Volume 23, Issue 4 (Oct - Nov 2019)                   2019, 23(4): 332-341 | Back to browse issues page

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Boustani F, Ziagham S, Jahangirimehr A, Honarmandpour A. Prevalence of Premenstrual Syndrome, Premenstrual Dysphoric Disorder and Associated Factors Among Female High School Students. Journal of Inflammatory Diseases. 2019; 23 (4) :332-341
URL: http://journal.qums.ac.ir/article-1-2771-en.html
1- Student Research Committee, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
2- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran. , saraziagham@yahoo.com
3- Department of Health, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
4- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
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1. Introduction
Health has been a top priority for women's rights in recent years, because in addition to their emotional role in the family, their occupational and social roles in society have become more prominent [1]. One of the psychosomatic issues associated with the reproductive system function in women is premenstrual syndrome (PMS). PMS is defined as recurrent mood, emotional, and physical symptoms that occur during luteal menstrual phase which is solved with the onset of menstruation immediately or a few days after it [2]. According to different studies conducted around the world, the prevalence of PMS  has been reported to be 40% in Europe, 85% in Africa, 46% in Asia, and 60% in South America [7].
Its prevalence among adolescents and youngsters in Iran has been increased from 16%-78.4% [3, 8]. The prevalence of this syndrome in a society varies depending on the factors such as culture, attitude, age, exercise, diet, and underlying diseases. It has high effects on individual and social functioning of patients with PMS. Considering the important individual and social role of women in society, and given that no study has been conducted to investigate the prevalence of PMS in Shoushtar, Iran, the present study was aimed to investigate the prevalence of PMS and premenstrual dysphoric disorder (PMDD) and the factors associated with them.
2. Materials and Methods 
This descriptive-analytical study was carried out on 368 female students studying at public high schools of Shoushtar, Iran in 2016. The samples were selected from 15 high schools by stratified random sampling technique. Data were collected by a  demographic form (surveying age, body mass index (BMI), mother’s age and job, age at menarche, and length of menstrual period), and the premenstrual symptoms screening tool (PSST) in Persian to determine the PMS and PMDD prevalence. The PSST consisted of 19 items in two sections rated as 0= never, 1= mild, 2= moderate, and 3= severe. The collected data were analyzed in SPSS V. 21 software using descriptive statistics and Kolmogorov-Smirnov test of normality, chi-square test of agreement between qualitative variables, and Man-Whitney test for comparison of quantitative variables between two study groups. The difference was considered significant if P<0.05.
3. Results
Students had a Mean±SD age of 16.3±0.87 years. Their age at menarche ranged 9-16 years with a Mean±SD value of 12.68±1.19 years. They reported the length of menstrual period as 2-10 days with a mean value of 5.9±1.45 days; for 319 (87.4%) of them, mother’s job was housekeeping and for others, the status was “employed”; 226 (61.41%) had physical activity and 142 (38.59%) had no activity; and 143 (39.4%) were using chemical medicines to relieve their pain. In this study, family history of PMS (P=0.017) and mother’s job (P=0.046) had a significant effect on the occurrence of PMS.
No significant difference was found between the two groups in terms of age, height, BMI, age at menarche, and length of menstrual period (P>0.05). From among participants, 197 (53.5%) had the signs and symptoms of PMS, of whom 20 (10.2%) had mild symptoms, 89 (45.2%) had moderate symptoms, and 88 (44.7%) had severe symptoms. Moreover, 45 (12.22%) suffered from PMDD. The most common symptoms included nervousness/irritability (n=151, 82.6%), muscle/joint pain (n=109, 59.9%), and relationship with family (n=138, 75.8%).
4. Conclusion
Our results reported the PMS prevalence of 49.72% and PMDD prevalence of 12.22%. Studies have reported different rates of PMS prevalence in different countries. For example, it is 38% among high school students in Iran (Kerman) and 11% in Switzerland, 92% among Chinese women, 64.6% among Japanese female adolescents, 53% for the Pakistani population, and 30.4% in the French population [8, 9, 14]. The prevalence of this syndrome is 67.7% for the Iranian women working in factories and 98.2%  for the Iranian female college students [15]. Ahmadi et al. in a study on the female high school students of Ilam city, in Iran reported a prevalence rate of 36.84% for PMS and 11.65% for PMDD [23]. Our results are consistent with the results of above mentioned studies. 
Family history of PMS was observed in 28.3% of participants in our study. There is a considerable relationship between the mothers and daughters and between sisters in terms of menstrual symptoms, indicating that the mother’s attitude is most likely to influence her daughter’s response to the disease. Positive family history increases the possible occurrence of PMS [5]. The most prevalent physical signs of PMS in the present study were muscle pain, headache, and flatulence and the least common signs were breast pain and overweight. In the previous studies [4, 17, 18], the most common physical signs were reported muscle pain and flatulence, which are in agreement with the results of our study. The most prevalent mood symptoms in the current study were anger, fatigue/shortage of energy, and difficulty concentrating  and the least common symptoms were loss of interest in working and insomnia. 
Ethical Considerations
Compliance with ethical guidelines

This study was approved by the Research Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (Code: IR.AJUMS.REC.1395, 731).
This study was extracted from a research project approved by the Shoushtar Faculty of Medical Sciences, Shoushtar.

Authors' contributions
Conceptualization: Forough Boustani and Sara Ziagham;  Writing and data analysis: Forough Boustani, Azam Jahangirimehr and Azam Honarmandpour; Editing, supervision and project administration: Sara Ziagham; Initial draft preparation by Forough Boustani.
Conflicts of interest
The authors declare no conflicts of interest.
The authors would like to thank the Deputy for Research and Technology of Shoushtar University of Medical Sciences, and the students participated in the study for their valuable cooperation and support.  

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Type of Study: Research | Subject: Midwifery

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