Premenstrual symptoms and academic performance: exploring female medical students' experience, triggering factors,...

Premenstrual dysphoric disorder (PMDD) represents the most severe form of premenstrual symptoms, markedly affecting emotional well-being, physical health, and academic functioning. Medical students are particularly susceptible due to high academic demands and stress exposure. However, evidence from Saudi Arabia remains limited. This study examined the proportion of participants who screened positive for PMDD based on PTSS criteria, its associated triggering factors, and coping strategies among female medical students in the central region of Saudi Arabia.

A cross-sectional descriptive study was conducted among 492 female students enrolled in medical colleges. Participants were recruited through convenience sampling. Data were collected using a self-administered questionnaire consisting of sociodemographic and menstrual-related items and the validated Premenstrual Symptoms Screening Tool (PSST). Data analysis was performed using JMP Pro 17. Ethical approval was obtained from the Institutional Review Board at KAIMRC (SP23R/242/11). The study adhered to STROBE reporting guidelines.

The proportion of participants who screened positive for PMDD based on PTSS criteria of PMDD was 11%, while 42.5% of participants met criteria for moderate-to-severe premenstrual syndrome (PMS). The most frequently reported symptom triggers included stress (70.33%), poor general health (43.90%), poor nutrition (38.82%), and academic examinations (38.62%). Common coping strategies included rest (70.33%), consumption of warm herbal drinks (49.59%), and the use of heat therapy (48.58%). Only 21% reported seeking medical consultation. Significant associations were identified between PMS/PMDD severity and marital status (p = 0.010), college type (p = 0.029), menstrual blood amount (p < 0.001), dysmenorrhea (p < 0.001), and menstrual cycle regularity (p < 0.001). Symptom severity demonstrated a strong positive correlation with absenteeism due to dysmenorrhea (r = 0.402, p < 0.001).

PMDD and moderate-to-severe PMS are common among female medical students and are influenced by stress, lifestyle factors, and menstrual health characteristics. Despite the considerable impact on academic functioning and attendance, most students adopt self-management approaches and rarely seek medical care. These findings underscore the need for targeted health education, stress management support, and enhanced menstrual health services within academic institutions.