# 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.

## Key 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.