Menstrual Distress Questionnaire (MEDI-Q): a new tool to assess menstruation-related distress

Published:September 06, 2021DOI:


      Research question

      Menstruation is a physiological event often associated with subjective distress. Is there a tool that assesses and objectively evaluates the global distress experienced by women during their period?


      An observational cross-sectional study conducted between June 2019 and May 2020 at Careggi University Hospital, Florence, Italy. A new questionnaire, The Menstrual Distress Questionnaire (MEDI-Q), was developed and administered to a group of healthy women (n = 418) of fertile age (18–50 years), without known uterine, psychiatric disorders, or both. The MEDI-Q investigated 25 items, covering the following areas: pain, discomfort, psychic or cognitive changes, gastrointestinal symptoms and changes in physiological functions. MEDI-Q Total Score and the three sub-scales, Menstrual Symptoms (MS), Menstrual Symptoms Distress (MSD) and Menstrual Specificity Index (MESI) were evaluated. The validation of MEDI-Q was achieved by testing test–retest reliability and internal consistency, convergent and concurrent validity.


      The MEDI-Q produced reliable results with good internal consistency, convergent and concurrent validity. MEDI-Q Total Score, MS and MSD all positively correlated with general psychopathology and premenstrual symptoms. A receiver operating characteristic analysis was used to determine the cut-off value of 20 (inclusive) and to identify the women with clinically relevant menstrual distress (area under the curve 0.90, 95% CI 0.86 to 0.93; P < 0.001).


      MEDI-Q is a new tool for evaluating menstruation-related distress, and provides a representative score of stress perception. MEDI-Q may be added to routine women's healthcare to help identify and adequately monitor menstruation-related disorders, and their effect on wellbeing, promptly.


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      Silvia Vannuccini is a Consultant in Obstetrics and Gynaecology at University Careggi Hospital, Florence, Italy. Her PhD on molecular medicine focused on uterine disorders (endometriosis, adenomyosis and uterine fibroids), their imaging diagnosis, hormonal treatments, stress and effect on quality of life.
      Key message
      Menstruation is a physiological event that is often associated with subjective distress. The Menstrual Distress Questionnaire (MEDI-Q) is a new tool that evaluates menstruation-related distress and provides a representative score of stress perception to help identify and adequately monitor menstruation-related disorders and their effect on wellbeing.