Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis

Association between premenstrual syndrome and eating disturbance in college students: a cross-sectional study

BACKGROUND

Premenstrual syndrome (PMS) is a severe problem in women, and a well-balanced diet helps improve PMS symptoms. Eating disturbances are a major health problem in young women. Limited research has explored the correlation between eating behaviors and PMS symptoms in Japan. This study aimed to compare eating disturbances and the severity of PMS symptoms in college students.

METHODS

This study was conducted among female college students using an online questionnaire. The questionnaire included basic information (age, height, and weight), PMS symptoms, and eating behaviors assessed using the Eating Attitudes Test 26.

RESULTS

The proportion of those with PMS symptoms who were disturbed by PMS symptoms was significantly higher in the group with eating disturbance. Those who were affected by the physical symptoms of PMS had significantly higher scores on the subscales related to diet, bulimia and food preoccupation.

CONCLUSION

The results showed an association between PMS symptom severity and eating disturbance. The findings of this study indicate that individuals with eating disturbances may experience adverse effects on PMS symptoms, even in cases where weight is not at the extremes of excessive underweight or obesity.

Determinants of dysmenorrhoea among female adolescents: results from a community-based cohort study in Amsterdam

RESEARCH QUESTION

What is the contribution of sociodemographic, psychosocial, lifestyle and reproductive factors up to the age of 11-12 years to the occurrence of dysmenorrhoea at age 15-16 years within the Amsterdam Born Children and their Development (ABCD) study?

DESIGN

Data of 1038 female adolescents were used. Participants' baseline characteristics were obtained using self-reported questionnaires up to the age of 11-12 years, as well as the obstetric information of their mothers during pregnancy. Dysmenorrhoea was assessed at the age of 15-16 years, and was deemed to be present if an adolescent reported menstrual abdominal and/or back pain and therefore took medication and/or hormonal contraception. Using a backward selection approach, potential determinants of dysmenorrhoea were selected and multivariable associations were determined.

RESULTS

The overall prevalence of dysmenorrhoea was 49.5% among the participants. Intake of 3-4.5 sugar-sweetened beverages/day (P = 0.035) and higher gynaecological age (i.e. years since menarche) (P < 0.001) were significantly associated with higher occurrence of dysmenorrhoea in the final model, which explained 8.1% of the total variance in the occurrence of dysmenorrhoea. No significant associations were found between the occurrence of dysmenorrhoea and sociodemographic or psychosocial factors.

CONCLUSIONS

This investigation of various potential risk factors for dysmenorrhoea suggests that diet and reproductive factors are particularly important predictors of the occurrence of dysmenorrhoea among young adolescents. Specifically, intake of sugar-sweetened beverages and higher gynaecological age were predictive of the occurrence of dysmenorrhoea. Other lifestyle factors were also identified as possible risk factors. Using this knowledge, effective strategies can be developed to reduce the burden of dysmenorrhoea among adolescents, and to provide appropriate care for those suffering from the condition.

Prevalence of dysmenorrhea and associated factors and its effect on daily academic activities among female undergraduate students of Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia

Background

Dysmenorrhea is pain during menstrual flow and is the most common gynecologic complaint in reproductive-age girls. The severity of dysmenorrhea ranges from mild to severe pain during menstruation, which affects their academic activities.

Objective

To assess the prevalence and associated risk factors of dysmenorrhea and its effects on academic activities among Hawassa University students from April 1-30/2021.

Methods

A cross-sectional study was conducted and a systematic random sampling technique was used to select 348 study participants. Standardized self-administered questionnaires were used to obtain relevant data. The severity of pain was assessed using a verbal multidimensional scoring system and Numerical Pain Rating Scale (NPRS) methods. The collected data was entered into Epi info version 7 and exported to SPSS version 21 for analysis and then descriptive statistics and logistic regression analysis were performed.

