Mediating effect of internalized misogyny on the relationship between premenstrual syndrome and body image

Internalized misogyny is strongly associated with premenstrual syndrome and dysmenorrhea, and negative attitudes and behaviors toward women may contribute to poorer health outcomes. Negative body image has also been associated with premenstrual symptoms in women, suggesting that internalized misogyny may mediate the relationship between premenstrual symptom severity and body image dissatisfaction. Accordingly, this study aimed to determine the mediating effect of internalized misogyny on the relationship between premenstrual symptom severity and body image dissatisfaction.

This study employed a cross-sectional design. Anticipating participant attrition during the data collection process, additional participants were recruited. The final sample consisted of 396 women who completed the survey within the study period. Data were collected using a web-based survey developed with Google Forms. The survey included a researcher-developed Personal Information Form, the Premenstrual Syndrome Scale, the Body Image Scale, and the Internalized Misogyny Scale. The mediating role of internalized misogyny in the relationship between premenstrual symptom severity and body image was examined using a simple mediation analysis with the PROCESS macro (Model 4).

Analysis of the total effect showed that premenstrual symptom severity had a significant negative effect on body image before the inclusion of internalized misogyny (B = -0.200, SE = 0.035, p < 0.001). After internalized misogyny was added to the model, the direct effect of premenstrual symptom severity on body image decreased but remained statistically significant (B = -0.184, SE = 0.035, p < 0.001). The indirect effect of premenstrual symptom severity on body image through internalized misogyny was also statistically significant (B = -0.016, SE = 0.008, 95% CI [-0.033, -0.003]), indicating partial mediation. Because the bootstrap confidence interval did not include zero, the indirect effect was considered statistically significant; however, its magnitude was small relative to the direct effect.

The findings indicate that internalized misogyny is an important explanatory factor in the relationship between premenstrual symptom severity and body image dissatisfaction.