Behind the pain: Experiences and coping strategies to primary dysmenorrhea among adolescent girls in selected settings of Lusaka, Zambia

Primary dysmenorrhea, or painful menstrual cramps, affects many adolescent girls and can significantly disrupt their daily lives, school attendance, and social interactions. This study explored experiences and coping strategies with primary dysmenorrhea among adolescent girls in Lusaka, Zambia. Methods: Using a phenomenological approach, we conducted DrawingOut workshops and in–depth interviews among 20 adolescent girls in Lusaka in August 2024. These workshops allowed girls to visually express their experiences with menstrual  pain and the strategies they use to manage it. The research team analysed these drawings and interview transcripts to identify recurring themes using thematic analysis with the aid of Atlas.ti software. Results: Findings show that primary dysmenorrhea affects many aspects of the adolescents’ lives. Pain often leads to missing school, social withdrawal, and emotional distress. Barriers to getting healthcare include dismissive attitudes from healthcare providers, reliance on traditional remedies, and a lack of family support or understanding. Misconceptions and  minimal education on menstrual health further complicate these experiences, leaving girls with few effective ways to manage their pain. Common coping strategies include over–the–counter painkillers, traditional remedies, and  personal adjustments, although these strategies are often only partly effective. Conclusion: The study underscores  that primary dysmenorrhea is not merely a physical issue but also affects girls’ mental and social well–being. There  is an urgent need for better menstrual health education, more accessible healthcare tailored to adolescent needs, and support systems that address cultural stigmas and misconceptions. Improved resources and understanding can help girls manage dysmenorrhea more effectively and enhance their quality of life.