Prevalence and Determinant of Premenstrual Dysphoric Disorder among Secondary School Female Students, Makkah Al-Mokarramah, Saudi Arabia

Abstract

Background: Premenstrual dysphoric disorder (PMDD) is characterized by psychological and physiological function impairment and can pose threat on adolescents’ academic performance and well-being. Objectives: This study aimed to determine the prevalence and determinants of PMDD among secondary school female students at Al-Iskan sector, Makkah Al-Mukarramah. Methods: A cross-sectional study involving 246 secondary school female students in Makkah Al-Mukarramah. A self-administered questionnaire was used for data collection. Variables such as demographic characteristics and PMDD were determined. Results: A total of 246 respondents participated in the study. Their age ranged from 16 to 21 years with an average of 17.0±0.9, Saudi national (82.1%), single (98.8%), and have no children (99.6%). In terms of educational attainment, about 37.4% of the respondents are in primary level, followed by 35.4% in the tertiary level, and 27.2% in the secondary level. In terms of individual symptoms experienced by the respondents before menstrual cycle, more than 4 in every 5 participants have suffered from mood swings or nervousness (82.5%) and from lethargy (80.1%). In addition, more than half of females interviewed have suffered too much or too little sleep (74.8%), a change in appetite increase or decrease (69.9%), muscle and joint pain (67.1%), difficulty in concentration and lack of effectiveness and productivity at work (65.0%), low indifference to the usual activities (58.9%), depression (58.5%), headaches (54.5%), from a sense of bloating in the abdomen (52.4%), and aggression (51.2%). Based on the findings of this study, about 40.7% of the participants were found to experienced irregular menstrual cycles. Age was found to be statistically significant associated with regularity of menstrual cycles. In terms of educational level, chi-square test revealed significant statistical association between educational level and premenstrual dysphoric disorder symptoms, such as lethargy, too much or too little sleep, and breast pain or swelling. Lastly, significant association was found between menstrual cycle and change in appetite. Conclusions: PMDD is characterized by substantial weakening of the ability to function socially or occupationally for a week prior to menstruation. It can be expressed through a combination of emotional, physical, and lifestyle symptoms. As such, management and treatment of PMDD must be made in accordance to the severity, types of symptoms, patient’s age, and preferences.