Title: Prevalence, Risk Factors, and Management Practices of Primary Dysmenorrhea among
Young Females
Version: 1 Date: 14 Mar 2021
Reviewer's report:
Dear Authors
I consider the submitted manuscript to be of interest to readers, methodologically sound and
potentially publishable in this journal. I would only advise that a few small improvements be
made beforehand, which basically involve including some clarifications and taking into account
some relevant recent bibliographical references in the introduction, methodology and expanding
the discussion of the results, taking these references into account.
In terms of inclusion criteria, they refer to “ and having menses during the past six month” this
criteria should be justified by including a bibliographic citation of previous studies on primary
dysmenorrhoea using the same criteria.
Did you use any techniques to make the sample representative? Could you elaborate on the
recruitment process and convenience sampling?
It is not clear where the pain score and the magnitude of analgesia come from.
They should include literature references for the VAS scale, as well as studies on primary
dysmenorrhoea using the same grouping (The scales’ scores were classified as follows; [1-3] is
considered mild pain, [4-7] moderate pain and [8-10] severe pain.)
Some phrases such as “Despite its high prevalence, there is inconclusive evidence regarding the
management-seeking practices and its perceived effectiveness among females with PD.” should
be changed to "the evidence is limited on ...." as there are recent studies on the subject that it
would be interesting to reference as:
1. Management of Primary Dysmenorrhea among University Students in the South of Spain and
Family Influence.
Parra-Fernández ML, Onieva-Zafra MD, Abreu-Sánchez A, Ramos-Pichardo JD, Iglesias-
López MT, Fernández-Martínez E.Int J Environ Res Public Health. 2020 Aug 1;17(15):5570.
doi: 10.3390/ijerph17155570.PMID: 32752254
You will also find in the reading of the previous manuscript, interesting aspects to improve your
discussion.
Regarding the prevalence of primary dysmenorrhoea in young people, the citations used are from
4 years ago, I advise you to include more recent studies on the subject in a young population,
such as this one published at the end of 2020:
Type of Dysmenorrhea, Menstrual Characteristics and Symptoms in Nursing Students in
Southern Spain.
Abreu-Sánchez A, Parra-Fernández ML, Onieva-Zafra MD, Ramos-Pichardo JD, Fernández-
Martínez E.Healthcare (Basel). 2020 Aug 26;8(3):302. doi: 10.3390/healthcare8030302.PMID:
32858887
Results:
In table 1, Pearson's Chi-square #2 column can be deleted as it does not provide any relevant
information to the reader.
The categorisation of age into 18-24 and 25+ is unclear.
They should clarify what they mean by "Family history of dysmenorrhea". Does it refer only
to first-degree relatives?
Discussion:
It would be interesting to discuss their results on the reasons why participants did not consult
a health professional with those of this recently published study of young Spanish women on
the subject:
Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare
Professionals?
Ramos-Pichardo JD, Ortega-Galán ÁM, Iglesias-López MT, Abreu-Sánchez A, Fernández-
Martínez E.Int J Environ Res Public Health. 2020 Nov 5;17(21):8173. doi: 10.3390/
ijerph17218173.PMID: 33167417