Dietary factors associated with premenstrual syndrome: A cross-sectional study of Turkish university students Premenstrual syndrome and nutrition

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Müge Yılmaz
Salime Mucuk
Tutku Atuk, Kahraman


premenstrual syndrome, food consumption, dietary factors, sugar


Background/aim: The etiology of premenstrual syndrome (PMS) is not precisely known; however, eating habits can affect the risk of PMS. This study compared the food consumption of individuals with and without PMS and determined the risk factors for PMS.

Materials and method: This cross-sectional study consisted of 237 university students (PMS n=131, non-PMS n=106). Data were collected through face-to-face interviews with a questionnaire form including questions about sociodemographic characteristics of the participants, a PMS scale, food frequency questionnaire, and their anthropometric measurements. Participants’ 3-day food consumption was recorded. Risk factors for PMS were determined using logistic regression analysis. The threshold of significance level was p<0.05.

Results: The mean score of PMS was significantly higher in participants with PMS (138.59±19.57) compared to those without PMS (92.22±17.99) (p<0.05). Participants with PMS consumed milk pudding/ice cream, biscuit/cracker varieties, honey/jam/molasses, sugar, coffee, chocolate/hazelnut-peanut butter, and carbonated/cola drinks more frequently than those without PMS. The amounts of daily energy (p=0.051) and carbohydrate consumption (p=0.036) of the group with PMS were higher than participants without PMS. The risk of PMS increased 2.903 times more in those who consumed milk puddings/ice cream more frequently (1-2 times/week or more), 2.468 times more in those who consumed honey/jam/molasses (5-6 times/week or more), and 2.270 times more in those who consumed sugar (5-6 times/week or more) (p<0.05). As income levels decreased, the risk of PMS increased (p<0.05).

Conclusion: Participants experiencing PMS problems consumed foods with high, simple sugar content more frequently, which increased the risk of PMS. Therefore, a healthy diet rich in complex carbohydrates and with limited consumption of simple sugars is suggested to prevent PMS.


