INTRODUCTION:

Changes are typical when people mature, especially when they are young adults, and they are often thought to be fundamental changes.¹ Teenage females experience significant physical and emotional changes during puberty, as well as the beginning of their menstrual cycle.

Periods, also known as menstruation, are the regular vaginal bleeding that women experience once a month.²Girls often reach menarche between the ages of 11 and 14, and menopause may set in by the time they are 51 years old.²These qualities continue to exist as each young person transitions into maturity.¹Around 50-80 % of women typically experience premenstrual symptoms.³Numerous emotional and mental changes will occur in addition to the physical ones. Premenstrual symptoms are most common in young adults between the ages of 18 and 35 mainly caused by hormonal changes like an imbalance in the hormones such as estrogen and progesterone.⁴

According to estimates from around the world, 75% of women of reproductive age have Premenstrual symptoms, with younger women experiencing the condition more frequently. In India, urban girls' rates of Premenstrual symptoms ranged from 55.8% to 67%, while rural girls' rates ranged from 40.9-51.6%. In the population of medical students in India, Premenstrual symptoms affects about 60.5% of students.⁴Physical, emotional, and behavioral symptoms that appear prior to menstruation and then disappear after it are known as premenstrual symptoms. The person's social, professional, or personal life is unaffected by these symptoms. Contrarily, premenstrual symptoms experienced by a woman with a premenstrual condition, such as premenstrual syndrome, can negatively impact her quality of life and limit her ability to work, attend school, socialize, and have a satisfying family life. Numerous individuals struggle with significant psychological symptoms that make it difficult for them to participate in social and professional activities.⁵

An emotional response that is poorly controlled and does not fit within the typically acceptable range of emotional reaction is referred to as having emotional dysregulation.⁶Most changes are psychological in nature, such as ones that affect a person's mood. In contrast to the conventionally accepted range of emotional reaction, experiencing emotions is controlled. The main behavioral changes that we might see in a dysregulated person are irritability, anger projection, anxiety, decreased activity, attraction to various substances that can lead to addiction, suicidal thoughts, and self-injury. This may have an impact on quality of life, resulting in decreased social engagement and relationship problems, particularly at home, at work, and in school.⁶Factors contributing to emotional dysregulation are: Early-life trauma, parental abandonment, and physical brain damage.⁶

The frequency of Premenstrual symptoms was found to be 72% among Turkish college students, which has a detrimental effect on people's quality of life, especially in the physical, mental, and environmental domains. Additionally, an Iranian study of medical students found that those with severe Premenstrual symptoms had significantly different mental health and environmental symptoms than those without symptoms.^7,8The goal of the study is to determine the relevant symptoms occur during before the menstruation that affect young people' lives and how they connect to emotional regulation. The research will also give an idea about the relationship existing between these two variables. In general, these symptoms will have an impact on a young adult's daily lifestyle, particularly their academic life by causing more absenteeism in the college. Irritability may end up with a lot of conflict among peers. Lack of confidence and increased exhaustion is an additional cause contributing towards Low performance. Since the researchers have seen many young adults with these symptoms affecting their mental stability while in college, the following study was undertaken.

MATERIALS AND METHODS:

A Correlational research design was used. The sample consisting of 124 subjects in which Students between the age group of 18-35 years were selected by Randomized sampling method (Computer generated random numbers).

The result was analyzed by using SPSS. The sample size was obtained using the formula

2(Zα+Zβ)²

N = ––––––––––– –––– + 3, r = 0.178¹⁴

C²

DERS-18 scale was developed by Sarah E. Victor & E. David Klonsky in the year 2016, with the r value 0.91, composed six subscales: awareness, clarity, goals, impulse, non-acceptance, strategies and found reliable for all the age groups and the grading is ≤ 30 - Good emotional regulation, ˃31 - Poor emotional regulation.⁹

Premenstrual symptom assessment checklist (standardized tool) consisted of 13 items and rated each categories as Never, Rarely, Sometimes, Often, Always. Calculated r value was 0.98 showing highly reliable. Pretesting and content validity of the tool was also carried out by administering to 08 participants.

Data was collected from 08-08-2022 to 20-08-2022. Before data collection investigators familiarized themselves and confidentiality was maintained. Tool was administered via google forms.

