Stress and menstrual disorders among Iranian medical students: A cross-sectional study

Background: Menstrual disorders are common among women and can cause discomfort. Several environmental factors are considered to be associated with these disorders.
Aim: To investigate the prevalence of psychological stress and menstrual disorders among Iranian medical students and to assess the environmental factors, including stress, that are associated with menstrual disorders.
Methods and material: This cross-sectional study was conducted on female medical students of Islamic Azad University Tehran Medical Sciences Branch, Tehran, Iran. Demographics, menstrual patterns and stress profile of the sample were assessed. Logistic regression models were used to evaluate factors associated with stress and menstrual disorders.
Results: Out of 358 participants, 10.1% had a menstrual cycle < 21 days (polymenorrhea), 2.8% had a menstrual cycle of >35 days (oligomenorrhea), and 9.2% had irregular menstrual cycle (metrorrhagia). Moreover, 13.7% had period lengths of >7 days (hypermenorrhea). 51.1% of the sample experienced heavy menstrual bleeding (menorrhagia). The average stress score was 19.87±9.09. BMI, cigarette and hookah smoking were significantly associated with higher stress (OR=1.158, 1.123 and 1.117, respectively). Polymenorrhea was significantly associated with age at menarche and stress score (OR=0.735 and 1.046, respectively). Metrorrhagia was also significantly associated with age at menarche and stress score (OR=0.757 and 1.043, respectively). New interns were less likely to have hypermenorrhea and metrorrhagia compared to pre-interns (OR=0.173 and 0.500, respectively).
Conclusions: Stress was associated with short and irregular menstrual cycles. There was a higher prevalence of stress and menstrual disorders among medical students compared to general population, which warrants further investigation and action.