Pharmacological and nonpharmacological management of dysmenorrhea among senior high school girls in two districts in the Central Region of Ghana.

Background: Dysmenorrhea is a common menstrual health problem among adolescents, often managed through pharmacological and non-pharmacological strategies. However, the factors that predict adolescents' choice between these management approaches remain poorly understood, particularly in settings where traditional and modern practices coexist. This study examined the predictors of pharmacological and non-pharmacological management practices among school-going female adolescents in Ghana. Methods: A cross-sectional survey was conducted among 490 female students aged 13-24 years in 2 senior high schools within the Effutu and Agona West Municipalities. Participants were recruited using simple random sampling. For minors (aged 13-17 years), written informed consent was obtained from Legally Authorized Representatives and written assent from participants; adult participants (aged 18-24 years) provided written informed consent directly. Exclusion criteria included diagnosed gynecological disorders, inability to provide informed assent or parental/guardian consent, and cognitive impairments. Data were collected using a structured questionnaire and analyzed with chi-square tests and logistic regression. Results: The prevalence of dysmenorrhea was 82.4%. Pharmacological management was significantly associated with dysmenorrhea experience (χ2 = 11.51, p = 0.003). Pain intensity emerged as a strong predictor, with adolescents reporting moderate (Exp(B) = 1.7, p = 0.03) and severe pain (Exp(B) = 2.42, p < 0.01) more likely to use medications. Non-pharmacological practices were significantly associated with program of study (χ2 = 28.75, p = 0.001), while demographic factors showed no significant associations. Conclusion: Pain severity drives pharmacological management, whereas educational exposure influences non-pharmacological choices. Comprehensive menstrual health education is needed across academic programs to promote effective, evidence-based management of dysmenorrhea among adolescents in Ghana.