Academic Strain under Hormonal Stress: Premenstrual Syndrome and Premenstrual Dysphoric Disorder among Female Medical Students - Prevalence and Academic Impact
DOI:
https://doi.org/10.37762/jgmds.13-2.803Keywords:
Premenstrual Syndrome, Premenstrual Dysphoric Disorder, Academic Performance, Students, MedicalAbstract
ABSTRACT
OBJECTIVES
The study aims to determine the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) among female medical students and evaluate the impact these conditions have on the students’ academic performance.
METHODOLOGY
This cross-sectional study was conducted over two months at Suleman Roshan Medical College, using a census to include all female medical students with regular cycles and no major health conditions. Data were collected via a structured questionnaire based on ICD-10 and DSM-5 criteria to diagnose PMS and PMDD, and to assess academic impact. Participation was voluntary, anonymous, and required informed consent. Data were analyzed using SPSS version 23, employing both descriptive and inferential statistics. A p-value of less than 0.05 was considered statistically significant.
RESULTS
Study found high prevalence of premenstrual disorders among the 182 participants, with 90.1% meeting the criteria for PMS and 26.4% for PMDD. The most common moderate-to-severe symptoms were fatigue 61.0%, irritability 52.2%, and depressed mood 50.5%. Symptoms were strongly associated with academic impairment, with over 70% of students reporting negative effects on exam performance and concentration. A direct dose-response relationship was observed, with increased symptom severity associated with greater academic performance difficulties.
CONCLUSION
This study concludes that premenstrual syndrome and premenstrual dysphoric disorder are highly prevalent among female medical students and are significantly associated with substantial academic impairment.
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Green LJ, O'Brien PMS, Panay N, Craig M; Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome. BJOG. 2017;124:e73–e105. doi:10.1111/1471-0528.14260 DOI: https://doi.org/10.1111/1471-0528.14260
World Health Organization. International statistical classification of diseases and related health problems. 10th revision (ICD-10). Geneva: World Health Organization; 1992
Yonkers KA. Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder. UpToDate. 2008. Available from: https://www.uptodate.com DOI: https://doi.org/10.1037/e651992010-001
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Association; 2013 DOI: https://doi.org/10.1176/appi.books.9780890425596
Ryu A, Kim TH. Premenstrual syndrome: A mini review. Maturitas. 2015;82(4):436-440. doi:10.1016/j.maturitas.2015.08.010 PMID:26358865 DOI: https://doi.org/10.1016/j.maturitas.2015.08.010
Rezende AP, Alvarenga FR, Ramos M, Franken DL, Costa JS, Pattussi MP, et al. Prevalence of premenstrual syndrome and associated factors among academics of a university in midwest Brazil. Rev Bras Ginecol Obstet. 2022;44:133-141. doi:10.1055/s-0041-1741456 PMID:35349323 DOI: https://doi.org/10.1055/s-0041-1741456
Nisar N, Zehra N, Haider G, Munir AA, Sohoo NA. Frequency, intensity and impact of premenstrual syndrome in medical students. J Coll Physicians Surg Pak. 2008;18(8):481-484. PMID:18760073
Hashim R, Ayyub A, Hameed S, Qamar K, Ali S, Raza G. Premenstrual syndrome: Messes with my academic performance. Pak Armed Forces Med J. 2014;64(2):199-203
Jadoon NA, Yaqoob R, Raza A, Shehzad MA, Choudhry ZS. Anxiety and depression among medical students: A cross-sectional study. J Pak Med Assoc. 2010;60(8):699-702. PMID:20726214
Tolossa FW, Bekele ML. Prevalence, impacts and medical managements of premenstrual syndrome among female students: Cross-sectional study in College of Health Sciences, Mekelle University, Ethiopia. BMC Womens Health. 2014;14:52. doi:10.1186/1472-6874-14-52 PMID:24629038 DOI: https://doi.org/10.1186/1472-6874-14-52
Parry BL, Nowakowski S, Martinez LF, Berga SL. Premenstrual dysphoric disorder. In: Pfaff DW, Arnold AP, Etgen AM, Fahrbach SE, Rubin RT, editors. Hormones, Brain and Behavior. 2nd ed. San Diego: Academic Press; 2009. p. 2945-2974. doi:10.1016/B978-008088783-8.00094-9 DOI: https://doi.org/10.1016/B978-008088783-8.00094-2
