Assessment of changes in premenstrual syndrome (PMS) before and after menstruation: A cross sectional study in Tangail, Bangladesh 10.55131/jphd/2025/230206
Main Article Content
Abstract
Premenstrual syndrome (PMS) is a common condition affecting a significant number of women worldwide, characterized by various physical, emotional, and behavioral symptoms that occur in the luteal phase of the menstrual cycle and resolve after menstruation begins. This study aimed to assess the prevalence, severity and changes of PMS and its association with demographic and dietary factors among 400 women of childbearing age of 18-45 years, selected through purposive sampling in Tangail, Bangladesh. Data were collected using a structured questionnaire that included demographic information, dietary habits and various PMS symptoms. Participants reported on the frequency and intensity of multiple common PMS symptoms across three categories: psychological, behavioral, and physical. Psychological symptoms were prevalent, with irritability (62.81%), depression (53.90%), anxiety (43.84%) and blubbering (57.82%) being common. Behavioral symptoms included tiredness (71.32%), fatigue (59.61%), lack of concentration (5311%) and insomnia (49.08%). Physical symptoms like abdominal pain (66.90%), nausea & vomiting (52.10%) and headache (44.81%) were also widespread. Statistical analysis demonstrated significant reductions (p<0.05) in symptoms such as psychological (irritability, nervousness, blubbering), behavioral (increased appetite, insomnia, tiredness), and physical (headache, back pain) symptoms in post-menstruation, indicating hormonal influences on symptom severity. Logistic regression analyses indicated that older age (AOR=1.03, 95%CI: 1.00-1.06) and higher BMI (AOR=1.02, 95%CI: 1.00-1.05) significantly increased the odds of severe irritation, while higher educational levels were protective. Excessive sugar and fat intake were linked to increased severity of irritation (AOR=2.26, 95%CI: 1.27-4.01 & AOR=1.61, 95%CI: 0.98-2.65) and tension (AOR=1.63, 95%CI: 1.05-2.53 & AOR=1.36, 95%CI: 0.86-2.14). In contrast, multi-nutrient supplements showed a protective effect against severe irritation, suggesting a complex relationship with PMS. Overall, it is recommended that public health initiatives incorporate targeted nutritional interventions, such as promoting balanced diets rich in essential nutrients, and raising awareness about PMS management is necessary to improve women's health outcomes.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Liguori F, Saraiello E, Calella P. Premenstrual Syndrome and Premenstrual Dysphoric Disorder's Impact on Quality of Life, and the Role of Physical Activity. Medicina (Kaunas). 2023;59(11):2044. doi: 10.3390/medicina59112044
Modzelewski S, Oracz A, Żukow X, Iłendo K, Śledzikowka Z, Waszkiewicz N. Premenstrual syndrome: new insights into etiology and review of treatment methods. Frontiers in Psychiatry. 2024;15:1363875. doi: 10.3389/fpsyt.2024.1363875
Geta TG, Woldeamanuel GG, Dassa TT. Prevalence and associated factors of premenstrual syndrome among women of the reproductive age group in Ethiopia: systematic review and meta-analysis. PLoS One. 2020;15(11). doi: 10.1371/journal.pone.0241702
Firoozi R, Kafi M, Salehi I, Shirmohammadi M. The relationship between severity of premenstrual syndrome and psychiatric symptoms. Iran J Psychiatry. 2012;7(1):36-40.
Dilbaz B, Aksan A. Premenstrual syndrome, a common but underrated entity: review of the clinical literature. J Turk Ger Gynecol Assoc. 2021;22(2): 139-148. doi: 10.4274/jtgga.galenos. 2021.2020.0133
Raval CM, Panchal BN, Tiwari DS, Vala AU, Bhatt RB. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among college students of Bhavnagar, Gujarat. Indian J Psychiatry. 2016;58(2):164-170. doi: 10.4103/0019-5545.18379
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, Mekelle, northern Ethiopia. BMC Womens Health. 2014;14:52. doi: 10.1186/1472-6874-14-52
Dutta A, Sharma A. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in India: a systematic review and meta-analysis. Health Promot Perspect. 2021;11(2):161. doi: 10.34172/hpp. 2021.20
Uddin I, Islam R, Shuchy S, Mony S, Chowdhury D, Naim A, et al. Comparative study on premenstrual syndrome (PMS) symptoms among the adolescent girls in Bangladesh. Int J Child Adolesc Health. 2023;16(2):149-156.
