Mental and Reproductive Health Correlates of Academic Performance among Debre Berhan University Female Students, Ethiopia: The Case of Premenstrual Dysphoric Disorder

Prevalence and associated factors of premenstrual dysphoric disorder among high school students in Finote Selam town, northwest Ethiopia

Background

Premenstrual dysphoric disorder (PMDD) is the most prevalent but neglected psychiatric disorder, with somatic symptoms that are severe enough to markedly affect usual daily activities and have a negative impact on mental health and quality of life by affecting female patients' behavior and cognition. Studies regarding premenstrual dysphoric disorder and associated factors among high school students in low- and middle-income countries are limited. Therefore, the aim of this study was to assess the prevalence and associated factors of PMDD among high school students, and this is pivotal in further investigation.

Methods

A school-based cross-sectional study was conducted from March 25 to April 17, 2023 using a simple random-sampling technique to select a sample of 564 participants. Premenstrual dysphoric disorder was assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Self-administered standardized questionnaires were used to collect data.

Result

A total of 548 study participants participated, with a 97.2% response rate. The prevalence of premenstrual dysphoric disorder among high school students was found to be 33.03% (95%CI: 29.20-37.09). In a multivariable analysis, irregular menstruation cycle (AOR = 4.242, 95%CI = 2.182-8.246), depression (AOR = 5.272, 95%CI = 2.779-10.002), having greater than 4 days of menstruation bleeding duration (AOR = 2.138, 95%CI = 1.105-4.138), and high perceived stress (AOR = 3.468, 95%CL = 1.217-9.880) were the factors significantly associated with premenstrual dysphoric disorder.

Conclusion

The overall prevalence of PMDD which was one-third among high school students was high. Moreover, long duration of menstruation bleeding, depressive symptoms, irregular menstruation cycle, and high perceived stress were significant factors in PMDD. Therefore, it needs early screening and intervention in primary healthcare settings, especially for those who have high perceived stress, having depression, having a long duration of menstruation bleeding, and having an irregular menstruation cycle, so as to have good academic achievement and psychological wellbeing.

Burden of irregular menstrual cycle and its predictors among reproductive-age women in Ethiopia: Systematic review and meta-analysis

Introduction

Irregular menstrual cycle has negative health and psychosocial repercussions for women of reproductive age worldwide. However, there is no national data for policymakers and health planners in Ethiopia. Therefore, this review aimed to determine the overall burden of irregular menstrual cycle and predictors among reproductive-age women in Ethiopia.

Methods

International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google, and Google Scholar) and lists of references were employed to search literature in Ethiopia. The random-effects model was used to calculate the odds ratios of the outcome variable using STATA version 18. The heterogeneity of the studies was measured by computing I 2 and p-values. In addition, sensitivity analysis and funnel plots were performed to test the stability of pooled data in the presence of outliers and publication bias.

Results

The review includes 21 studies and 9109 populations. The overall burden of irregular menstrual cycles among reproductive-age women was 35% (95% CI: 30-41) with I 2 = 96.96%. Sleeping for <5 h a day (AOR: 2.49; 95% CI: 1.49-3.49) and a stressful life (AOR: 3.15; 95% CI: 1.44-4.85) were predictors of irregular menstrual cycles.

Conclusion

More than one in every three reproductive-age women in Ethiopia experience irregular menstrual cycles. Sleeping for <5 h a day and stress increase the likelihood of an irregular menstrual cycle, which can be modified by improving sleeping hours and decreasing stress stimulators through psychotherapy.

Determinants of premenstrual dysphoric disorder and associated factors among regular undergraduate students at Hawassa University Southern, Ethiopia, 2023: institution-based cross-sectional study

BACKGROUND

Premenstrual dysphoric disorder (PMDD) is a condition causing severe emotional, physical, and behavioral symptoms before menstruation. It greatly hinders daily activities, affecting academic and interpersonal relationships. Attention is not given to premenstrual disorders among female students in higher education. As a result, students are susceptible to stress, and their academic success is influenced by various factors, including their menstrual cycle, and the long-term outcomes and consequences are poorly researched. Even though PMDD has a significant negative impact on student's academic achievement and success limited research has been conducted in low- and middle-income countries including Ethiopia, especially in the study setting. Therefore, a study is needed to assess premenstrual dysphoric disorder and associated factors among regular undergraduate students at Hawassa University.

