Abstract
This study aims to explore the association between stress coping and primary dysmenorrhea among Chinese female adolescent students. A two-step random, stratified, cluster sampling method was employed to assess the health status of female adolescents; aged 10 to 19 years attending middle and secondary schools in the urban region of Shenzhen city. The survey utilized a structured questionnaire that addressed menstrual details, dietary and sleep habits, and psychological factors. Binary logistic regression analysis was conducted to support the research objectives, and interaction and subgroup analyses were performed. Among the 1449 adolescent females surveyed, 72% reported experiencing dysmenorrhea. The analysis identified significant associations between primary dysmenorrhea and stress coping, menstrual cycle length, dietary, sleep duration, and family history. After adjusting for potential confounders, including menstrual characteristics and family history, compared with adolescents who experienced no difficulty coping with stress, those reporting moderate difficulty were 1.66 times more likely to experience primary dysmenorrhea (95% CI 1.12-2.47), while those reporting severe difficulty were 1.97 times more likely (95% CI 1.01-3.18). Additional sensitivity analyses substantiated the robustness of these findings. Our study establishes a significant association between stress coping and the incidence of dysmenorrhea among Chinese female adolescent students, highlighting the critical need to incorporate stress management strategies to addressing menstrual pain.