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1. Appleton SM. Premenstrual Syndrome: Evidence-based, evaluation and treatment. Clin Obstet Gynecol 2018; 61: 52-61.
2. Ryu A, Kim TH. Premenstrual syndrome: A mini review. Maturitas 2015; 82; 436–40.
3. Yonkers KA, O’Brien PMS, Eriksson E. Premenstrual syndrome. Lancet 2008; 71: 1200–10.
4. Whelan AM, Jurgens TM, Naylor H. Herbs, vitamins and minerals in the treatment of Premenstrual syndrome: a systematic review. Can J Clin Pharmacol 2009; 16: e407–e429.
5. Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nutr 2000; 19: 3–12.
6. Yurt M, Mercanlıgil SM, Kabaran S. Effect of dairy products intake in women with premenstrual syndrome: a randomized controlled trial. Progress in Nutrition 2020; 22: 137–45.
7. Esmaeilpour M, Ghasemian S, Alizadeh M. Diets enriched with whole grains reduce premenstrual syndrome scores in nurses: an open-label parallel randomised controlled trial. Br J Nutr 2019; 121: 992–1001.
8. Yılmaz-Akyüz E. Aydın-Kartal Y. The effect of diet and aerobic exercise on Premenstrual Syndrome: Randomized controlled trial. Rev Nutr 2019; 32: e180246
9. High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents. Gynecol Endocrinol 2018; 34: 659–63.
11. Farasati N, Siassi F, Koohdani F, Qorbani M, Abashzadeh K, Sotoudeh G. Western dietary pattern is related to premenstrual syndrome: a case–control study. Br J Nutr 2015; 114: 2016–21.
12. Cheng SH, Shih CC, Yang YK, Chen KT, Chang YH, Yang YC. Factors associated with premenstrual syndrome – a survey of new female university students. Kaohsiung J Med Sci 2013; 29: 100–5.
13. Seedhom AE, Mohammed ES, Mahfouz EM. Life style factors associated with premenstrual syndrome among El-Minia University Students, Egypt. Int Sch Res Notices 2013; Article ID 617123
14. Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, Owais AA, et al. Premenstrual syndrome is associated with dietary and lifestyle behaviors among university students: A cross-sectional study from Sharjah, UAE. Nutrients 2019; 11: 1939.
15. Yoshimi K, Shiina M, Takeda T. Lifestyle factors associated with premenstrual syndrome: A cross-sectional study of Japanese high school students. J Pediatr Adolesc Gynecol 2019; 32: 590–5.
16. Işgın-Atıcı K, Kanbur N, Akgül S, Büyüktuncer Z. Diet quality in adolescents with premenstrual syndrome: A cross-sectional study. Nutr Diet 2020; 77: 351–58.
17. Özmermer T, Koruk F. Premenstrual syndrome frequency, premenstrual syndrome coping strategies and factors affecting premenstrual syndrome in university students in Turkey. International Journal of Health and Life-Sciences 2019; 4: 138–55.
18. Açıkgöz A, Dayı A, Binbay T. Prevalence of premenstrual syndrome and its relationship to depressive symptoms in first-year university students. Saudi Med J 2017; 38: 1125–31.
19. Işık H, Ergöl Ş, Aynıoğlu Ö, Şahbaz A, Kuzu A, Uzun M. Premenstrual syndrome and life quality in Turkish health science students. Turk J Med Sci 2016; 46: 695–701.
20. Houghton SC, Manson JE, Whitcomb BW, Hankinson SE, Troy LM, Bigelow C, et al. Intake of dietary fat and fat subtypes and risk of premenstrual syndrome in the Nurses’ Health Study II 2017; 118: 849–57.
21. Houghton SC, Manson JE, Whitcomb BW, Hankinson SE, Troy LM, Bigelow C, et al. Carbohydrate and fiber intake and the risk of premenstrual Syndrome. Eur J Clin Nutr 2018; 72: 861–70.
22. Houghton SC, Manson JE, Whitcomb BW, Hankinson SE, Troy LM, Bigelow C, et al. Protein intake and the risk of premenstrual syndrome. Public Health Nutr 2019; 22: 1762–69.
23. Cross GB, Marley J, Miles H, Willson K. Changes in nutrient intake during the menstrual cycle of overweight women with premenstrual syndrome. Br J Nutr 2001; 85: 475–82.
24. Cruz JJ, Cruz FES. Premenstrual Syndrome - A Short Review. Int J Gynaecol Obstet 2016; 5: 00164.
25. Madden AM, Smith S. Body composition and morphological assessment of nutritional status in adults: A review of anthropometric variables. J Hum Nutr Diet 2016; 29: 7–25.
26. Sağlam M, Arıkan H, Savcı S, İnal-İnce D, Boşnak-Güçlü M. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills 2010; 111: 278–84.
27. Craig CL , Marshall AL , Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-Country reliability and validity. Med. Sci Sports Exerc 2003; 35: 1381–95.
28. Gençdoğan B. A New Scale for Premenstrual Syndrome. Turk Psikiyatri Derg 2006; 2: 82–7.
29. Turkey Dietary Guidelines, Ministry of Health of Turkey Publication No: 1046, Ankara 2016.
30. Rakıcıoğlu N, Tek NA Ayaz A, Pekcan G. Photograph catalog of food and dishes: porsition sizes and amounts. Ankara: Hazırlık Ofset Pub; 2015
31. BeBis: Nutrition Database software, İstanbul. Available from:
32. Benton MJ, Hutchins AM, Dawes JJ. Effect of menstrual cycle on resting metabolism: A systematic review and meta-analysis. PLoS One 2020; 15: e0236025.
33. Bahramia A, Gonoodib K, Khayyatzadehc SS, Tayefid M, Darroudie S, Bahrami-Taghanakif H, The association of trace elements with premenstrual syndrome, dysmenorrhea and irritable bowel syndrome in adolescents. Eur J Obstet Gynecol Reprod Biol 2019; 233: 114–9
34. Purdue-Smithe AC, Manson JE, Hankinson SE, Bertone-Johnson ER. A prospective study of caffeine and coffee intake and premenstrual syndrome. Am J Clin Nutr 2016; 104: 499–507
35. Wikoff D, Welsh BT, Henderson R, Brorby GP, Britt J, Myers E, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017; 109: 585–648

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