Lifestyle Factors Associated with Premenstrual Syndrome: A Cross-sectional Study of Japanese High School Students

Study Objective: To investigate the relationships between premenstrual syndrome (PMS) and lifestyle, sleep, and dietary habits among Japanese high school students. Design: Cross-sectional study. Setting: Two public high schools in Sendai, the largest city in northeastern Japan. Participants: A school-based survey was conducted among 1818 female Japanese high school students in 2015, and 1022 students with regular menstrual cycles (25-38 days) completed the questionnaire. Interventions and Main Outcome Measures: Relationships between PMS and lifestyle, sleep, and dietary habits. Results: The rates of moderate to severe PMS and premenstrual dysphoric disorder were 9.7% (99/1022) and 2.2% (22/1022), respectively. A total of 121 students (11.9%) were classified as having PMS-the PMS(+) group. Significant differences were observed between the PMS(+) group and those without PMS-the PMS(-) group-in age at menarche (P = .022), menstrual pain (P < .001), hypnagogic disorder (P < .001), long Internet use time (P < .001), eating breakfast (P = .018), chewing well (P = .037), and belonging to a sports club (P = .046). Multivariate analysis revealed that the risk factors for PMS were menstrual pain (odds ratio [OR], 4.74; 95% confidence interval [CI]: 2.83-7.95), hypnagogic disorder (OR, 2.22; 95% CI, 1.47-3.35), stress fracture (OR, 2.19; 95% CI, 1.21-3.98), and Internet use time (OR, 1.003; 95% CI, 1.001-1.005). Belonging to a sports club decreased the risk of PMS (OR, 0.57; 95% CI, 0.35-0.91). Conclusion: Sleep, dietary habits, belonging to a sports club, and screen time affect PMS among high school students.