Factors Affecting Healthcare Access for Dysmenorrhea: A Scoping Review Protocol

Citation

Ní Chéileachair F, Caes L, Belfield S, Bartl M & Durand H (2025) Factors Affecting Healthcare Access for Dysmenorrhea: A Scoping Review Protocol. BMJ Open.

Abstract
Introduction Dysmenorrhea (period pain) is a global public health issue affecting up to 91% of the 1.8 billion individuals who menstruate. While research has emphasised the improvement of menstrual health in low-middle income countries, undertreated dysmenorrhea remains an issue in high-income countries (HICs), where individuals often assume their pain experiences are normal. Studies report that individuals with dysmenorrhea delay seeking medical care, avoid it entirely, or are subjected to diagnostic and treatment delays. Difficulties accessing care is troubling, as individuals may suffer without access to evidence-based techniques, as well as the potential for underlying pathologies (e.g., endometriosis, pelvic inflammatory disease) to go undiagnosed. Many HICs have launched strategies for women’s health to address gaps in care access and knowledge around menstruation. Guided by Levesque and colleagues' (2013) Conceptual Framework of Access to Healthcare, this review will contribute to these strategies by providing an overview of factors affecting healthcare access for dysmenorrhea in HICs from the point of perceiving a healthcare need to engaging with care, as well as factors affecting perceived quality of care. Methods and Analysis This scoping review will follow the Joanna Briggs Institute’s (JBI) guidance for scoping reviews and will be conducted with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist extension for Scoping Reviews. Guided by Levesque and colleagues’ (2013) Conceptual Framework of Access to Healthcare, searching will seek to locate both peer-reviewed studies across PubMed, CINAHL, PsycINFO and Web of Science databases, as well as using webscraping to locate relevant grey literature. Results will be synthesized and mapped to construct a pathway to care, highlighting factors affecting the healthcare access for dysmenorrhea, as well as factors related to the quality of healthcare interactions. Ethics and Dissemination This review does not require ethical approval, as only existing data will be analysed. Results will be shared using peer-reviewed publications and conference presentations. Datasets emerging from the study will be made available on Open Science Framework. Registration: This review was initially registered on Open Science Framework (https://osf.io/2dsrc/) in February 2024, with an updated protocol registered in February 2025 and again in July 2025. Keywords: Dysmenorrhea, Healthcare Access, Period Pain, Endometriosis, Clinician

Keywords
Dysmenorrhea; Healthcare Access; Period Pain; Endometriosis; Clinician