The Relationship between Perimenstrual Symptoms and Menstrual Attitude in high-school girls in Mashhad city in years 2011-2012

Document Type : Original Article


1 Lecturer of Midwifery, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Lecturer of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor of Biostatistics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Menstrual attitude is one of the important factors predicting menstrual symptoms which vary among different cultures and countries. The purpose of this study is to determine the relationship between menstrual symptoms and menstrual attitude in high school girls in Mashhad.
Methods: This correlational study was conducted on 407 high-school girls in Mashhad through a two stage sampling method in year 2011. Participants completed questionnaires including demographic and menstrual characteristics, lifestyle and menstrual attitude and menstrual symptoms questionnaires during the three phases of the menstrual cycle (a week before menstrual period, menstrual bleeding period and weeks after menstruation). Data were analyzed using SPSS software version 14 and statistical tests such as Pearson correlation coefficient test, independent T-student, ANOVA and linear regression.
Results: 74% of students reported premenstrual symptoms, 94.1% menstrual symptoms and 40.8% postmenstrual symptoms. 24.8% of students agreed that menstruation was a troublous event, 28% a bothersome event; 12.3% a natural event, 27% a predictable event and 14.5% evaluated it as neutral. There was also the Pearson correlation coefficient test showed there was a significant correlation between perimenstrual symptoms and all dimensions of the menstrual attitude.
Conclusion: Perimenstrual symptoms have significant correlation with all dimensions of the menstrual attitude.


1. Alavi M, Poushaneh K, Khosravi A. [Puberty health: knowledge, attitude and practice of the adolescent girls in
Tehran, Iran] [Article in Persian]. Payesh 2009;8(1):59-65.
2. Mazza JJ, Fleming C.B, Abott RD, Haggerty KP, Catalano RF. Identifying trajectories of adolescent depressive
phenomena: an examination of early risk factors. J Youth Adolesc 2010 Jun;39(6):579-93.
3. Shairi M, Atrifard M, Shojaee P, Taghizadevarjoi M. [Psychological state comparison of female students of high
schools and female students of universities during menstrual times Daneshvar] [Article in Persian], Sci Res J
Shahed Univ 2008;15(76):35-44.
4. Flug D, Largo RH, Prader A. Menstrual patterns in adolescent swiss girls: a longitudinal study. Ann Hum Biol
1984 Nov-Dec;11(6):495-508.
5. Zegeye DT, Megabiaw B, Mulu A. Age at menarche and the menstrual pattern of secondary school adolescents
in northwest Ethiopia. BMC Womens Health 2009 Oct 5;9:29.
6. Yang JM, Chen QY, Jiang XZ. Effects of metallic mercury on the perimenstrual symptoms and menstrual
outcomes of exposed workers. Am J Ind Med 2002 Nov;42(5):403-9.
7. Thomas l, Narayanan G. Psycho-social correlates of perimenstrual distress. J Indian Acad Appl Psychol 2006
8. Lu ZJ. The relationship between menstrual attitudes and menstrual symptoms among Taiwanese women. J Adv
Nurs 2001 Mar;33(5):621-8.
9. Carr-Nangle RE, Johnson WG, Bergeron KC, Nangle DW. Body image changes over the menstrual cycle in
normal women. Int J Eat Disord 1994 Nov;16(3):267-73.
10. Houston AM, Abraham A, Huang Z, D’Angelo LJ. Knowledge, attitudes, and consequences of menstrual health
in urban adolescent females. J Pediatr Adolesc Gynecol 2006 Aug;19(4):271-5.
11. Wong LP. Premenstrual syndrome and dysmenorrhea: urban-rural and multiethnic differences in perception,
impacts, and treatment seeking. J Pediatr Adolesc Gynecol 2011 Oct;24(5):272-7.
12. Chen HM, Chen CH. Related factors and consequences of menstrual distress in adolescent girls with
dysmenorrheal. Kaohsiung J Med Sci 2005 Mar;21(3):121-7.
13. Cockburn J, Pawson M. Psychological challenges in obstetrics and gynecology. London:Springer;2007.
14. Chang Y, Chen Y. Study of Menstrual Attitudes and Distress Among Postmenarcheal Female Students in
Hualien County. Journal of Nursing Research 2009; 17(1):20-29.
15. Chen H, Chen H. Related factors and consequences of menstrual distress in adolescent girls with dysmenorrhea.
Kaohsiung J Med Sci March 2005 ; 21 (3):121-127.
16. Kordi M, Mohamadirizi S, Shakeri MT, Salehi Fadardi JA, Hafizi L. [The relationship between midwives’ work
stress and perimenstrual distress] [Article in Persian]. Iran J Obstet Gynecol Infertil 2011;14(3):54-63.
17. Vichnin M, Freeman EW, Lin H, Hillman J, Bui S. Premenstrual syndrome (PMS) in adolescents: severity and
impairment. J Pediatr Adolesc Gynecol 2006 Dec;19(6):397-402.
18. Derman O, Kanbur NO, Tokur TE, Kutluk T. Premenstrual syndrome and associated symptoms in adolescent
girls. Eur J Obstet Gynecol Reprod Biol 2004 Oct; 15;116(2):201-6.
19. Bakhshani NM, Nowroozi Mousavi M, Khodabandeh G. Prevalence and severity of premenstrual symptoms
among Iranian female university students. J Pak Med Assoc 2009 Apr;59(4):205-8.
20. Lee JC, Yu BK, Byeon JH, Lee KH, Min JH, Park SH. A study on the menstruation of Korean adolescent girls
in Seoul. Korean J Pediatr 2011 May;54(5):201-6.
21. Takeda T, Koga S, Yaegashi N. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in
Japanese high school students. Arch Womens Ment Health 2010 Dec;13(6):535-7.
22. Wong LP, Khoo EM. Menstrual-related attitudes and symptoms among multi-racial asian adolescent females.
Int J Behav Med 2011 Sep;18(3):246-53.
23. Alonso C, Coe CL. Disruptions of social relationships accentuate the association between emotional distress and
menstrual pain in young women. Health Psychol 2001 Nov;20(6):411-6.
24. Britton CJ. Learning about ‘The curse’ - An anthropological perspective on experiences of menstruation.
Women’s Stud Int Forum1996 Nov;19(6):645-53.