Translation, cross-cultural adaptation, and preliminary psychometric validation of the spanish version of the Menstrual Distress Questionnaire (MEDI-Q)

Introduction: menstrual distress is a common condition that can significantly affect psychological well-being, daily functioning, and academic performance among young women. However, in Spanish-speaking contexts, particularly in Latin America, there is a limited availability of psychometrically validated instruments to assess this phenomenon. The Menstrual Distress Questionnaire (MEDI-Q) was developed to evaluate physical and emotional symptoms associated with the menstrual cycle. Objective: to translate, culturally adapt, and preliminarily evaluate validity evidence and reliability of the Spanish version of the MEDI-Q among Paraguayan university students, considering evidence based on content, internal structure, and relations with external variables, as well as to explore its association with mental health indicators and academic absenteeism. Methodology: a quantitative, cross-sectional, instrumental study was conducted with 216 university students. Factorial structure was examined using confirmatory factor analysis, and reliability was assessed through Cronbach’s alpha and McDonald’s omega. Associations between menstrual distress, anxiety, depression, and academic absenteeism were also analyzed. Results: the mean age was 24 ± 6.5 years. The MEDI-Q showed high internal consistency (α = 0.901; ω = 0.90). The unidimensional model did not meet the prespecified criteria for acceptable overall fit: although the SRMR was adequate (0.057), the RMSEA (0.088) exceeded 0.08 and the CFI (0.880) and TLI (0.860) were below 0.90. In this self-selected sample, 65.7 % of participants scored ≥20 on the MEDI-Q. In the adjusted multivariable model, academic absenteeism (aOR = 4.67; 95 % CI: 2.23–9.77), anxiety symptoms (aOR = 5.26; 95 % CI: 2.31–11.95), and depressive symptoms (aOR = 3.49; 95 % CI: 1.54–7.90) remained associated with MEDI-Q scores ≥20. Conclusions: The Spanish version of the MEDI-Q showed high internal consistency; however, the unidimensional model did not meet the prespecified criteria for acceptable fit, indicating that evidence based on internal structure remains limited. The adjusted associations were cross-sectional, showed limited precision, and do not support causal, predictive, or diagnostic interpretations.