This observational cross-sectional study aimed to estimate the prevalence of moderate-to-severe premenstrual syndrome (PMS) and symptoms consistent with premenstrual dysphoric disorder (PMDD) among female university students in Lebanon, to identify associated risk factors, and to describe management practices and their perceived effectiveness.
Data were collected at Beirut Arab University between April 20 and May 8, 2026, using validated instruments to screen for premenstrual symptoms, social media addiction, and perceived stress.
A convenience sample of female students aged 18–45 years was recruited across the university’s four campuses. Exclusion criteria removed participants reporting gynecological disorders (for example, PCOS, endometriosis, uterine fibroids), diagnosed psychiatric or thyroid conditions, current hormonal contraception, pregnancy or breastfeeding, amenorrhea, or chronic pelvic inflammatory disease.
The final analysis included 1,062 participants after exclusions. Premenstrual symptoms were assessed with the Premenstrual Symptoms Screening Tool (PSST). Social media addiction and perceived stress were measured using the Bergen Social Media Addiction Scale (BSMAS) and the Perceived Stress Scale-4 (PSS-4), respectively. The questionnaire also covered sociodemographic, menstrual, lifestyle, behavioral, psychosocial, and management-related factors.
The mean age was 22.09 ± 4.58 years (range 18–45); nearly half were 18–20 years old. More than half of participants were enrolled in non-medical faculties. Most participants were single or engaged (91.2%). Mean body mass index (BMI) was 23.92 ± 4.21 kg/m2, with 56% normal weight, 29.2% overweight, and 7.7% obese.
Menstrual history showed a mean age at menarche of 12.35 ± 1.29 years and an average cycle length of 28.26 ± 3.57 days. Mean menstrual duration was 6.16 ± 1.29 days. Moderate menstrual bleeding pattern was the most frequently reported.
Overall, 46.8% of participants screened positive for moderate-to-severe PMS based on PSST classification, and 16.5% had symptom patterns consistent with PMDD.
The most frequently reported moderate-to-severe symptom domains were physical symptoms (69.7%), fatigue or lack of energy (68.8%), depressed mood or hopelessness (67.8%), and overeating or food cravings (66.2%). Insomnia was the least frequently reported symptom, with nearly half reporting no insomnia.
Premenstrual symptoms commonly interfered with daily functioning. Home responsibilities had the highest reported interference, with 50.5% indicating moderate-to-severe impact. Social activities and study efficiency or productivity were affected in 44.6% and 43.2% of participants, respectively. Relationships with colleagues showed lower interference. Academic absenteeism during symptomatic periods was reported by 37.2% of the sample.
Among participants with moderate-to-severe PMS or PMDD, 39% reported using pharmacological management. The predominant pharmacological approach reported was non-steroidal anti-inflammatory drugs (NSAIDs). Non-pharmacological measures (not detailed numerically in the source summary) and healthcare consultation rates were assessed by the questionnaire; the source reports that less than half of medication users (45.8%) perceived their treatment as very effective.
The study notes that patterns observed are consistent with other regional reports where self-management and analgesic use are common approaches for symptomatic relief.
Multivariable binary logistic regression identified several factors independently associated with higher odds of moderate-to-severe PMS:
These findings indicate associations with modifiable behavioral, dietary, and psychosocial factors in this population.
The study adhered to the Declaration of Helsinki and received Institutional Review Board approval from Beirut Arab University on April 17, 2026. Electronic informed consent was obtained from all participants. The questionnaire required completion of mandatory items; as a result, there were no missing data in the submitted responses. Data were anonymized and analyzed using IBM SPSS Statistics version 24.
This study documents a high burden of moderate-to-severe PMS and a substantial prevalence of PMDD among female university students at a Lebanese university. Symptoms commonly produced functional impairment, including reduced academic productivity and absenteeism. Management was frequently self-directed, with NSAIDs commonly used but perceived as highly effective by fewer than half of users.
The analysis identified several modifiable risk factors—smoking, heavy menstrual bleeding, dietary patterns (meal skipping, fast-food consumption), excessive social media use, and elevated perceived stress—that were associated with greater symptom severity. The authors highlight the need for university-based awareness, screening, and counseling programs targeting these modifiable risk factors and promoting appropriate management strategies for premenstrual symptoms.
Limitations: the source reports the study design, exclusions, and sampling approach (convenience sampling) but does not provide further discussion of limitations in the provided text. Details beyond those reported in the source are not included here.