Premenstrual symptoms in Pakistani women and their effect on activities of daily life

Objective: To study the prevalence of Premenstrual symptoms in Pakistani women aged 15 to 49 years, and to determine the effects of the symptoms on activities of daily life and treatment sought for them. Methods: This study was cross sectional, population based using a questionnaire of 402 women from Karachi, Lahore and Islamabad. A checklist of 23 premenstrual symptoms, socio-demographic factors and lifestyle variables was used. Statistical analysis was done with SAS and R statistical packages. Results: Majority 98.8% of women were unaware of Premenstrual syndrome and Premenstrual dysphoric disorder. Using ICD-10 classification 79.9 % (CI: 75.6 - 83.7) of women and using American College of Obstetricians and Gynaecologists criteria, 12.7% (CI: 9.6 -16.3) had same and through DSM IV Classification 5.5% (CI: 3.5 - 8.2) had Premenstrual dysphoric disorder. There was no significant difference between the three cities. Common symptoms were abdominal bloating, cramps, lack of energy, irritability and mood swings. The effect of PMS severity on activities of daily life was highly significant (Loglinear model, p .001). Physician consultation increased with severity of PMS: 12.7% for ICD 10 PMS, 25.6% for ACOG PMS, and 40.9% for Premenstrual dysphoric disorder, (p = 0.002). Conclusion: Physical symptoms predominate in the premenstrual experience of the Pakistani women in this study, and have a significant impact on their daily life activities.