Assessment of changes in premenstrual syndrome (PMS) before and after menstruation: A cross sectional study in Tangail, Bangladesh

Premenstrual syndrome (PMS) is a common condition affecting a significant number of women worldwide, characterized by various physical, emotional, and behavioral symptoms that occur in the luteal phase of the menstrual cycle and resolve after menstruation begins. This study aimed to assess the prevalence, severity and changes of PMS and its association with demographic and dietary factors among 400 women of childbearing age of 18-45 years, selected through purposive sampling in Tangail, Bangladesh. Data were collected using a structured questionnaire that included demographic information, dietary habits and various PMS symptoms. Participants reported on the frequency and intensity of multiple common PMS symptoms across three categories: psychological, behavioral, and physical. Psychological symptoms were prevalent, with irritability (62.81%), depression (53.90%), anxiety (43.84%) and blubbering (57.82%) being common. Behavioral symptoms included tiredness (71.32%), fatigue (59.61%), lack of concentration (5311%) and insomnia (49.08%). Physical symptoms like abdominal pain (66.90%), nausea & vomiting (52.10%) and headache (44.81%) were also widespread. Statistical analysis demonstrated significant reductions (p<0.05) in symptoms such as psychological (irritability, nervousness, blubbering), behavioral (increased appetite, insomnia, tiredness), and physical (headache, back pain) symptoms in post-menstruation, indicating hormonal influences on symptom severity. Logistic regression analyses indicated that older age (AOR=1.03, 95%CI: 1.00-1.06) and higher BMI (AOR=1.02, 95%CI: 1.00-1.05) significantly increased the odds of severe irritation, while higher educational levels were protective. Excessive sugar and fat intake were linked to increased severity of irritation (AOR=2.26, 95%CI: 1.27-4.01 & AOR=1.61, 95%CI: 0.98-2.65) and tension (AOR=1.63, 95%CI: 1.05-2.53 & AOR=1.36, 95%CI: 0.86-2.14). In contrast, multi-nutrient supplements showed a protective effect against severe irritation, suggesting a complex relationship with PMS. Overall, it is recommended that public health initiatives incorporate targeted nutritional interventions, such as promoting balanced diets rich in essential nutrients, and raising awareness about PMS management is necessary to improve women's health outcomes.