Begum R, Rahman N, Hasan R, Jamil Y, Anjom Tamanna S, Islam R. Vitamin A Fortified Edible Oils and Rice: The Knowledge Level and Consumption Rate among Different Place of Residences in Tangail District, Bangladesh. Journal of Nutritional Science and Vitaminology. 2021;67(1): 13-20. doi: 10.3177/jnsv.67.13
Upadhyay M, Mahishale A, Kari A. Prevalence of premenstrual syndrome in college going girls - A cross sectional study. Clin Epidemiol Glob Health. 2023;20:101234. doi: 10.1016/j.cegh. 2023.101234
Al Sabbah H, Al Mutawa N, Assaf EA. Prevalence of premenstrual syndrome and its associations with dietary and other lifestyle factors among university female students in Dubai: A cross-sectional study. Women's Health (Lond). 2024;20:17455057241260026. doi: 10.1177/17455057241260026
Benton D. Carbohydrate ingestion, blood glucose and mood. Neurosci Biobehav Rev. 2002;26(3):293-308. doi: 10.1016/s0149-7634(02)00004-0
Thys-Jacobs S. Micronutrients and the premenstrual syndrome: the case for calcium. J Am Coll Nutr. 2000;19(2): 220-227. doi: 10.1080/07315724.2000. 10718920
Siminiuc R, Ţurcanu D. Impact of nutritional diet therapy on premenstrual syndrome. Front Nutr. 2023;10: 1079417. doi: 10.3389/fnut.2023. 1079417
Bertone-Johnson ER. Vitamin D and the occurrence of depression: causal association or circumstantial evidence?. Nutr Rev. 2009;67(8):481-492. doi: 10.1111/j.1753-4887.2009.00220.x
Ebrahimi E, Khayati Motlagh S, Nemati S, Tavakoli Z. Effects of magnesium and vitamin B6 on the severity of premenstrual syndrome symptoms. J Caring Sci. 2012;1(4): 183-189. doi: 10.5681/jcs.2012.026
Farpour S, Soleimani D, Moradinazar M, Samadi M. The relationship of dietary inflammatory index and dietary patterns with premenstrual syndrome among women in Kermanshah: An analytical cross-sectional study. Food Sci Nutr. 2023;11(7):4146-4154. doi: 10.1002/fsn3.3404
Freeman EW. Premenstrual syndrome and premenstrual dysphoric disorder: definitions and diagnosis. Psychoneuroendocrinology. 2003;28 Suppl 3:25-37. doi: 10.1016/s0306-4530(03)00099-4
Yonkers KA, O'Brien PM, Eriksson E. Premenstrual syndrome. Lancet. 2008;371(9619):1200-1210. doi: 10.1016/S0140-6736(08)60527-9
Barth C, Villringe, A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in neuroscience. 2015;9:37. doi: 10.3389/fnins.2015.00037
Hantsoo L, Epperson CN. Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Current psychiatry reports. 2015;17(11), 87. doi: 10.1007/s11920-015-0628-3
Wang P, Liu C, Liu L, Zhang X, Ren B, Li B. The Antidepressant-like Effects of Estrogen-mediated Ghrelin. Current neuropharmacology; 2015;13(4), 524–535. doi: 10.2174/1570159x1304150 831120650
Abbas K, Usman G, Ahmed M, Qazi R, Asghar A, Masood Shah A, et al. Physical and Psychological Symptoms Associated With Premenstrual Syndrome and Their Impact on the Daily Routine of Women in a Low Socioeconomic Status Locality. Cureus. 2020;12(10). doi: 10.7759/ cureus.10821
Kolatorova L, Vitku J, Suchopar J, Hill M, Parizek A. Progesterone: A Steroid with Wide Range of Effects in Physiology as Well as Human Medicine. International journal of molecular sciences. 2022;23(14):7989. doi: 10.3390/ijms23147989
Bhuvaneswari K, Rabindran P, Bharadwaj B. Prevalence of premenstrual syndrome and its impact on quality of life among selected college students in Puducherry. The national medical journal of india.2019; 32(1), 2019. doi: 10.4103/0970-258X.272109
Samadi Z, Taghian F, Valiani M. The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls. Iran J Nurs Midwifery Res. 2013;18(1):14-19.
Handy AB, Greenfield SF, Yonkers KA, Payne LA. Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review. Harv Rev Psychiatry. 2022;30(2):100-117. doi: 10.1097/HRP.00000000000 00329
Bansal D, Raman R, Rao TSS. Premenstrual Dysphoric Disorder: Ranking the Symptoms and Severity in Indian College Students. Journal of Psychosexual Health. 2019;1(2):159–163. doi: 10.1177/2631831819827183
Abirami P, Ambika S. Assess the prevalence of premenstrual syndrome among adolescent girls at Srm college of nursing, srm university, kattankulathur. Asian J Pharm Clin Res. 2017;10(5):202-205. doi: 10.22159/ ajpcr.2017.v10i5.13332
Dye L, Blundell JE. Menstrual cycle and appetite control: implications for weight regulation. Hum Reprod. 1997;12(6):1142-1151. https://doi.org/ 10.1093/humrep/12.6.1142.
O'Brien S, Rapkin A, Dennerstein L, Nevatte T. Diagnosis and management of premenstrual disorders. BMJ. 2011;342. doi: 10.1136/bmj.d2994
Baker FC, Driver HS, Paiker J, Rogers GG, Mitchell D. Acetaminophen does not affect 24-h body temperature or sleep in the luteal phase of the menstrual cycle. J Appl Physiol. 2002;92(4):1684-1691. doi: 10.1152/ japplphysiol.00919.2001
Yen JY, Lin HC, Lin PC, Liu TL, Long CY, Ko CH. Early- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder. Int J Environ Res Public Health. 2019;16(22):4352. doi: 10.3390/ijerph16224352
Bäckström T, Andreen L, Birzniece V, Björn I, Johansson IM, Nordenstam-Haghjo M, et al. The role of hormones and hormonal treatments in premenstrual syndrome. CNS Drugs. 2003;17(5):325-342. doi: 10.2165/ 00023210-200317050-00003
Ghosh S, Chaudhuri S, Jain VK, Aggarwal K. Profiling and hormonal therapy for acne in women. Indian J Dermatol. 2014;59(2):107-115. doi: 10.4103/0019-5154.127667
Itriyeva K. The effects of obesity on the menstrual cycle. Curr Probl Pediatr Adolesc Health Care. 2022;52(8): 101241. doi: 10.1016/j.cppeds.2022. 101241
Chocano-Bedoya PO, Manson JE, Hankinson SE, Willett WC, Johnson SR, Chasan-Taber L, Ronnenberg AG, Bigelow C, Bertone-Johnson ER. Dietary B vitamin intake and incident premenstrual syndrome. Am J Clin Nutr. 2011;93(5):1080-1086. doi: 10.3945/ajcn.110.009530
Dickerson LM, Mazyck PJ, Hunter MH. Premenstrual syndrome. Am Fam Physician. 2003;67(8):1743-1752.