Influence of menstrual pain intensity, menstrual symptoms, and catastrophization on cognitive function in young women with primary dysmenorrhea

Korean J Pain. 2026 Apr 1;39(2):272-283. doi: 10.3344/kjp.25326.

ABSTRACT

BACKGROUND: Cognitive function is negatively affected in different chronic painful conditions. This study aimed to examine the relationship between pain intensity, menstrual symptoms, catastrophization, and cognitive functions in young women with primary dysmenorrhea.

METHODS: This cross-sectional study comprised 132 nulliparous young women with primary dysmenorrhea. Sociodemographic characteristics and detailed medical, obstetric, and urogynecological history were recorded. Menstrual pain intensity was evaluated with the Visual Analogue Scale, symptoms experienced during the menstrual cycle with the Menstruation Symptom Questionnaire (MSQ), pain-related emotions with the Pain Catastrophizing Scale (PCS), and cognitive functions with the Montreal Cognitive Assessment (MoCA) and Stroop test. All evaluations were performed in the periovulatory phase.

RESULTS: The mean MoCA total score was 24.31 ± 4.86 in young women with primary dysmenorrhea. The MoCA visuospatial/executive subscale showed negative correlations with menstrual pain intensity, pain duration, complaint duration, MSQ coping strategies, PCS rumination, PCS helplessness, and PCS total scores (r = -0.191 to -0.291, P < 0.05). In addition, Stroop 4-time showed a weak positive correlation with complaint duration (r = 0.236, P = 0.016) and PCS rumination scores (r = 0.222, P = 0.024).

CONCLUSIONS: Young women with primary dysmenorrhea had low MoCA scores. In primary dysmenorrhea, visuospatial/executive cognitive function and selective attention were impaired, especially in relation to the severity of menstrual pain, pain duration, some menstrual symptoms, and pain catastrophization. Cognitive training, especially to improve visuospatial/executive cognitive function and selective attention, should be included in pain management programs applied to women with primary dysmenorrhea.

PMID:41918307 | DOI:10.3344/kjp.25326