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IS THERE ANY IMPACT OF EMPLOYMENT STATUS ON PREMENSTRUAL SYMPTOMATOLOGY.

Byline: Nazish Hayat and Saima Perveen

ABSTRACT

Objective: To find out the difference between various premenstrual symptoms in employed and unemployed women.

Methodology: This was a cross sectional, prospective, comparative study conducted from May 2010 to April 2011, in Emergency and Out Patient sections of Obstetrics and Gynecology department, Lady Reading Hospital, Peshawar. By purposive non-probability sampling technique, 150 subjects were selected among attendants of regular patients, after fulfilling inclusion criterion of employed and unemployed women, in age group of 15-40years. Premenstrual symptoms were recorded as, Quantification of severity of psychological, social and physical symptoms, for two consecutive symptomatic cycles. SPSS 16.0 was used to analyze the data. Chi-Square test was used to compare the premenstrual symptoms between employed and unemployed women. P value [?] 0.05 was taken as significant between pairs of variables.

Results: A total of 150 female patients recruited in the study. Out of these 50.7% (n=76) were employed and unemployed were 49.3% (n=74). Mean age was 266.2 years (15-45). Overall 72% (n=109) of subjects were symptomatic with one or more premenstrual symptoms. Psychological symptoms were found in 68 of 150 women (45%). About 50% of women in the employed group had psychological symptoms as compared to 40% in the un-employed group. Social symptoms were present in 64 of 150 women (42%). About 36 out of 76 employed women (47%) whereas 28 out of 74 un-employed women (37%) reported social symptoms. Physical symptoms were present in 89 of 150 women (59%). These were present in 43 out of 76 employed (56%) and 46 out of 74 un-employed women (62%).

Conclusion: The results suggest that the distribution of premenstrual symptoms does not vary significantly between employed and un-employed women. Although different groups of females may have different manifestations, these are not statistically significant to emphasize the role of environmental factors in its causation.

Key Words: Premenstrual symptoms, Premenstrual syndrome, employed women, unemployed women.

INTRODUCTION

Premenstrual syndrome (PMS) is a psycho-neuro-endocrine disorder with biologic, psychologic and social parameters. A woman is considered to have PMS if she complains of recurrent psychological or somatic symptoms (or both), occurring specifically during the luteal phase of menstrual cycle and which resolve in follicular phase at least by the end of menstruation1-3. The symptoms may include headache, breast tenderness, pelvic pain, premenstrual tension, irritability, dysphoria and mood lability1,4,5.

PMS is a common cyclic disorder of young and middle aged women. Up to 75% of women experience some recurrent premenstrual symptoms; 20-40% are mentally or physically incapacitated to some degree and 5% experience severe distress6.

Various treatment options have been proposed including life style changes for mild symptoms and supplementation with medication in case of moderate to severe symptoms7-9. This may include from simple dietary supplementation of calcium and evening primrose oil to selective serotonin reuptake inhibitors such as Fluoxetine, which offer most effective symptomatic relief10-12. Hormonal interventions have been shown to be effective. Medical menopause with Gonadotrophin Releasing Hormone agonists is also under investigation13,14.

Studies have evaluated its association with stress and working lifestyle7-9. In our study, we wish to analyze the effect of having an employed status on occurrence of recurrent premenstrual symptoms as this will allow better understanding of the psychological and physical aspect of the disease.

METHODOLOGY

This was a cross sectional, prospective, comparative study conducted from May 2010 to April 2011, in Emergency and Out Patient sections of Obstetrics and Gynecology department of Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. By purposive non-probability sampling technique, 150 sample size was selected among attendants of regular patients, after fulfilling inclusion criterion of employed and unemployed women, in age group of 15-40 years, having regular menstrual cycles, without history of major depression, epilepsy or hypertension or taking medications for these disorders and those taking oral contraceptives, diuretics or corticosteroids. Recurrent premenstrual symptoms were recorded and PMS diagnosed as, Quantification of severity of psychological (e.g; tension, anxiety), social (e.g; lack of energy) and physical (headache, breast tenderness) symptoms, for two consecutive symptomatic cycles.

Employment was defined as those women working outside their homes, engaged in paid jobs, and unemployment was defined as women including house wives, not engaged in paid jobs outside their homes. SPSS 16.0 was used to analyze the data. MeanSD, frequency and percentages were used for numerical and categorical variables, respectively. ChiSquare test was used to compare premenstrual symptoms between employed and unemployed women. P value [?] 0.05 was taken as significant between pairs of variables.

RESULTS

A total of 150 patients recruited in the study. Out of these 50.7% (n=76) were employed and unemployed were 49.3% (n=74). Mean age was 266.2 years (15-45). About 61% (n=91) patients were unmarried, 38% (n=57) were married, and one case each of widow and divorced. Overall 72% (n=109) of subjects were symptomatic with one or more premenstrual symptoms. About 58 out of 76 employed (76%) as against 51 out of 74 unemployed women (68%) complained of one or more premenstrual symptoms (Table No.1). Psychological symptoms were found in 68 of 150 women (45%). About 50% of women in the employed group had psychological symptoms as compared to 40% in the un-employed group. Social symptoms were present in 64 of 150 women (42%). About 36 out of 76 employed women (47%) whereas 28 out of 74 un-employed women (37%) reported social symptoms. Physical symptoms were present in 89 of 150 women (59%). These were present in 43 out of 76 employed (56%) and 46 out of 74 un-employed women (62%).

Comparison of psychological, social and physical symptoms between employed and unemployed women is given in tables 2. About 46% of employed women compared to 40% of unemployed women had symptoms severe enough to be labeled as suffering from premenstrual syndrome (Table 3).