Results

The prevalence of dysmenorrhea was 80% (277). Of those affected by dysmenorrhea, using the verbal multidimensional scoring system, 47.6% (132) were found to have mild pain, 39.7% (110) had moderate pain, and 12.6% (35) had severe pain. However, using the Numeric Pain Rating Scale (NPRS), 21.7% (60) were found to have mild pain, 33.2% (92) had moderate pain, 37.5% (104) had severe pain, and 7.6% (21) had very severe pain. It was found to have a negative effect on academic activity, such as loss of concentration in class (p = 0.00), disruption of study time (p = 0.00), sleep disturbances (p = 0.00), issues in personal relationships (p = 0.00), and absenteeism (p = 0.00). Associated factors included being sexually active, having a family history of dysmenorrhea, and the presence of depression.

Conclusion

Dysmenorrhea is prevalent in this study and has a significant impact on academic activities. Family history of dysmenorrhea, being sexually active, and the presence of depression are associated factors.

Prevalence and Associated Factors of Premenstrual Syndrome in Chinese Adolescent Girls

Epidemiological data on premenstrual syndrome (PMS) in Chinese adolescents are limited. This study reported the prevalence and associated factors of PMS in a large sample of Chinese adolescents. A total of 5099 adolescent girls who had menarche participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort study in Shandong, China. A self-administered questionnaire was used to ask about PMS, age at menarche, menstrual cycle interval, menstrual flow length, menstrual regularity, period pain, body weight and height, trait anger, stressful life events, and demographics. The mean age of the sample was 15.19 years (SD = 1.32). The overall prevalence of PMS was 24.6%. The prevalence rates of PMS-anxiety, PMS-water retention, PMS-craving, and PMS-depression were 18.9%, 4.0%, 7.9%, and 11.5%, respectively. The most common symptoms were premenstrual irritability (54%) and fatigue (52.5%). Stepwise logistic regression showed that high levels of life stress (OR 2.26), high levels of trait anger (OR 4.65), alcohol consumption (OR 1.28), menstrual cycle interval ≤ 24 days (OR 1.45), and mild (OR 1.50), moderate (OR 2.57) or severe period pain (OR 4.84) were all significantly associated with increased likelihood of PMS. In conclusion, approximately 1 in 4 Chinese adolescent girls suffered from PMS. Multiple psychosocial and menstrual factors were associated with PMS. Further research is needed to understand developmental changes of PMS and its long-term impacts on psychosocial wellbeing in Chinese adolescent girls.

The Changes in Menstrual and Menstrual-Related Symptoms among Japanese Female University Students: A Prospective Cohort Study from Three Months to Nine Months after Admission

Menstrual and menstrual-related symptoms can significantly impact an individual's physical and psychological health. Understanding how these symptoms evolve over time is crucial to provide appropriate support and healthcare services to young women. This study aimed to investigate changes in menstrual and menstrual-related symptoms among first-year female university students. A prospective longitudinal design was used to compare the symptom profiles between two time points (three and nine months after admission). Out of 100 female university students, 30 responses were analyzed. Data on menstrual and menstrual-related symptoms were collected using standardized questionnaires focusing on menstrual status and the Menstrual Distress Questionnaire (MDQ); no notable changes occurred between the time points. Approximately half reported having irregular menstruation during the three time periods. Among the sub-scales, premenstrual "impaired concentration" showed a tendency to be lower, whereas menstrual "water retention" tended to be higher in timepoint 2 compared to timepoint 1. "Distractible" was found to be significantly lower in timepoint 2 compared to timepoint 1. There was a significant association between a sleep duration of <7 h and worsened MDQ scores. These findings may underscore the importance of providing comprehensive lifestyle and menstrual education to new university students, along with access to appropriate medical care.

