Investigating the association between diet and primary dysmenorrhea: a systematic review
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Objective Dysmenorrhea is the most common gynecological condition in women and significantly negatively impacts quality of life. Current treatment uses medications with the potential for side effects. As interest in dietary therapy for gynecological conditions grows in the form of "cycle-syncing," we sought to investigate the association between diet and dysmenorrhea as reported in recent peer-reviewed literature. Evidence Review We searched PubMed, SCOPUS, and Embase on January 1, 2025 using the search terms (Diet OR dietary OR Nutrition) AND (dysmenorrhea OR cramps). Studies published between 2020–2025 available in English were exported into Covidence, which automatically removed duplicate studies. This time period was selected because "cycle-syncing" became more widespread around 2019 and a prior systematic review was published at that time. One independent reviewer evaluated studies for inclusion. Studies were included if they explored the association between dietary patterns or food groups and the presence or severity of primary dysmenorrhea in premenopausal menstruating women. Studies were excluded if subjects were postmenopausal or pregnant or had a diagnosed gynecological pathology. If the exposure of interest was not a dietary pattern or food group but rather a single food, a supplement, or a micro or macronutrient profile, the study was excluded. Reviews, posters, and abstracts were excluded. Quality assessment was evaluated using the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Studies were grouped by dietary pattern or food group for synthesis and analysis of data. Results Of 806 unique studies that met the initial search criteria, 14 studies met the inclusion criteria and were included in this review. Study designs included cross-sectional (12), prospective cohort (1), and case-control (1). The included studies were conducted in 11 different countries from four different continents. Study cohorts ranged in size from 40–2,060 subjects with ages ranging from 11–40 years. The studies on the Mediterranean diet (MD) and its association with dysmenorrhea showed either no association or a beneficial association (i.e., greater adherence to the MD is associated with a reduced severity of dysmenorrhea). Those that analyzed fruit and vegetable consumption in addition had mixed results, but studies of the highest quality were those that reported a beneficial association. However, the studies that adjusted for confounding showed no association. Studies analyzing dietary patterns characteristic of a Western diet showed either no association with dysmenorrhea or an association with worsened dysmenorrhea. Both studies that analyzed the inflammatory status of diets found that inflammatory diets were associated with increased dysmenorrhea. Studies may have been biased by reporting methods, unknown gynecological pathology, the use of hormonal contraceptives, and the lack of adjustment for confounding variables. Conclusion Ultimately, more studies with higher quality and rigor need to be conducted on this topic, ideally those that are interventional in nature. At this time, the available evidence suggests that increased consumption of fruits and vegetables, typical of a MD, and reduced consumption of inflammatory foods or foods typical of a Western diet may reduce the risk of dysmenorrhea.
Source: F&S Reviews
Institution: University of Pennsylvania
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,500
OpenAlex ID: W7164883729