Hamdan-Mansour AM, Hamaideh SH, Arabiat DH, Azzeghaiby SN. Psychosocial correlates of motivation for academic accomplishment among university students. Procedia Soc Behav Sci. 2014;159:32-36. doi:10.1016/j.sbspro.2014.12.323 DOI: https://doi.org/10.1016/j.sbspro.2014.12.323
Hamaideh SH, Al-Ashram SA, Al-Modallal H. Premenstrual syndrome and premenstrual dysphoric disorder among Jordanian women. J Psychiatr Ment Health Nurs. 2014;21(1):60-68. doi:10.1111/jpm.12047 PMID:23701449 DOI: https://doi.org/10.1111/jpm.12047
Bakhshani NM, Mousavi MN, Khodabandeh G. Prevalence and severity of premenstrual symptoms among Iranian female university students. J Pak Med Assoc. 2009;59(4):205-208. PMID:19402278
Ezadi Z, Ramozi M, Barati H, Hosseini M, Hakimi S, Mohammady N, et al. Prevalence and associated factors of premenstrual syndrome among female university students of reproductive age group in Kabul, Afghanistan: A cross-sectional study. Womens Health Rep (New Rochelle). 2025;6(1):403-411. doi:10.1089/whr.2024.0106 DOI: https://doi.org/10.1089/whr.2024.0106
Kalsoom U, Sultana A, Amjad T, Bairam S. Prevalence of premenstrual syndrome and knowledge assessment regarding its prevention among medical students of a private medical college of Islamabad. Pak Armed Forces Med J. 2018;68(1):159-164
Bukhari SS, Burki SA, Joiya RS, Ijaz F, Rahman F, Awan MA, et al. Impact of examination stress on premenstrual syndrome among female medical students. Ann King Edward Med Univ. 2023;29(Suppl 3):229-233. doi:10.21649/akemu.v29iSpl3.5576 DOI: https://doi.org/10.21649/akemu.v29iSpl3.5576
Siregar MF. Stress levels and characteristics of medical faculty students undergoing premenstrual syndrome and its association with academic achievements. Stress. 2013;3(1)
Talib Hassan I, Saadi Issa H, Hussein EA, Ali Haddad R. The effect of premenstrual tension on academic performance and social interactions among Iraqi medical students. Cell Mol Biomed Rep. 2023;3(4):205-211. doi:10.55705/cmbr.2023.390101.1113 DOI: https://doi.org/10.55705/cmbr.2023.390101.1113
Alemu SM, Habtewold TD, Haile YG. Mental and reproductive health correlates of academic performance among Debre Berhan University female students, Ethiopia: The case of premenstrual dysphoric disorder. Biomed Res Int. 2017;2017:9348159. doi:10.1155/2017/9348159 PMID:28567457 DOI: https://doi.org/10.1155/2017/9348159
Tenkir A, Fisseha N, Ayele B. Premenstrual syndrome: Prevalence and effect on academic and social performances of students in Jimma University, Ethiopia. Ethiop J Health Dev. 2003;17(3):181-188. doi:10.4314/ejhd.v17i3.9838
Omara EI, Salama RA, Tadross TM, Ahmed SK, Mohamed MG, Dewan SM, et al. Impact of premenstrual tension syndrome on academic performance among female university students from the United Arab Emirates: A cross-sectional study. Health Sci Rep. 2024;7(10):e70124. doi:10.1002/hsr2.70124 PMID:39221471 DOI: https://doi.org/10.1002/hsr2.70124
Minichil W, Eskindir E, Demilew D, Mirkena Y. Magnitude of premenstrual dysphoric disorder and its correlation with academic performance among female medical and health science students at University of Gondar, Ethiopia. BMJ Open. 2020;10(7):e034166. doi:10.1136/bmjopen-2019-034166 PMID:32665392 DOI: https://doi.org/10.1136/bmjopen-2019-034166
Shehata N, Arafa A, El Wahed HA, Fahim AS, Hussein GK. Epidemiology of dysmenorrhea among university students in Egypt. Int J Womens Health Wellness. 2018;4(1):073. doi:10.23937/2474-1353/1510073 DOI: https://doi.org/10.23937/2474-1353/1510073
Latthe P, Latthe M, Say L, Gülmezoglu AM, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: A neglected reproductive health morbidity. BMC Public Health. 2006;6:177. doi:10.1186/1471-2458-6-177 PMID:16824213 DOI: https://doi.org/10.1186/1471-2458-6-177
Dahlawi H, Bukhari I, Alshammari F, Althaqib G, Alhawasawi M, Bashiri R, et al. Effect of dysmenorrhea on academic performance among students studying in Princess Nourah Bint Abdulrahman University, Riyadh. Int J Med Dev Ctries. 2021;5(2):588-594. doi:10.24911/IJMDC.51-1608990432 DOI: https://doi.org/10.24911/IJMDC.51-1608990432
Goweda RA, Alkot MM, Alturkistani FA, et al. Prevalence of premenstrual dysphoric disorder among medical students of Umm Al-Qura University, Makkah, Saudi Arabia. World Fam Med J. 2016;99:1-7
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