Oral contraceptive use and premenstrual syndrome among sexually active female university students in Cameroon

Abstract

Introduction premenstrual syndrome (PMS) is a prevalent health problem affecting women of reproductive age and some young women use oral contraceptive pills (OCPs) to prevent unwanted pregnancy. However, the association between OCP use and the experience of symptoms of PMS has not been studied in Cameroon. We examined the association between the use of OCPs and PMS among female university students in Cameroon. Methods we used data extracted from a larger study on sexual and reproductive health that was conducted between July and August 2018 among female university students at the University of Yaoundé 1, Cameroon. A pre-tested, validated and paper-based self-administered questionnaire was used to collect data. We extracted data (demographic and health characteristics, contraceptive use and experience of PMS) for the 424 sexually active students who participated in the larger study. We used Poisson regression analysis to examine the association between OCP use and PMS and conducted stratified analysis to determine effect modification. The level of statistical significance was set at p≤0.05. Results the median age of the 424 sexually active female university students was 23 years (IQR=21-25). About 77.8% of participants self-reported to have experienced symptoms of PMS prior to their last menstrual period. The most commonly reported symptoms of PMS were breast tenderness (55.7%), acne/pimples (39.2%) and abdominal pain (31.1%). After adjusting for confounders in multivariate analysis, we found a statistically significant relationship between the use of OCPs and experience of symptoms of PMS. Current OCP users had a slightly increased risk (PR=1.21; 95%CI, 1.09-1.32, p<0.001) of developing symptoms of PMS compared to non-pill users. We found that age modified the effect of this association. Among older students (≥25 years), the direction of the effect was strongly positive and statistically significant (APR=1.32; 95%CI, 1.12-1.56, p=0.001). Conclusion the proportion of female university students who reported to have experienced symptoms of PMS prior to their last menstrual period was high. The use of OCPs was positively associated with the risk of developing symptoms of PMS and this relationship was modified by age. Further studies in Cameroon and other sub-Saharan African countries are required to understand this relationship.

Mood swing during menstruation: Confounding factors and drug use

“…Also, Mood swing was discovered as a symptom overlapping with psycho-emotional, physical, and behavioural symptoms in women during menstruation, suggesting that these symptoms are relatively associated. The overall PMS prevalence was 67.4% which was slightly higher than but comparable to 67% reported from Ethiopia ( 7 ), lower than 77.8% and 78.6% reported from Cameroon and Eritrea respectively ( 3 , 21 ), far below 89%, 91.5%, 92% and 99.5% prevalence reported somewhere in Nigeria, Jordan, Pakistan and Japan respectively ( 8 , 11 , 22 , 23 ). This variation may be due to differences in the population samples, instruments used, PMS pattern, other factors like stress induced hypertension, and side effects associated with OCP usage; a potential association between high PMS prevalence and women using OCPs has been reported in one study ( 3 ).…”

“…Sample size determination : This was done according to Akoku and Minichil ( 2 , 3 ) with little variation using the single population formula by adopting the estimated proportion of 69.2% mood swing prevalence from a previous study, using 95% Confidence Interval (α=0.05), standard normal distribution Z at 1.96, 5% margin error. Exactly 328 participants were considered for this study.…”

“…The luteal or premenstrual stage is usually accompanied with various symptoms which may be distressful and negatively affect the psycho-emotional, physical and behavioural output; this is referred to as premenstrual syndrome (PMS) while a severe PMS is referred to as premenstrual dysphoric disorder (PMDD). About 75% women complain of PMS, younger women less than 25 years, experience this syndrome than older women while PMDD occurs in 3–8% of women with PMS ( 2 , 3 ). PMS accounts for 47.8% worldwide with higher prevalence in sub-Saharan Africa where Ethiopia reported 67% and 72% PMS prevalence respectively while 42.9% prevalence was reported in South-Eastern Nigeria ( 2 , 3 , 5 , 6 , 7 ).…”

“…About 75% women complain of PMS, younger women less than 25 years, experience this syndrome than older women while PMDD occurs in 3–8% of women with PMS ( 2 , 3 ). PMS accounts for 47.8% worldwide with higher prevalence in sub-Saharan Africa where Ethiopia reported 67% and 72% PMS prevalence respectively while 42.9% prevalence was reported in South-Eastern Nigeria ( 2 , 3 , 5 , 6 , 7 ).…”

Determining the Relationship Between Midwifery Students' Frequency of Experiencing Premenstrual Syndrome and Perceived Stress Level

“…Bizim çalışmamızda ise, BKİ'ye göre PMS yaşama durumu arasında istatiksel açıdan anlamlı bir farklılık tespit edilmiştir. Fazla kilolu olanların premenstrual sendrom yaşama sıklığı daha fazladır.Akoku ve arkadaşlarının 2020 yılında öğrencilerle yaptığı çalışmada, oral kontraseptif kullananların, PMS semptomları gelişme riskinin daha yüksek olduğu bildirilmektedir 32. Bizim çalışmamızda da oral kontraseptif kullanan öğrencilerin, premenstrual semptom yaşama sıklığı daha fazladır.…”