Premenstrual Syndrome among Reproductive-Age Women: a Narrative Review of the Literature

Abstract

Background: Premenstrual syndrome (PMS) is a common and clinically important condition among women of reproductive age, characterized by recurrent physical, psychological, and behavioural symptoms occurring during the luteal phase of the menstrual cycle and resolving with the onset of menstruation. The condition can adversely affect daily activities, academic and occupational performance, interpersonal relationships, and overall quality of life. Despite its substantial burden, reported prevalence and associated factors vary considerably across populations, partly due to differences in diagnostic criteria, assessment tools, and study settings. Methods: A narrative review of published literature was undertaken to synthesize evidence regarding the epidemiology, clinical manifestations, risk factors, diagnostic approaches, quality-of-life implications, and management of PMS. The review also examined limitations in existing evidence and identified important areas for future research. Results: The reviewed literature demonstrates that PMS is highly prevalent among women of reproductive age, although estimates vary according to population characteristics and diagnostic methodology. Commonly reported manifestations include fatigue, dysmenorrhoea, breast and bodily discomfort, mood swings, irritability, anxiety, depressive symptoms, reduced concentration, and behavioural changes. Psychological stress, unhealthy dietary practices, physical inactivity, high caffeine intake, menstrual irregularities, and sleep disturbances have been reported as important factors associated with the occurrence or severity of PMS. PMS may substantially impair academic and occupational functioning, social relationships, daily activities, and quality of life. Evidence supports lifestyle-based approaches, including regular physical activity, healthy dietary practices, adequate sleep, stress reduction, and appropriate patient education, while pharmacological treatment may be considered for women with moderate-to-severe or persistent symptoms. Conclusion: PMS represents an important yet frequently under-recognized public health and women’s health concern, with multidimensional physical, psychological, behavioural, and social consequences. Variability in diagnostic approaches and the predominance of studies conducted among adolescent or institutional populations highlight the need for well-designed community-based research using standardized diagnostic criteria and validated assessment instruments. Future studies should adopt an integrated approach to examine biological, psychosocial, menstrual, and lifestyle determinants alongside functional impairment and quality-of-life outcomes. Such evidence may facilitate targeted preventive strategies, early identification, and evidence-based management of PMS among women of reproductive age.