The Link of Menstrual Disturbances to Work Performance: A Cross-Sectional among Medical Interns in Addis Ababa

Abstract

Abstract Background: Menstrual disturbances, particularly primary dysmenorrhea, are common issues affecting women of reproductive age when it comes to their daily functioning but more specifically their work performance. Medical interns are no exception to this reality. In spite of the high prevalence of this condition, there are limited studies done when it comes to the relation of menstrual disturbances and work performance. Objective: To assess the relation between menstrual disturbances and work performance among female medical interns at medical colleges in Addis Ababa, Ethiopia, in 2026. Methods: An institution-based cross-sectional study was conducted among 165 female medical interns selected using quota sampling from medical colleges in Addis Ababa. Data were collected using a structured, self-administered questionnaire that included the Menstrual Distress Questionnaire (MEDI-Q), the Dysmenorrhea-Related Impact on Functioning Scale (DRIFS), and the Work Productivity and Activity Impairment (WPAI) questionnaire. Dysmenorrhea was defined as a MEDI-Q score ≥8, and functional impairment as a DRIFS score ≥44. Data were analyzed using SPSS version 25. Descriptive statistics were used to summarize participants characteristics and binary logistic regression was employed to assess associations, with a p-value ≤0.05 considered statistically significant. Results: Results: A total of 165 female medical interns participated in the study. The prevalence of dysmenorrhea was 75.2% (n=124), and functional impairment was observed in 26.7% (n=44) of participants. Among those with dysmenorrhea, 31.5% (n=39) experienced functional impairment compared to 12.2% (n=5) of those without. Dysmenorrhea was significantly associated with functional impairment (p=0.020), with affected interns having 3.3 times higher odds of impairment (OR=3.304; 95% Cl not provided). The WAI revealed substantial work impairment: mean absenteeism was 4.4% (SD+10.3), presenteeism was 62.5% (SD+21.8), overall work productivity loss was 63.3% (SD+22.3), and activity impairment was 56.4% (SD+23.1). All WPAI components were significantly higher among interns with dysmenorrhea (p<0.001 for all). 89.7% of participants reported no institutional support for managing menstrual symptoms at work. Commonly cited barriers included lack of time (75.2%), no private space (59.4%), and lack of supplies (58.2%). The most desired accommodations were one-day leave (86.7%), short breaks (70.9%), and female-only rest areas (58.2%). Conclusion: Primary dysmenorrhea is highly prevalent among female medical interns in Addis Ababa and is significantly associated with reduced work performance and functional impairment. Although absenteeism was relatively low, high levels of presenteeism and productivity loss were observed. The lack of institutional support highlights the need for workplace policies that address menstrual health and provide supportive measures for affected interns. Keywords: menstrual disturbances, medical interns, work performance