METHODS

An institutional-based cross-sectional study was conducted among 374 regular undergraduate female students at Hawassa University, College of Medicine and Health Sciences. A self-administered structured premenstrual symptoms screening tool for adolescents was used to assess premenstrual dysphoric disorder. The collected data were loaded into a statistical package for the social science version 25 and analyzed using it. Both bivariate and multivariate logistic regression were used to identify factors associated with premenstrual dysphoric disorder. Each independent variable was entered separately into bivariate analysis, and a variable with a p-value less than 0.25 were included in the multivariate analysis to adjust the possible confounders. Statistically significant was declared at a 95% confidence interval when variable with a p-value less than 0.05 in the multivariate analysis with premenstrual dysphoric disorder.

RESULTS

The magnitude of premenstrual dysphoric disorder in this study was 62.6% (95% CI 57.4-67.5). Having severe premenstrual pain (AOR = 6.44;95%CI 1.02-40.73), having irregular menstrual cycle (AOR = 2.21; 95% CI 1.32-3.70), students who had poor social support (AOR = 5.10;95%CI, (2.76-12.92) and moderate social support (AOR = 4.93;95%CI (2.18-11.18), and students who used contraception (AOR = 3.76;95%CI, 2.21-6,40) were statistically significant factors with the outcome variable.

CONCLUSION

The prevalence of premenstrual dysphoric disorder was high as compared to other studies. There was a strong link between irregular menstrual cycle, severe menstrual pain (severe dysmenorrhea), poor social support, and contraception use with premenstrual dysphoric disorder. This needs early screening and intervention to prevent the complications and worsening of the symptoms that affect students' academic performance by the institution.

Prevalence of premenstrual syndrome and its associated factors in Africa: a systematic review and meta-analysis

Background

Clinical research and epidemiological studies have shown that many women experience physical and behavioral symptoms that begin during the luteal phase of the menstrual cycle and terminate around the onset of menses; this is called premenstrual syndrome. The reviews stated that the pooled prevalence of premenstrual syndrome was around 50 percent. However, there has been no review done on premenstrual syndrome in Africa. Therefore, the aim of this systematic review and meta-analysis was to summarize the most recent data evidence on the pooled prevalence of premenstrual syndrome and its pooled effect of associated factors in Africa.

Method

We used an appropriate guideline for systematic reviews and meta-analyses reports, which is the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This review protocol was registered in PROSPERO (CRD42023414021). The publications were identified from PubMed/Medline, EMBASE, Scopus databases, and other grey searches. The included papers were the original data that reported the prevalence of premenstrual syndrome and associated factors published, in English, and papers available online from January 1, 2000, to May 30, 2023. The data was extracted in Microsoft Excel, and then it would be imported into STATA 11.0 for analysis.

Results

We have included 16 studies conducted in African countries with 6530 study participants. In this meta-analysis, the pooled prevalence of premenstrual syndrome among the reproductive-age participants in Africa was 46.98 (95% CI: 28.9-65.06%). Further, in subgroup analysis, the pooled prevalence of premenstrual syndrome was 57.32% in Nigeria, 43.8% in Ethiopia, and 38.6% among university students and 66.04% among secondary school students. Among associated factors, the early age of menarche was significantly related to premenstrual syndrome.

Conclusion

In this review, the pooled prevalence of premenstrual syndrome in Africa was high. Among factors, the early age of menarche was a risk factor for premenstrual syndrome. This finding might help the stakeholders (mental health policy makers, administrators, and mental health professionals) to address prevention, early screening, and management of PMS among reproductive-age women, and to give attention to more vulnerable bodies.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023414021.

Some, but not all of the premenstrual syndrome symptoms affect the medical exam scores in medical students

Objectives:

This research aims to identify the effects of premenstrual syndrome (PMS) symptoms on the school exam scores in medical students.

Methods:

This cross-sectional study was designed at Sakarya University School of Medicine The study included medical students who were in the first, second, and third year of class. In this study, there were 193 male and 100 female students. The study investigated how PMS symptoms affected medical student’s exam scores and school success. All exam scores were recorded during the two-consecutive semester so duration of study was one year

Results:

There were 100 female students, and they had five different committee exams for one year. Female student’s exam scores were significantly higher for four committees and an average score of all year. The mean age of female students was 19.9 ±1.5. Acne, nausea/vomiting, sleeping, abdominal bloating, and prurience change had significantly different exam scores compared to the group without these symptoms. Students with acne had substantially higher exam scores than without acne; inversely, the other four symptoms negatively affected exam scores.

