Association Between Insulin Resistance and Dysmenorrhea: Insights from a HOMA-IR–Based Case-Control Study in Southwestern Nigerian Female Undergraduates Tesl

Abstract

Dysmenorrhea remains one of the most prevalent gynaecological complaints among young women, often leading to reduced academic productivity and quality of life. Traditionally, it has been attributed to prostaglandin-mediated uterine hypercontractility. However, emerging evidence suggests that metabolic disturbances, particularly insulin resistance (IR), may also contribute to its pathophysiology. This study investigated the association between insulin resistance and dysmenorrhea among female undergraduates using the Homeostatic Model Assessment for Insulin Resistance (HOMAIR). A case-control study was conducted among 160 female ndergraduates aged 18–30 years at Fountain University, Osun State, Nigeria. Participants were classified into dysmenorrheic (n=80) and non-dysmenorrheic (n=80) groups. Data were obtained through structured questionnaires, anthropometric measurements, and biochemical 
assays of fasting glucose (enzymatic method) and fasting insulin (ELISA). HOMA-IR was calculated, and statistical analyses were performed using independent t-tests, chi-square tests, Pearson correlation, and multivariate regression, with significance set at p<0.05. 
Students with dysmenorrhea exhibited significantly higher HOMA-IR values than controls (3.3 ± 1.1 vs. 1.9 ± 0.7; p<0.001). HOMA-IR correlated positively with pain severity (r = 0.62, p<0.001) and emerged as an independent predictor of pain intensity (β= 0.54, 95% CI: 0.36–0.72, p<0.001). Lifestyle factors, such as dietary patterns and physical activity levels, also influenced both metabolic and pain outcomes. Insulin resistance is strongly associated with the presence and severity of dysmenorrhea in young women without polycystic ovary syndrome. Incorporating metabolic screening and lifestyle counselling into menstrual health care could improve prevention and management strategies, fostering holistic reproductive well-being