstrual attitudes (p=0.01-0.04), lower occupational performance and satisfaction (p<0.001), and reduced self-esteem (p<0.001). Cognitive performance significantly declined during the luteal phase (p=0.01-0.004). No significant differences were observed in body awareness (p>0.05). Conclusion: Women with PD experience cognitive, emotional, and occupational challenges that extend beyond menstrual pain. Integrative, multidisciplinary interventions addressing both physical and psychosocial domains are recommended to improve overall functioning and well-being.