Premenstrual Symptoms and Dysmenorrhea Associated with Daily Routine Activities among Female Undergraduate Medical Students

Background: Menstrual cycle is the physiological changes that occur in female for the purpose of sexual reproduction. Premenstrual symptoms and dysmenorrhea are common problems related to menstruation among female which consequently effect their social and daily activities.

Objectives: To determine the prevalence of menstrual disturbances and factors which influence menstrual disturbances, and the effect of menstrual disturbances on the students’ daily routine activities

Methods: This cross-sectional study was conducted in private medical college in Melaka, Malaysia from March to December 2015. A total of 292 female undergraduate students provided informed consent and participated in this study. Self-administered questionnaire was distributed and the students were asked to complete a questionnaire which consisted of demographic data, detailed menstrual history, BMI, fast food diet habit and exercise. Menstrual symptoms during menstruation at last menstrual period (LMP) including dysmenorrhea, premenstrual symptoms and treatment seeking behavior were asked. Dysmenorrhea was assessed using numeric pain scale of score 0 to 10 in which 0 means no pain and 10 means the worst pain. We also assessed the disturbance of their daily activities due to the menstrual symptoms and irritability using Born-Steiner Irritability Scale. Univariate logistic regression analysis was used. Odds ratio together with 95% confidence interval were calculated.

Results: A total of 292 female undergraduate students participated in this study and response rate was 83.43%. Among female students, 69.5% had dysmenorrhea during LMP with median pain intensity of 5 (IQR 4.0 – 7.0) and 84.9% had premenstrual symptoms. The daily routine activities were affected in 52.7% of participants. Among them, 77.3% needed prolonged rest, 42.9% could not study, 29.9% missed social activities and 22.1% missed some or whole day classes. Regarding self-rated irritability, 65.8% had mild irritability and 20.5% had moderate irritability in LMP. The female students who had dysmenorrhea were significantly more likely to be affected in their daily routines activities with odds ratio 2.68 (95% CI 1.60 – 4.49). Similarly, the female students who had premenstrual symptoms were significantly more likely to be affected in their daily routines activities with odds ratio 2.47 (95% CI 1.26 – 4.83).

Conclusion: The prevalence of dysmenorrhea and premenstrual symptoms were high among female medical students. It was found that school absence, inability to study, and missed social and daily activities were related to these symptoms.