Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

Rezende, Ana Paula Rodrigues; Alvarenga, Fernanda Rassi; Ramos, Marcelo; Franken, Débora Luiza; Costa, Juvenal Soares Dias da; Pattussi, Marcos Pascoal; Paniz, Vera Maria Vieira

doi:10.1055/s-0041-1741456

Brasil

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Original Article • Rev. Bras. Ginecol. Obstet. 44 (02) • Feb 2022 • https://doi.org/10.1055/s-0041-1741456 linkcopy

Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

Prevalência de síndrome pré-menstrual e fatores associados entre acadêmicas de uma Universidade no Centro-Oeste do Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in university students, the factors associated with PMS, the most prevalent symptoms, and the interference of symptoms in academic, family, social, and work activities.

Methods This cross-sectional study included 1,115 university students aged ≥ 18 years from the University of Rio Verde, Goiás. Premenstrual syndrome and PMDD were identified using the Premenstrual Symptoms Screening Tool. Associations with sociodemographic, behavioral, reproductive, nutritional, and health factors were investigated using the Poisson regression.

Results The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). The most prevalent symptoms were physical, such as breast tenderness, bloating, e weight gain (73%); followed by psychological ones such as overeating/food cravings, tearful/more sensitive to rejection (> 60%). More than 30% of the patients reported that the symptoms interfered in a moderate-tosevere way in their social and academic activities. After adjusted analysis, PMS was more prevalent in those who were attending the 1st/2nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71).

Conclusion Almost half of the university students had PMS and ~ 11%, PMDD. Physical symptoms were themost common and interfered in amoderate-to-severe way in various aspects of life. Attending the first semesters, consuming alcohol, and having depression were risk factors for PMS. The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome.

Keywords: premenstrual syndrome; premenstrual dysphoric disorder; cross-sectional studies; risk factors; students

Variables	n	%
Total	1,115	100
Age (years)
18–20	212	19.0
20.1–22	386	34.6
22.1–24	294	26.4
> 24	223	20.0
Skin color
White	653	58.6
Non-white	462	41.4
Course period (semester) (n = 1,114 - uninformed: 1)
≥ 9^th	163	14.6
7^th and 8^th	219	19.7
5^th and 6^th	241	21.6
3^rd and 4^th	262	23.5
1^st and 2^nd	229	20.6
Economic class^* (n = 1,076 - uninformed: 39)
A (high)	448	41.6
B	496	46.1
C–E (low)	132	12.3
Practice of physical activity^** (n = 1,084 - uninformed: 31)
No	404	37.3
Yes	680	62.7
Eating habits^*** (n = 1,114 - uninformed: 1)
Unhealthy	625	56.1
Healthy	489	43.9
Smoking status (n = 1,093 - uninformed: 22)
Non-smoker	1,003	91.8
Former smoker	45	4.1
Smoker	45	4.1
Alcohol consumption (in the last month) (n = 1,114 - uninformed: 1)
No	290	26.0
Yes	824	74.0
Use of hormonal contraceptives (n = 969 - uninformed: 146)
Do not use	336	34.7
1	487	50.3
≥ 2	146	15.1
Menarche (n = 1,106 - uninformed: 9)
≥ 12 years	780	70.5
< 12 years	326	29.5
Nutritional status (n = 1,095 - uninformed: 20)
Normal	924	84.4
Overweight	135	12.3
Obesity	36	3.3
Hyperthyroidism/Hypothyroidism^**** (n = 1,098 - uninformed: 17)
No	1,011	92.1
Yes	87	7.9
Depression^**** (n = 1,081 - uninformed: 34)
No	858	79.4
Yes	223	20.6

	Absent n (%)	Mild n (%)	Moderate n (%)	Severe n (%)
Premenstrual symptoms
Anger/irritability	120 (10.8)	304 (27.3)	492 (44.1)	199 (17.9)
Anxiety/tension	120 (10.8)	302 (27.1)	488 (43.8)	205 (18.4)
Tearful/more sensitive to rejection	114 (10.2)	235 (21.1)	471 (42.2)	295 (26.5)
Depressed mood/hopelessness	267 (24.0)	321 (28.8)	345 (30.9)	182 (16.3)
Lack of interest in activities at work	322 (28.9)	340 (30.5)	329 (29.5)	124 (11.1)
Lack of interest in homework	307 (27.5)	333 (29.9)	333 (29.9)	142 (12.7)
Lack of interest in social activities	313 (28.1)	368 (33.0)	312 (28.0)	122 (10.9)
Difficulty concentrating	418 (37.5)	322 (28.9)	278 (24.9)	97 (8.7)
Fatigue/lack of energy	271 (24.3)	331 (29.7)	381 (34.2)	132 (11.8)
Overeating/food cravings	90 (8.1)	239 (21.4)	438 (39.3)	348 (31.2)
Insomnia	584 (52.4)	274 (24.6)	193 (17.3)	64 (5.7)
Hypersomnia	422 (37.9)	291 (26.1)	268 (24.0)	134 (12.0)
Feeling overwhelmed	457 (41.0)	275 (24.7)	289 (25.9)	94 (8.4)
Physical symptoms: breast tenderness, headaches, joint/ muscle pain, bloating, weight gain.	86 (7.7)	220 (19.7)	439 (39.4)	370 (33.2)
Interferes with
Work/college efficiency or productivity	278 (24.9)	438 (39.3)	346 (31.0)	53 (4.8)
Relationships with coworkers/colleagues	257 (23.1)	425 (38.1)	359 (32.2)	74 (6.6)
Relationships with family	233 (20.9)	422 (37.9)	376 (33.7)	84 (7.5)
Social life activities	248 (22.2)	450 (40.4)	349 (31.3)	68 (6.1)
Home responsibilities	366 (32.8)	442 (39.6)	250 (22.4)	57 (5.1)

