Correlation Between Perceived Stress Scores and Menstrual Characteristics in Young Indian Women

TL;DR

Higher stress levels in young Indian women are linked to more severe menstrual issues like heavy bleeding and irregular cycles.

Contribution

This study empirically links perceived stress scores with specific menstrual characteristics in young Indian women.

Findings

Higher stress scores correlated with increased menstrual blood loss and irregularities.

Stress was associated with a higher prevalence of heavy menstrual flow and dysmenorrhea.

Menstrual duration was positively correlated with cycle length and blood loss.

Abstract

Introduction: Stress is a common causative factor of menstrual irregularities, and the effect is supposed to be mediated by an alteration in normal pulsatile gonadotropin-releasing hormone (GnRH) secretion by stress.

Methodology: A cohort of 150 apparently healthy young women as volunteers was selected randomly. They were asked to attempt the perceived stress scale-14 (PSS-14) questionnaire, and based upon their scores, 50 women were allocated into group A (score of ≤28) and group B (score of ≥29), by a stratified sampling method. Their menstrual characteristics, including age of menarche, cycle length, duration of menses, any history of heavy menstrual flow (staining/passage of clots), severe debilitating dysmenorrhea, irregularities, and pictorial blood assessment chart (PBAC) scores, were recorded. The chi-square (χ2) test, Student's t-test, and Pearson's correlation coefficient were used to analyze the data using SPSS software version 21.0 (IBM Corp., Armonk, NY).

Results: Group B had higher PBAC scores than group A (110.24±70.00 versus 87.56±38.51; t=2.007 and p=0.047). A history of menstrual irregularity was more common in group B as compared to group A (22% versus 4%; χ2=7.162 and p=0.002), and a history of heavy menstrual flow was also more common in group B as compared to group A (72% versus 44%; χ2=8.046 and p=0.005). In the overall selected population, PSS scores were positively correlated with a history of heavy menstrual flow (r=0.267; p=0.007) and a history of debilitating dysmenorrhea (r=0.246; p=0.014). PBAC scores were positively correlated with menstrual irregularity (r=0.497; p<0.001), the duration of menses (r=0.422; p<0.001), a history of debilitating dysmenorrhea (r=0.212; p=0.034), and a history of heavy menstrual flow (r=0.212; p=0.034). The duration of menses was positively correlated with menstrual cycle length (r=0.287; p=0.004) and a history of debilitating dysmenorrhea (r=0.211; p=0.035). The history of heavy menstrual flow was also positively correlated with the history of debilitating dysmenorrhea (r=0.323; p=0.001).

Conclusion: Women suffering from higher perceived stress have higher menstrual blood flow, greater blood loss, and more chances of menstrual irregularities. Perceived stress levels are positively correlated with a history of dysmenorrhea and heavy menstrual flow. Menstrual blood loss is more in women with menstrual irregularities, longer menstrual duration, a history of dysmenorrhea, and heavy menstrual flow. Longer menstrual cycles tend to have longer menstrual duration. Dysmenorrhea is positively correlated with heavier menstrual flow.