Prevalence of Premenstrual Syndrome and Its Effect on Academic Performance among Taibah University Student in Al Madinah

Research Article

J Fam Med. 2022; 9(4): 1301.

Prevalence of Premenstrual Syndrome and Its Effect on Academic Performance among Taibah University Student in Al Madinah

AlhawsawiNM¹ and Shiekh W²*

11Academy of Family Medicine, Joint Program of Family Medicine, Al-Madinah, Saudi Arabia (KSA)

22Consultant Family Medicine, Joint Program Of Family Medicine, Al-Madinah, Saudi Arabia (KSA)

*Corresponding author: Wafa Shiekh, Consultant Family Medicine, Joint Program of Family Medicine, Al-Madinah, Saudi Arabia (KSA)

Received: April 18, 2022; Accepted: May 04, 2022; Published: May 11, 2022


Background: Premenstrual syndrome is one of the common problems affecting female in different age groups and could affects the academic performance of students.

Aims of this study were to estimate the prevalence of premenstrual syndrome and determine its effect on school performance among university medical students.

Material and Methods: It was a cross-sectional study done in Al-Madinah city, Saudi Arabia including all female medical students from level 2 to 5, enrolled at Taibah University. Data were collected through self-administrated questionnaire. It contains 4 main parts: socio demographic characters of the students, menstrual and premenstrual characteristics, and premenstrual syndrome scale.

Results: The study included 257 students, with a response rate of 70.8%. Their age ranged between 18 and 29 years with an arithmetic mean of 21.8 years and a Standard Deviation (SD) of 1.8 years. According to the premenstrual syndrome scale score with a cut-off level of 111, the prevalence of PMS among female medical students was 65.4%. PMS was not significantly associated with students` academic performance. However, it is associated with premenstrual or menstrual pain (p<0.001), family history of premenstrual syndrome (p=0.016), dysmenorrhea (p=0.002) and severe back pain or cramps (p<0.001 and p=0.007, respectively).

Conclusion: Premenstrual tension syndrome is a prevalent alarming health problem affecting a great sector of female medical University students, Taibah University, Al-Madinah, Saudi Arabia. It affected the daily work of a considerable proportion of students. However, it did not impact their academic performance.

Keywords: Premenstrual tension syndrome; Prevalence; Academic performance; Medical students


Menstruation is a natural phenomenon involving the discharge of blood from the uterus through the vagina, occurring at more or less regular monthly intervals during the reproductive life of female [1]. Normal menstruation first occurs in adolescents between 11 and 14 years of age, with a period length of 7 days or less, and a normal cycle length of 21 to 45 days with average blood loss of 20-80ml [2].There are various types of menstrual disorders one of them is Premenstrual Syndrome (PMS).

Premenstrual Syndrome (PMS) is describing cognitive, physical, affective, psychological, and behavioral symptoms that occur during the luteal phase of the menstrual cycle and resolve quickly within a few days of the onset of menstruation. Premenstrual syndrome has different criteria by different organizations. The intensity of the symptoms varies among individuals and also between cycles in the same individual. Approximately 20-30% of premenopausal women exhibit PMS symptoms and 5-8% suffer from extreme psychological disturbances that are classified as Premenstrual Dysphoric Disorder (PMDD) under Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) [3].

While PMS is associated with 200 different symptoms, the underlying cause(s) remain unclear. It is believed that the trigger behind PMS is multifactorial in nature, with perturbations in reproductive hormone levels being one of the major causes. Hormonal fluctuations differ among women, which explain the differences in the severity of the symptoms.

Different hypotheses have been suggested for explanation how the PMS occurs such as thyroid dysfunction, genetic factors, hypoglycemia, hormonal imbalance, fluid retention, stress and psychological factors but mainly it occurs secondary to hormonal imbalance [4]. In addition, lifestyle habits like nutritional history and regular exercise could be linked with premenstrual syndrome [5]. Many studies showed that there is a strong association between the PMS and impaired quality of life among young age group women. However, the quality of life is also affected by both social and working life. PMS also has an effect on the quality of sleeping [6]. The PMS among young adolescents’ age groups girls could also affect their school performance and social interactions in a negative way. Approximately 80% of reproductive age women experience these symptoms pre-menstrual at some point in their lifetime [7].

PMS is associated with a lower positive academic affect and lower frontal rest asymmetry scores [8]. Which are themselves related to reward processing dysfunction, lower productivity, and an interference with studies, however, this has been less studied specially in Saudi Arabia. Thus this study was designed to estimate the prevalence of premenstrual syndrome and its effect on academic performance among Taibah university students in Madinah Saudi Arabia.


This was a cross-sectional study conducted from July 2021 to December 2021, in the Taibah university, Madinah Al-Munawarah, which is located in northern Saudi Arabia. Female medical students were included from all academic years. According to the WHO sample size calculator, the sample size was 360. Data was collected through self-administrated questionnaire.

It contains 3 main parts:

1. Socio demographic characters of the students.

2. Menstrual and premenstrual characteristics.

3. Premenstrual syndrome scale to define premenstrual tension syndrome.

It includes nine subscales; “depressive feelings, anxiety, fatigue, irritability, depressive thinking pain, changed appetite, changed sleep, and swelling subscales. The total PMS score was computed PMS (44-220). Students scored 111 or higher were regards as having premenstrual syndrome [9].

After obtaining approval from the research committee in Madinah, consent was taken from the program director of Joint Program of Family Medicine. The researcher distributed a questionnaire to students after taking their consent and explained and clarified it to them and the questionnaire was taken at the same time by the researcher from the respondents.

Data were analyzed using the Statistical Package for the Social Sciences version 26 (SPSS Incl., Chicago, IL). Qualitative variables were presented as frequency and percent. Quantitative variables were tested for normality distribution and were presented as mean and standard deviation. The Chi-square test was used for group comparison. This study considered variables statistically significant at p < 0.05.


The study included 257 students; out of a total targeted of 363 with a response rate of 70.8%. Table 1 summarized the Sociodemographic characteristics of the participants. Their age ranged between 18 and 29 years with an arithmetic mean of 21.8±1.8 years. Majority of them 248(96.5%) were Saudis and singles 243(95.6%). Only 7(2.7%) of the students had children. More than one-quarter 70(27.2%) were enrolled in the 6th academic year whereas only 9.7% were enrolled in the 4th academic year (Table 1 and Figure 1,2 and 3).