Nattapong Buddhabunyakan, Srinaree Kaewrudee, Chompilas Chongsomchai, Sukree Soontrapa, Woraluk Somboonporn, Jen Sothornwit Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Background: Premenstrual syndrome (PMS) is a common health problem among adolescents. Objective: To assess the prevalence of PMS in Thai high school students. Materials and methods: This was a prospective study conducted among menstruating high school students in Khon Kaen, Thailand, from September to December, 2015. Participants were asked to prospectively complete an anonymous questionnaire, which included information about demographic data, menstrual patterns, and symptoms to be recorded on a daily calendar of premenstrual experiences according to the diagnostic criteria proposed by the American College of Obstetricians and Gynecologists. All of the data were prospectively recorded for 90 consecutive days. Results: Of the 399 participants, 289 (72.4%) completed the self-report questionnaire.

1. Calendar Of Premenstrual Experiences Downloads

Eighty-six participants (29.8%; 95% CI, 24.5%–35.4%) reported having PMS. The most common somatic and affective symptoms among participants with PMS were breast tenderness (74.4%) and angry outbursts (97.7%). There were significant differences between the PMS and non-PMS groups, and PMS was associated with various problems related to educational activities, including lack of concentration and motivation, poor individual work performance, poor collaborative work performance, and low scores.

However, there were no significant differences regarding interpersonal relationships between the PMS and non-PMS groups. Conclusions: PMS is a common menstrual disorder among Thai high school students. The most common symptoms reported in this study were angry outbursts and breast tenderness.

Keywords: premenstrual symptoms, prevalence, association, high school students. Introduction Premenstrual syndrome (PMS) is a cyclic phenomenon of somatic and affective symptoms appearing in the days preceding menses and interfering with one’s work or lifestyle followed by a symptom-free interval. PMS is variously defined.

The American College of Obstetricians and Gynecologists (ACOG) defined PMS as a clinical condition characterized by the cyclic presence of physical and emotional symptoms unrelated to any organic disease that appear during the 5 days before menses in each of the three prior menstrual cycles and disappear within 4 days of the onset of menses, without recurrence until at least cycle day 13. Additionally, the American Psychiatric Association (APA) has also established criteria for the diagnosis of severe PMS or premenstrual dysphoric disorder (PMDD).

Calendar Of Premenstrual Experiences Downloads

Women are diagnosed with PMDD when their lives are significantly affected by moderate to severe symptoms as defined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. The prevalence of PMS among adolescents varies from 10% to 53%, depending on the population studied and diagnostic measures used.

– For example, 10% and 3% of the participants in a Swiss Study experienced PMS and PMDD, respectively. In a Japanese study, prevalence rates of moderate to severe PMS and PMDD were 53% and 1.2%, respectively.

In a previous US population-based study, prevalence rates of PMS and PMDD were 8% and 5%, respectively. Women with PMS tend to have a significantly lower quality of life, increased absenteeism from work, decreased work productivity, impaired relationships with others, and more frequent visits to health providers than those who do not experience PMS. As there have yet been no prospective studies evaluating PMS prevalence among Thai adolescents according to the recent ACOG diagnostic criteria, this study was conducted to determine the prevalence of PMS and its impacts on educational activities and interpersonal relationships among Thai adolescents in Khon Kaen, Thailand. Materials and methods The study was conducted from September to December, 2015, with the approval of the Khon Kaen University Ethics Committee. We recruited 399 menstruating upper high school students (10th to 12th grade) in Khon Kaen, Thailand. A cluster sampling method was applied in enrolling the participants.

The target sample size was estimated to be 399, on the basis of an 80% power and 95% CI for the expected prevalence of 50%, with 10% loss to follow-up. Eligible criteria included: 1) age 15–18 years and 2) regular menstrual cycles (21–35 days). Participants were excluded if they had histories of: 1) medical problems including thyroid disorders, autoimmune disease, asthma, adrenal disorders, or epilepsy; 2) untreated depression or psychiatric disorders; 3) gynecologic problems including endometriosis or pelvic inflammatory disease; or 4) using hormonal medication such as oral contraceptive pills. The parents or guardians of the participating students provided written informed consent.

