Reviewer ’s report  
 
Title: Prevalence of dysmenorrhea among university students in  northern Ghana; its impact and 
management strategies  
 
Version: 0 Date: 11 Jun 2017  
 
Reviewer: Lena Marions  
 
Reviewer's report:  
 
This subject is very important to describe since there are many women su ffering from pelvic pain 
due to menstruation in spite of available methods. I have however some concerns after reading 
the manuscript. In the introduction the authors state that fatty diet restriction, rest and spinal 
manipulation eases pain due to dysmeno rrhea. To my knowledge this is not evidence based and 
also not the potential positive effect on dietary supplements..It is mentioned that combined 
contraceptives might be an effective option but is that available for these women? It is not 
included in the results but that might not be an option in Ghana. Would be interesting to know  
 
 
In the method part I do not quite understand the power calculation and study size determination. 
How did 990 become the total studypopulation? Out of 1249? And then 389 particip ants were 
supposed to represent the study population?  
 
 
Regarding the questionnaire it is not described how many questions? Anonymous? How was 
pain assessed? Did they get the three categories mild, moderate and severe to choose between or 
was there a VAS or  NRS? Or open -ended? This is important when results are being compared.  
 
 
There is quite wide range in age of the participants with some outlayers (48 years). A median 
value could make this clearer. How was quality of Life assessed? There are validated forms  for 
this, were they used?  
 
 
In the tables a lot of information can be deleted without losing any important information i.e type 
of accomodation at menarche, area of residence during vacation etc.  
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language correc tions before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or sa lary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
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financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
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below. If your reply is yes to any, please give details below.  
 
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