Association between Premenstrual Syndrome and Stress Levels among Medical Students of a Teaching Hospital: A Cross-Sectional Study

Abstract

Background and objectives: Premenstrual syndrome (PMS) is a prevalent cyclic disorder affecting women of reproductive age, characterized by a group of emotional, behavioural, and physical symptoms in the luteal phase of the menstrual cycle. Medical and dental students represent a particularly vulnerable population due to the high academic demands and psychosocial stressors they encounter. This study aimed to determine the prevalence of PMS and its association with perceived stress levels among medical and dental female students of a teaching hospital.

Materials and Methods: A descriptive cross-sectional study was conducted among 102 female MBBS and BDS students from December 2024 to May 2025. Ethical clearance was obtained from Institutional Review Committee (CMC-IRC/081/082/113). Premenstrual Symptoms were assessed using The Premenstrual Symptoms Screening Tool (PSST), and perceived stress was measured using the validated 10-item Perceived Stress Scale (PSS-10). Data was analyzed using descriptive statistics and the Chi-square test, and a p-value of less than 0.05 was considered statistically significant.

Results: The mean age of participants was 20.34 ± 1.60 years. A total of 27 (26.5%)  students experienced moderate to severe PMS. The majority (83, 81.4%) reported moderate perceived stress, while 18.6% had high perceived stress. The most common PMS symptoms were anger/irritability (moderate: 34, 33.3%), fatigue/lack of energy (moderate: 33, 32.4%), and difficulty concentrating (moderate:33, 32.4%). A significant association was found between PMS severity and perceived stress levels (p = 0.001), with 8 (40.7%) students with moderate-to-severe PMS experiencing high perceived stress, compared to only 8 (10.7%) among those with mild or no PMS.

Conclusion: PMS is prevalent among medical and dental female students and was significantly associated with higher perceived stress. These findings highlight the need for institutional mental health interventions and reproductive health support within medical education settings.