Menstrual Abnormalities in Female International Students in Japan: Changes during Pre-Arrival, Difficult, and Current Periods

The number of Japan's international students has rapidly increased in the last decade. This study examines the relationship between menstrual abnormalities in cycle and symptoms, stress level, and lifestyle of female international students in Japan across three time periods, namely pre-arrival, difficult, and current time periods. A cross-sectional design was employed, and data were collected through a self-administered questionnaire, including the menstrual distress questionnaire (MDQ), between December 2022 and February 2023. The questionnaire was distributed to 56 female international students from two universities in Japan, and a total of 29 valid responses were collected. We found varying menstrual cycle abnormalities and severity of menstrual symptoms across three time periods, with the difficult period after arrival in Japan displaying the highest symptom severity. Higher stress levels were significantly associated with more severe menstrual symptoms. Lifestyle habits such as alcohol consumption were also linked to menstrual symptoms. The current study emphasizes the importance of providing menstrual education, support, and resources to address international students' unique challenges in managing their menstrual health while studying abroad. By promoting awareness, education, and access to healthcare services, universities may contribute to international students' well-being and academic success.

Physical activity and combined hormonal contraception: association with female students' perception of menstrual symptoms

Aim: The aim of this study was to examine the association between physical activity (PA) and combined hormonal contraceptive (CHC) on female students' self perceptio of their menstrual cycle symptoms. Methods: Healthy French female students (n = 834) completed an online questionnaire to assess their PA level (Group 1: non-active; Group 2: moderate physical activity; Group 3: high physical activity; Group 4: very high physical activity), menstrual status or contraception use, self-reported diet and medication, impact on engagement in some social activities, and self-assessment of perceived mental and physical symptoms during the week prior to menses (PM) for students with a normal menstrual cycle (NMC), and the week of menses (ME) for normal menstrual cycle students and those using combined hormonal contraception. Results: Whatever the conditions (PM and ME, NMC and CHC), fewer self-perceived symptoms and self-reported alteration in fat intake were reported by the students in Group 4, and more analgesic and anti-inflammatory medication use was reported by Group 1. Fewer self-perceived symptoms were also found in CHC vs NMC female students for all physical activity levels, but in a more marked way when associated with very high physical activity. In addition, less university and sports practice absenteeism was observed with high and very high physical activity. Conclusion: In conclusion, the perception of menstrual cycle symptoms was lower with very high physical activity, as with combined hormonal contraception. Moreover, female students training more than 5 h/week also reported less university absenteeism and impairment in physical activities. Further studies are necessary to establish the causal link of physical activity and combined hormonal contraception on menstrual symptoms.

Menstrual cycle symptomatology during the COVID-19 pandemic: The role of interoceptive sensibility and psychological health

The literature on the COVID-19 pandemic has shown the importance of investigating its impact on mental health during this sensitive period, also in relation to the female menstrual cycle. To this end, interceptive sensibility has emerged as a fundamental construct for studying the mind-body interaction among psychosomatic and pain symptoms, particularly through the distinction between two attentional styles (namely, a "mindful" and a "non-mindful" sensibility). The aim of the following study is to verify the role of mental health and interoceptive sensibility on menstrual symptoms in women of childbearing age, during the pandemic, as well as to identify the specific contribution of the existing dimensions of interoceptive sensibility in the prediction of symptoms' severity. Data were collected through an online survey, for which 5294 women responded on demographic information, menstrual history, symptoms' disturbance, and completed the Italian versions of the GHQ-12 and the MAIA. The analyses showed that symptoms were strongly correlated to either the GHQ-12 and the MAIA subscales Noticing, Emotional Awareness, Trusting and Not-Worrying. This result was further verified via a hierarchical regression, which revealed that the same interoceptive dimensions and mental health strongly predicted the intensity of menstrual symptoms (R² = 0.177, ΔR² = 0.143) compared to other considered dimensions (R² = 0.180, ΔR² = 0.002). Results are partially in line with the premises but suggest that mental health has a strong impact on the experience of the menstrual cycle and that only a few interoceptive dimensions may be relevant in explaining the severity of menstrual symptoms. It is here suggested that noticing internal bodily signals and being aware of emotional states might become dysfunctional if not reconciled with a good ability to self-regulate internal states, but may rather contribute to the perpetuation of the 'vicious cycle' of heightened affective and attentional reactions to interoceptive sensations.