Table 1: Premenstrual symptoms in employed and unemployed women

Employment status###Premenstrual Symptoms###Total

###Positive###Negative

Employed###58###18###76

Unemployed###51###23###74

Total###109###41###150

Table 2: Comparison of symptoms among employed and un-employed women (n = 150)

###Symptoms###Employed###Un-Employed###Total###P value

###% (76)###% (74)

Psychological###Symptoms

###50 (38)###40 (30)###45 (68)

Symptoms###present

###0.245

###Symptoms

###50 (38)###60 (44)###55 (82)

###absents

Social###Symptoms

###47 (36)###37 (28)###42 (64)

Symptoms###present

###0.238

###Symptoms

###53 (40)###63 (46)###58 (86)

###absents

Physical###Symptoms

###56 (43)###62 (46)###59 (89)

Symptoms###present

###0.594

###Symptoms

###44 (33)###38 (28)###41 (61)

###absents

Table 3: Diagnosis of PMS in employed and un-employed women

###Employment status###Total

###Employed###Un-employed

Diagnosis of PMS###Positive###35###30###65

###Negative###41###44###85

Total###76###74###150

DISCUSSION

Premenstrual syndrome is a constellation of psychological, social and physical symptoms that affects the lives of a large number of women in their reproductive age. Among the finally selected 150 patients, employed and un-employed women were in almost equal percentage.

Up to 80% of menstruating women are estimated to experience premenstrual symptoms and according to the American College of Obstetricians and Gynecologists (ACOG) criteria, the prevalence of PMS is between 20-40%2. Moreover, recurrent premenstrual symptoms were noted in 72.7% of the cases while premenstrual syndrome was diagnosed in 43.3% of the cases, regardless of employment status2.

Among the employed women, about two third were engaged in physically demanding jobs. It was noted that premenstrual syndrome was more common in those working in offices (sedentary, less physically active job). Gannon et al found that women with PMS were less physically active9. However, his data refers to exercise as a measure of physical activity. Rasheed et al, however, found out that a larger population of those who were physically active had higher premenstrual symptom scores than those who were sedentary10.

When compared for premenstrual syndrome, the frequency of premenstrual syndrome was slightly higher in employed women (46%) than un-employed women (40%). However, the difference was not significant when chi-square test was applied. Regarding negative impact on routine functioning, employed women appeared to be affected more than un-employed women in this study.

In a study by Jabeen et al, it was found that employed women suffer from premenstrual syndrome to a greater extent as compared to un-employed women7. However, Collins et al demonstrated that employment was not related to premenstrual symptoms, but women in managerial jobs who experienced PMS perceived greater effects on their function than those in service jobs11. Yet another study by Deuster et al showed a lower prevalence of premenstrual syndrome in employed as compared to un-employed women12.

Of the three sets of symptoms, employed women complained more of psychological and social symptoms, while the physical symptoms occurred more frequently in un-employed women. Different studies have quoted different symptoms as being more frequent among the participants8,13.

CONCLUSION

The distribution of premenstrual symptoms does not vary significantly between employed and un-employed women. This stresses the inherent nature of the syndrome. Although different groups of females may have different manifestations, these are not statistically significant to emphasize the role of environmental factors in its causation.

REFERENCES

1. Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome. Green-top guideline. London: Royal Coll Obstet Gynaecol; 2007: 48.

2. American College of Obstetricians and Gynaecologists. Premenstrual syndrome. Washington, DC: National Guideline Clearinghouse; 2000.

3. Collin CM, Shushan A. Complications of menstruation: Abnormal uterine bleeding. In: Decherney AH, Nathan L, Goodwin TM, Laufer N, editors. Current diagnosis and treatment: Obstet Gynaecol. McGraw-Hill, New York; 2007:570-8.

4. Dennerstein L. Intercultural differences in the prevalence of premenstrual syndromes. Gynaecol Forum 2008; 13:13-5

5. O'Brien PMS. Aims of the Montreal consensus of the International Society for the Premenstrual Disorders. Gynaecology Forum, 2009; 14:29-32.

6. Tschudin P, Bertea CP, Zemp E. Prevalence and predictors of premenstrual dysphoric disorders in a population based sample. Arch Women Mental Health 2010; 13:485-94.

7. Jabeen M, Gul F. Frequency of premenstrual syndrome in working women Vs housewives in Peshawar. J Postgrad Med Inst 2007; 21:92-8.

8. Gunston KD. Premenstrual syndrome in Cape Town. Part 1. An analysis of 100 consecutive patients. S Afr Med J, 1986; 70(3):156-8.

9. Gannon L, Luchetta T, Pardie L, Rhodes K. Perimenstrual symptoms: relationship with chronic stress and selected life-style variables. Behav Med 1989; 15:149-59.

10. Rasheed P, Al-Sowielem, LS. Prevalence and predictors of premenstrual syndrome among college-aged women in Saudi Arabia. Ann Saudi Med 2003; 23:381-7.

11. Collins A. Premenstrual distress: Implications for women's working capacity and quality of life. In: Frankenhauser M, Lundberg U, Chesney M, editors. Women, work, and health: Stress and opportunities. Plenum New York; 1991:239-54.

12. Deuster PA, Adera T, South-Paul J. Biological, social, and behavioral factors associated with premenstrual syndrome. Arch Fam Med 1999; 8:122-8.

13. Lee KA, Rittenhouse CA. Prevalence of perimenstrual symptoms in employed women. Women Health, 1991; 17:17-32.

14. Hylan TR, Sundell K, Judge R. The impact of premenstrual symptomatology on functioning and treatment-seeking behavior: experience from the United States, United Kingdom, and France. J Womens Health Gend Based Med 1999; 8: 1043-52.
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Publication:Journal of Postgraduate Medical Institute
Article Type:Report
Geographic Code:9PAKI
Date:Sep 30, 2015
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