Association of Premenstrual Syndrome with Calcium Intake and Dysmenorrhea: A Cross-Sectional Study of High School Female Students in Karachi

Abstract

Objectives:To determine the prevalence of PMS among adolescent high school girls in Karachi and to evaluate its association with dysmenorrhea and dietary calcium intake.Methods:A cross-sectional study was conducted from April 2025 to December 2025 among 185 unmarried female students aged 14–19 years from selected high schools in Karachi, Pakistan. Data were collected using a pre-tested, self-administered questionnaire, which included demographic details, menstrual history, dietary calcium intake, and PMS diagnosis based on American College of Obstetrics and Gynecology (ACOG) criteria. Statistical analysis was performed using SPSS version 26, with chi-square test applied at a significance level of p<0.05.Results:The mean age of participants was 16.7 ± 1.08 years. A total of 166 (89.7%) students met the diagnostic criteria for PMS, with the highest prevalence observed among 17-year-olds (39.1%). Dysmenorrhea was reported by 160 (86.5%) participants, of whom 148 (89.1%) also fulfilled PMS criteria (p=0.002). PMS significantly interfered with educational activities in 93 (56%) participants (p<0.001). Dietary assessment revealed that 59% of participants consumed inadequate calcium, and among them, 62.3% were diagnosed with PMS.Conclusion:PMS is highly prevalent among adolescent girls in Karachi and is significantly associated with dysmenorrhea and low dietary calcium intake. It adversely affects academic and social life. Health education and preventive strategies focusing on nutrition and early management are urgently needed.Keywords:Premenstrual syndrome, Dysmenorrhea, Calcium intake, Adolescents.