Does exam stress make PMS worse?

Background: Stress is an unwelcome yet necessary aspect of all our lives which dictate our quality of life. This emotion is particularly unwelcome in the period of exams which is why this research was conducted, and for females specifically. Premenstrual Syndrome is a collection of symptoms occurring one week to ten days prior to a menstrual cycle involving but not limited to, fatigue, abdominal cramps, and restlessness. These symptoms can lead to disruption in their lives and a negative effect on the academic performance of female medical students. Objective: To determine the effect of examination stress on Premenstrual Syndrome in Pakistani medical students and to see if there is any correlation present. Methods: This was a cross-sectional study which was conducted between March and September of 2022 in CMH Lahore where 177 females were enrolled, prior to their exams with an exclusion criterion of females on antiepileptic medication, antipsychotics or birth control. Non-probability convenient sampling was used. Two pre-tested questionnaires were used to measure stress and Premenstrual Syndrome simultaneously, the Student Stress Inventory (SSI) and Premenstrual Syndrome Scale (PMSS), consensually and anonymously. Chi-squared test was utilized with a P-value less than 0.05 was taken as significant. Results: Out of 177 female students, for SSI, 53 had mild stress, 115 had moderate stress while 5 had high stress. As for PMSS, 2 students had no symptoms, 34 had mild symptoms, 63 had moderate symptoms, 57 had severe symptoms and 17 had very severe symptoms. We found a statistically significant link between pre-modular stress and its detrimental effects on premenstrual syndrome. Both the PMSS and the SSI had a p value of 0.004, which established a noteworthy association. Conclusion: A strong link was found between pre-examinational stress and menstrual irregularities in this research.

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