International journal of women's health · 2026
Dietary, Lifestyle, and Psychological Factors Associated with Premenstrual Syndrome Among Female University Students in Saudi Arabia: A Cross-Sectional Study.
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Huwaikem Mashael
Аннотация
BACKGROUND: Premenstrual syndrome (PMS) is common among women of reproductive age and has been associated with dietary, lifestyle, anthropometric, and psychological factors. However, evidence regarding the combined associations of these factors with PMS among young women in Saudi Arabia remains limited. This study examined dietary, lifestyle, anthropometric, psychological, and sleep-related factors associated with PMS among female university students.
METHODS: A cross-sectional study was conducted among 502 female students aged 18-29 years at King Faisal University, Saudi Arabia. Premenstrual symptoms were assessed using the Shortened Premenstrual Assessment Form (SPAF), dietary characteristics using a semi-quantitative Food Frequency Questionnaire (FFQ) and the Adolescent Food Habits Checklist (AFHC), and psychological distress using the Depression Anxiety Stress Scale-21 (DASS-21). Lifestyle, menstrual, anthropometric, and sleep-related characteristics were also assessed. Group differences were examined using non-parametric and categorical tests, and multivariable logistic regression was used to identify factors independently associated with PMS.
RESULTS: Participants with PMS had significantly higher stress, anxiety, depression, DASS-21 total, and sleep scores than those without PMS (all p < 0.001). In the multivariable analysis, stress score (AOR = 1.05, 95% CI: 1.02-1.10; p = 0.005) and sleep score (AOR = 1.03, 95% CI: 1.02-1.05; p < 0.001) remained significantly associated with PMS. Anxiety, depression, body mass index, and healthy dietary behaviour were not independently associated with PMS after adjustment.
CONCLUSION: Stress and sleep-related characteristics showed the clearest independent associations with PMS. Dietary and anthropometric measures were not independently associated with PMS after multivariable adjustment. Given the cross-sectional design, these findings should be interpreted as associations rather than causal relationships. Prospective studies are needed to clarify temporal relationships among psychological, sleep-related, dietary, lifestyle, and premenstrual health factors.
METHODS: A cross-sectional study was conducted among 502 female students aged 18-29 years at King Faisal University, Saudi Arabia. Premenstrual symptoms were assessed using the Shortened Premenstrual Assessment Form (SPAF), dietary characteristics using a semi-quantitative Food Frequency Questionnaire (FFQ) and the Adolescent Food Habits Checklist (AFHC), and psychological distress using the Depression Anxiety Stress Scale-21 (DASS-21). Lifestyle, menstrual, anthropometric, and sleep-related characteristics were also assessed. Group differences were examined using non-parametric and categorical tests, and multivariable logistic regression was used to identify factors independently associated with PMS.
RESULTS: Participants with PMS had significantly higher stress, anxiety, depression, DASS-21 total, and sleep scores than those without PMS (all p < 0.001). In the multivariable analysis, stress score (AOR = 1.05, 95% CI: 1.02-1.10; p = 0.005) and sleep score (AOR = 1.03, 95% CI: 1.02-1.05; p < 0.001) remained significantly associated with PMS. Anxiety, depression, body mass index, and healthy dietary behaviour were not independently associated with PMS after adjustment.
CONCLUSION: Stress and sleep-related characteristics showed the clearest independent associations with PMS. Dietary and anthropometric measures were not independently associated with PMS after multivariable adjustment. Given the cross-sectional design, these findings should be interpreted as associations rather than causal relationships. Prospective studies are needed to clarify temporal relationships among psychological, sleep-related, dietary, lifestyle, and premenstrual health factors.