Association Between Caffeine Consumption and Premenstrual Syndrome Among First Year Female Medical Students: A Cross-Sectional Study

Abstract

Background: Premenstrual syndrome (PMS) is a recurrent condition in reproductive-aged women that disrupts physical, emotional, and behavioral functioning. Neuroendocrine instability during the luteal phase plays a crucial role in PMS pathophysiology. Caffeine, a widely consumed psychoactive substance among medical students, may aggravate PMS symptoms through central nervous system and autonomic stimulation. 
Objective: To examine the relationship between caffeine intake and the insidence of premenstrual syndrome in first-year female medical students. 
Methods: This analytical observational research employed a cross-sectional approach and included 79 first-year female medical students recruited through simple random sampling. Caffeine intake was assessed using a semi-quantitative food frequency questionnaire, while premenstrual syndrome was evaluated with the Shortened Premenstrual Assessment Form (SPAF). Physical activity, stress level (DASS-21), and sleep quality (PSQI) were evaluated as confounding variables. Data were analyzed using the Chi-square and Fisher’s exact tests, with a significance level set at p < 0.05. 
Results: The prevalence of PMS was 82.3%. Most participants had low caffeine intake (64.6%), while 35.4% had moderate intake. All participants with moderate caffeine intake experienced PMS (100%). A significant relationship was identified between caffeine intake and the presence of PMS (p = 0.001). Physical activity was also significantly associated with PMS (p = 0.047). No significant association was observed between PMS and stress level (p = 1.000) or sleep quality (p = 0.359). 
Conclusion: Caffeine consumption is significantly associated with the occurrence of premenstrual syndrome among first-year female medical students. Moderate caffeine intake markedly increases PMS prevalence, whereas adequate physical activity appears to have a protective effect.