Diagnosis of PMS in this study was made according to the diagnostic criteria proposed by the ACOG. PMS can be diagnosed if the patient reports at least one of the following affective symptoms including depression, angry outbursts, irritability, anxiety, confusion, or social withdrawal and at least one of somatic symptoms including breast tenderness, abdominal bloating, headache, or swelling of extremities during the 5 days before menses in each of the three prior menstrual cycles. In addition, these symptoms are typically relieved within 4 days of the onset of menses, without recurrence until at least cycle day 13. The symptoms are present in the absence of any pharmacologic therapy, hormone ingestion, or drug or alcohol use. The symptoms must reproducibly occur during two cycles of the prospective records.

We applied the ACOG PMS questionnaires and the diary calendar of premenstrual experiences in collecting the data. The questionnaires were translated into Thai by the researchers and translated back into English by professional translators. The questionnaires and diary calendar were then sent to three professionals for assessment validation using the Item Objective Congruence index. An acculturated pilot study was conducted to improve the questionnaire quality. The questionnaires consisted of four sections. The first part consisted of demographic data questions including age, weight, height, exercise habits, coffee consumption, cigarette smoking, and alcohol consumption. The second part included gynecological history, menstrual patterns, and dysmenorrhea.

The third part included prospective symptoms on a diary calendar, which was constructed on the basis of ACOG PMS diagnostic criteria. The last part contained questions about the association with educational activities and interpersonal relationships. The severity of PMS symptoms was rated by the participants on the basis of their impacts on their daily lives, ranging from mild to moderate to severe. Mild symptoms were defined as not limiting daily activity.

Symptoms were considered moderate if there were marked limitations with regard to daily activity, and severe if the participants were unable to carry out the activities without discomfort. The anonymous questionnaires and attached consent forms were then distributed to the students, and participants were asked to record their symptoms for 90 days. Statistical analysis was carried out using SPSS software (IBM, Armonk, NY, USA). Descriptive statistics, including mean ± SD or percentage, were used when appropriate for reporting demographic data, prevalence of PMS, prevalence of impaired educational activity, and prevalence of impaired interpersonal relationships. A 95% CI of the prevalence of PMS was calculated to determine the precision of the primary outcome. The associations between PMS and participants’ educational activities and interpersonal relationships were analyzed via the χ 2 or Fisher’s exact test, as appropriate.

Statistical significance was set at P. Table 1 Characteristics of participants Note: Data are presented as numbers (percentage) or mean ± SD. Abbreviations: BMI, body mass index; PMS, premenstrual syndrome. Two hundred forty-eight participants (85.8%) reported having at least one of the 10 symptoms of PMS. The reported premenstrual somatic and affective symptoms and their frequency among the 85 participants with PMS are presented in.

The three most common somatic symptoms were breast tenderness (74.4%), headache (70.9%), and abdominal bloating (46.5%). The three most common affective symptoms were angry outbursts (97.7%), anxiety (73.3%), and irritability (68.6%). In most cases, these symptoms were rated as mild to moderate in severity. Table 2 Prevalence of premenstrual somatic and affective symptoms of PMS (N=86) Notes: a≥1 symptom/student.

BOn the basis of self-rating by participants, these are classified according to three levels, as follows: mild (no limitation of daily activity), moderate (marked limitation of daily activity), and severe (unable to carry out daily activity without discomfort). Data are presented as number (%). Abbreviation: PMS, premenstrual syndrome. The impacts of PMS on educational activities and interpersonal relationships are reported in. PMS was significantly associated with several problems regarding educational activity, as shown by lack of concentration and motivation, poor work performance, and low scores. However, PMS was not associated with absenteeism, difficulty in working, or the quality of interpersonal relationships. © Copyright 2017.

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