Conclusion:

Some of the PMS symptoms can be more annoying and should change the quality of life more than the other symptoms, so we should define these symptoms to improve our student’s quality of life and school success.

Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

OBJECTIVES

The study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.

DESIGN AND METHOD

Institution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.

SETTING AND PARTICIPANTS

Ethiopia (2019: n=647 female university students).

OUTCOMES

The primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.

RESULTS

The prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).

CONCLUSIONS

Dysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

Prevalence and associated factors of premenstrual syndrome among women of the reproductive age group in Ethiopia: Systematic review and meta-analysis

INTRODUCTION

Premenstrual syndrome is a clinical condition characterised by the cyclic occurrence of physical and emotional symptoms, which can interfere with normal activity. It significantly affects the health-related quality of life and can result in decreased work productivity. The prevalence of premenstrual syndrome varies widely in different countries and different regions of the same country. Thus, this study was aimed to estimate the pooled prevalence of premenstrual syndrome and its associated factors among women in Ethiopia.

MATERIALS AND METHODS

Published studies searched from electronic databases such as PubMed/Medline, google scholars, HINARI, Science Direct, Cochrane Library, and EMBASE were used. All studies done among women of the reproductive age group in Ethiopia and reported in the English language were included. The current study was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two authors extracted the data independently by using Microsoft excel extraction format and transported to STATA 14 software for analysis. I2 test was used to assess heterogeneity between the studies. A random-effect model was computed to estimate the pooled prevalence and associated factors of premenstrual syndrome. The prevalence and odds ratio with 95% confidence interval (CI) were presented using a forest plot.

RESULTS

After careful screening of 33 studies, nine studies were included in our systematic review and meta-analysis. The pooled prevalence of premenstrual syndrome in Ethiopia was found to be 53% (95% CI: 40.64, 65.36). Subgroup analysis by university versus high school showed a pooled prevalence of 53.87% (95% CI: 40.97, 67.60) and 56.19% (95% CI: 6.80, 105.58), respectively. The pooled odds ratio shows that age at menarche, menstrual pattern and hormonal contraceptive use had no statistically significant association with premenstrual syndrome.

CONCLUSION

More than half of the women under reproductive age group were experiencing premenstrual syndrome in Ethiopia.

Magnitude of premenstrual dysphoric disorder and its correlation with academic performance among female medical and health science students at University of Gondar, Ethiopia, 2019: a cross-sectional study

OBJECTIVE

To assess the magnitude of premenstrual dysphoric disorder (PMDD) and associated factors among female students of the College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, 2019.

DESIGN

Institution-based cross-sectional study design.

SETTING

College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

PARTICIPANTS

386 participants were recruited for self-administered interview using the stratified followed by simple random sampling technique.

MEASUREMENT

Data were collected by self-administered interview. Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) was used to measure PMDD. The Perceived Stress Scale (PSS) and the Oslo-3 social support are used to assess the factors. The data were checked, cleaned and entered into EpiData V.3.1 and exported to Statistical Package for Social Science (SPSS) V.21.0 for analysis. Bivariate and multivariable binary logistic regressions were used. OR with 95% CI was employed to see the strength of associations between dependent and independent variables. Variables with a p value <0.05 in multivariable logistic regression were declared as significantly associated.

RESULT

386 participants were involved in the study, with a response rate of 84.6%. The overall magnitude of PMDD in this study was 34.7% (30.3 to 39.1). Severe menstrual pain (adjusted OR (AOR)=2.82, 95% CI: 1.83 to 4.23), perception of an impact on academic performance due to menstrual pain (AOR=2.31, 95% CI: 1.23 to 4.32), and high perceived stress (AOR=3.52, 95% CI: 2.58 to 5.60) were significantly associated with PMDD disorder among female medical and health sciences students.

CONCLUSION

PMDD is high among female medical and health sciences students. Thus, it needs early screening and intervention especially for those who have severe menstrual pain, perceived to have an impact on academic performance and high perceived stress.