Variables	Prevalence of PMS	PR (95% CI)	p-value
	n (%)
Age (years)			0.325^a
18–20	102 (48.2)	1
20.1–22	186 (48.2)	1.00 (0.84–1.19)
22.1–24	137 (46.6)	0.97 (0.80–1.17)
> 24	98 (44.0)	0.92 (0.74–1.12)
Skin color			0.518^b
White	301 (46.1)	1
Non-white	272 (48.1)	1.04 (0.92–1.18)
Course period (semester)			0.001^a
≥ 9^th	62 (38.0)	1
7^th and 8^th	99 (45.2)	1.19 (0.93–1.52)
5^th and 6^th	107 (44.4)	1.17 (0.92–1.49)
3^rd and 4^th	129 (49.2)	1.30 (1.03–1.63)
1^st and 2^nd	125 (54.6)	1.44 (1.14–1.80)
Economic class			0.999^a
A (high)	207 (46.2)	1
B	238 (48.0)	1.04 (0.91–1.19)
C–E (low)	59 (44.7)	0.97 (0.78–1.20)
Practice of physical activity^*			0.869^b
No	191 (47.3)	1
Yes	325 (47.8)	1.01 (0.93–1.41)
Eating habits^**			0.047^b
Unhealthy	310 (49.6)	1
Healthy	213 (43.6)	0.88 (0.77–0.99)
Smoking status			0.018^b
Non-smoker	458 (45.7)	1
Former smoker	25 (55.6)	1.22 (0.93–1.59)
Smoker	28 (62.2)	1.36 (1.07–1.73)
Alcohol consumption (in the last month)			0.008^b
No	116 (40.0)	1
Yes	407 (49.4)	1.23 (1.06–1.44)
Use of hormonal contraceptives			0.036^a
Do not use	153 (45.8)	1
1	213 (43.7)	0.95 (0.82–1.11)
≥ 2	87 (59.6)	1.30 (1.09–1.55)
Menarche			0.064^b
≥ 12 years	353 (45.3)	1
< 12 years	167 (51.2)	1.13 (0.99–1.29)
Nutritional status			0.062^a
Normal	422 (45.7)	1
Overweight	75 (55.6)	1.22 (1.03–1.44)
Obesity	18 (50.0)	1.09 (0.78–1.53)
Hyperthyroidism/Hypothyroidism^***			0.206^b
No	467 (46.2)	1
Yes	46 (52.9)	1.14 (0.93–1.41)
Depression^****			< 0.001^b
No	354 (41.3)	1
Yes	145 (65.0)	1.58 (1.39–1.79)

Level	Variables	PR (95% CI)	p-value
1	Course period (semester)		0.001^a
	≥ 9^th	1
	7^th and 8^th	1.19 (0.93–1.52)
	5^th and 6^th	1.17 (0.92–1.49)
	3^rd and 4^th	1.30 (1.03–1.63)
	1^st and 2^nd	1.44 (1.14–1.80)
2	Eating habits^*		0.058^b
	Unhealthy	1
	Healthy	0.88 (0.76–1.00)
	Alcohol consumption (last 30 days)		0.018^b
	No	1
	Yes	1.23 (1.04–1.47)
	Use of hormonal contraceptives		0.115^a
	No
	1	0.94 (0.80–1.10)
	2 or +	1.22 (1.02–1.46)
	Menarche		0.094^b
	≥ 12 years	1
	< 12 years	1.13 (0.98–1.30)
3	Depression^**		< 0.001^b
	No	1
	Yes	1.49 (1.30–1.71)

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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Av. Brigadeiro Luís Antônio, 3421, sala 903 - Jardim Paulista, 01401-001 São Paulo SP - Brasil, Tel. (55 11) 5573-4919 - Rio de Janeiro - RJ - Brazil
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[TFN1] ^*
ABEP, Economic Classification Criterion of the Brazilian Association of Research Companies.

[TFN2] ^**
Practicing some physical activity for at least 150 minute/week.

[TFN3] ^***
Healthy eating habits considered: consumption of fruits and vegetables ≥ 5 days/week.

[TFN4] ^****
Diagnosed by a doctor, as reported by the university student.