Prevalence of menstrual disturbances and associated factors among female medical students in Southeast Asia: a systematic review and meta-analysis.

BACKGROUND

Menstrual disturbances are common among female medical students and may affect academic functioning, well-being, and daily activities, especially in Southeast Asia. This systematic review and meta-analysis aimed to estimate the prevalence of menstrual disturbances and synthesize associated factors among female medical students in Southeast Asia.

METHODS

PubMed, Embase, Scopus, Google Scholar, manual searching, and citation tracking were searched for studies published from January 1, 2000 to May 6, 2026. Eligible studies were observational studies that reported the prevalence of menstrual disturbances and associated factors among female undergraduate medical students in Southeast Asia. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist for analytical cross-sectional studies. Random-effects meta-analyses were conducted for outcomes with sufficient data, while associated factors were synthesized narratively.

RESULTS

17 studies involving 7,080 participants from Vietnam, Thailand, Indonesia, and Malaysia were included. Dysmenorrhea was the most frequently reported outcome, with a pooled prevalence of 78.11% (95% CI: 67.07%-86.21%; I² = 97.9%). The pooled prevalence was 30.10% for irregular menstruation (95% CI: 18.54%-44.89%; I² = 98.0%), 39.60% for premenstrual syndrome/premenstrual dysphoric disorder (95% CI: 20.13%-63.05%; I² = 98.5%), and 22.58% for abnormal menstrual cycle duration (95% CI: 15.48%-31.72%; I² = 95.0%). Family history showed the most consistent positive association with menstrual disturbances, with aOR ranging from 1.47 to 3.76. Psychological distress, functional impairment, caffeine intake, limited rest, and low or irregular physical activity were also reported as potential correlates, although evidence was heterogeneous. However, extremely high heterogeneity (I² >95%) was observed across all pooled outcomes; these estimates should therefore be interpreted with caution.

CONCLUSIONS

Menstrual disturbances are commonly reported among female medical students in Southeast Asia. However, the evidence is limited by cross-sectional designs, inconsistent outcome definitions, high heterogeneity, and frequent risk of bias. These findings should therefore be interpreted as exploratory rather than confirmatory.

TRIAL REGISTRATION: PROSPERO CRD420251178169.