Rising menstrual health diagnoses in Spain, 2017-2024: trends and social inequalities

Background

Menstrual health problems (MHP) significantly affect the quality of life and wellbeing of women and people who menstruate, representing a relevant public health concern. However, epidemiological evidence on prevalence and trends of MHP in Spain remains limited. We aimed to analyse trends in MHP diagnoses registered in Primary Care (2017–2024) by age group, income level and country of birth, analysing inequalities in 2024.

Methods

A temporal trend analysis was conducted using Spain’s Primary Care Clinical Database (BDCAP), including over 15.5 million observations of women aged 10–49 assigned to the National Health System. MHPs included dysmenorrhoea, oligomenorrhoea/amenorrhoea, menorrhagia, polymenorrhoea, premenstrual syndrome and endometriosis. Annual prevalence rates and annual percentage changes (APC) were calculated for each individual diagnosis and stratified by sociodemographic variables for overall MHP diagnoses. For 2024 prevalence ratios (PR) were estimated using Poisson models stratified by age group, income level, and country of birth.

Results

MHP prevalence increased from 11.7% in 2017 to 21.7% in 2024, with dysmenorrhoea as the most prevalent diagnosis (4.6% to 9.8%). The steepest increase over time was observed among women aged 40-44 years (APC = 11.1%) and those born in Spain (APC = 9.6%). In 2024, women aged 25-29 years (PR = 1.04 [1.06-1.41]), those in the lowest income group (PR = 3.18[3.05-3.32]), and those born in Eastern Mediterranean (PR = 1.20[1.19-1.21]) were at greater risk of receiving an MHP diagnosis.

Conclusions

The substantial increase in MHP diagnoses in Primary Care underscores the need to pay greater attention to menstrual health, which has been largely overlooked to date. An analysis by age and socioeconomic characteristics is needed to strengthen equity in diagnosis and access to care.

Key messages

• MHP diagnoses nearly doubled between 2017–2024, with dysmenorrhoea as the most prevalent diagnosis, and the greatest increase among women aged 40–44 years.

• Inequalities by age, income level, and country of birth require intersectional analyses and equitable policies to address social inequalities in diagnosis and access to menstrual health care in Spain.