Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) affect a substantial proportion of female university students and correlate with reduced academic performance and poorer psychological well-being, though the evidence remains observational and cannot establish causation.
A systematic review published in the Journal of Visualized Experiments synthesized 11 observational studies (all cross-sectional) on PMS and PMDD prevalence and their associations with academic and well-being outcomes in female medical and health sciences students. The researchers searched five major databases for English-language studies published between January 2014 and December 2024, identifying 317 records initially before narrowing to 11 that met inclusion criteria.
The prevalence of PMS among female students varied substantially across studies, ranging from 37.0% to 86.2%. Probable PMDD prevalence showed even wider variation, from 13.8% to 66.9%. However, the review notes a critical methodological limitation: all PMDD estimates were based on questionnaire screening rather than prospective diagnostic confirmation over multiple cycles. This means the figures represent screening-positive cases rather than confirmed diagnoses. The diagnostic heterogeneity across studies complicates direct comparisons, as different researchers used different criteria to define and measure these conditions.
When students reported premenstrual symptoms, the associations with academic outcomes were consistent across studies. Reported impairments included reduced concentration, increased absenteeism, lower class participation, and subjectively perceived decreases in academic performance. Psychological well-being measures also showed associations with premenstrual symptomatology. The review identified several factors correlated with more severe symptoms or higher prevalence: severe dysmenorrhea, family history of PMS or PMDD, academic stress, irregular or shorter menstrual cycles, and lower physical activity levels.
The review emphasizes important design limitations that constrain inference. All included studies were observational and cross-sectional, preventing any determination of causality. The heterogeneous diagnostic criteria and outcome measurement approaches limit the ability to pool data or make definitive generalizable statements about prevalence and effect sizes. The authors recommend that universities consider providing menstrual health education, accessible health services and counseling, and appropriately tailored academic or social support, while acknowledging that future research needs standardized diagnostic approaches and prospective designs to clarify these relationships.
If you're a female student experiencing cyclical changes in concentration, mood, or absenteeism, the association identified in this review suggests these symptoms are common and recognized by health researchers. This is relevant information to bring to a healthcare provider, particularly if symptoms are severe or interfering with your functioning.
The correlations with academic stress, physical activity, and menstrual cycle regularity point to modifiable factors worth addressing. Consistent morning-exercise, daily-steps-target, and stress management strategies may support menstrual health, though this review did not evaluate intervention studies. If you experience severe dysmenorrhea alongside premenstrual mood or cognitive changes, that constellation warrants medical evaluation.
Universities identified in this review as providing menstrual health education, counseling access, and academic accommodations may already have these resources available. It's worth checking whether your institution offers these services, particularly if symptoms significantly affect your ability to attend class or complete coursework.
Be cautious about interpreting prevalence figures as applying to you directly. The 37-86% range for PMS reflects wide variation across different study populations and diagnostic approaches. Your individual experience may differ from group averages, and screening questionnaires are not the same as clinical diagnosis.
| Attribute | Details |
|---|---|
| Study type | Systematic review of observational studies |
| Number of included studies | 11 (all cross-sectional, observational) |
| Population | Female medical and health sciences students |
| Geographic scope | Multiple countries (implicit from multibase search) |
| Diagnostic method | Mixed questionnaire screening (no prospective diagnostic confirmation) |
| PMS prevalence range | 37.0% to 86.2% |
| Probable PMDD prevalence range | 13.8% to 66.9% |
| Primary outcomes assessed | Academic performance, psychological well-being, menstrual symptom burden |
| Study quality | Moderate (all observational cross-sectional; heterogeneous methods) |
| Journal | Journal of Visualized Experiments |
| PubMed ID | 42872740 |
| Publication year | 2025 |
Systematic review: "Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Systematic Review of Academic Performance and Well-Being in University Students." Journal of Visualized Experiments. PubMed: 42872740
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