RESULTS:

A master data sheet was prepared and the coded data was entered. Statistical Package for the Social Sciences- version 16, manufactured by IBM company, in the year 2007 was used to analyze the coded data. The study results were organized as follows:

Table 1: Distribution of subjects according to their baseline Pro forma N=124

S. No.	Variable	f	%
1	Age in years (mean age 20.70± 1.051)
	19-20	59	47.6
	21-23	65	52.4
2	Type of Family
	Nuclear	116	93.6
	Joint	6	4.8
	Extended	2	1.6
3	Programme
	BSc Nursing	59	47.6
	MBBS	65	52.4
4	Batch
	II year	57	46
	III year	30	24.2
	IV years	37	29.8
5	Age of Menarche
	10-13	91	73.4
	14-17	33	26.6
6	Menstrual status
	Regular	103	83.1
	Irregular	21	16.9
7	Duration of Menstruation
	˂3 days	16	12.9
	4-5 days	89	71.8
	6-9 days	19	15.3

Majority of the participants were in the age group of 21-23 years (52.4%) and 46% of the participants were studying in II year.

Table 2: Level of emotional dysregulation with mean and standard deviation N=124

Level	Grading	f	%	Mean± SD
Good	1-30	14	11.3	42.24±10.99
Poor	31-90	110	88.7	42.24±10.99

Maximum score- 90

Majority of the participants (88.7%) have scored between 31-90 and the calculated mean value is 42.24±10.998 with mean percentage of 46.93% which shows poor emotional regulation.

Figure-1

Table 3: Domain wise mean, SD, mean percentage, of emotional dysregulation N=124

Domains	Maximum score	Mean± SD	Mean %
Awareness	15	9.47±2.363	63.1
Clarity	15	7.62±2.177	50.8
Goals	15	8.32±2.861	55.47
Impulse	15	6.82±2.723	45.47
Non- Acceptance	15	6.61±2.887	44.06
Strategies	15	6.52±2.730	46.47

The calculated mean and SD value is higher side when compared to the maximum score indicating poor emotional regulation in all the subdomains.

Table no. 4 interprets that the calculated mean and standard deviation for overall premenstrual symptoms is 34.23±9.52 which shows that maximum participants are having severe premenstrual symptoms. The commonest premenstrual symptoms which are always seen are: discomfort or pain (29.8%), backache (22.6%), Joint and muscle pain or joint stiffness (13.5%) whereas symptoms like Outburst of irritability or bad temper (26.6 %). Feeling sad or blue (25.8%) and feeling under stress (18.5 %) are often seen. Presence of Edema, swelling, puffiness, or water retention over any part of the body (67.7 %) and enlargement or swelling of breasts (59.7 %) are never seen.

Table 4: Frequency, percentage distribution, Mean and standard deviation of severity of premenstrual symptoms N=124

Symptoms	Never		Rarely		Sometimes		Often		Always		Mean± SD
	f	%	f	%	F	%	F	%	F	%	34.23± 9.525
Pain/ tenderness over the breast	46	37.1	29	23.4	31	25.0	10	8.1	8	6.4
Enlargement or swelling of breasts	74	59.7	21	16.9	21	16.9	6	4.8	2	1.6
Feeling unable to cope /overwhelmed by ordinary demands	27	21.8	41	33.1	36	29.0	15	12.1	5	4.0
Feeling under stress	11	8.9	31	25.0	46	37.1	23	18.5	13	10.5
Outburst of irritability / bad temper	10	8.1	24	19.4	41	33.1	33	26.6	16	12.9
Feeling sad / blue	11	8.9	22	17.7	49	39.5	32	25.8	10	8.1
Backaches	24	19.4	18	14.5	25	20.2	29	23.4	28	22.6
Joint and muscle pain/ joint stiffness	28	22.6	23	18.5	28	22.6	22	17.7	23	13.5
Weight gain	63	50.8	13	24.2	19	15.3	8	6.5	4	3.2
Relatively steady abdominal heaviness	21	16.9	31	25.0	38	30.6	23	18.5	11	8.9
Discomfort / pain	9	7.3	19	15.3	30	24.2	29	83.4	37	29.8
Presence of Edema, swelling, puffiness, or water retention over any part of the body	84	67.7	16	12.9	13	10.5	5	4.0	6	4.8
Feeling bloated	27	21.8	27	21.8	34	27.4	22	17.7	14	11.3

Maximum score- 65

Figure 2: Scatterplot showing correlation between emotional dysregulation and premenstrual symptoms.

Table 6: Association between emotional dysregulation and baseline proforma N=124

S. No.	Variable	Good (≤30)	Poor (>30)	χ2	df	P value
1	Age in years
	19-20	7	52	0.037	1	0.847
	21-23	7	58	0.037	1	0.847
2	Type of Family
	Nuclear	11	105	6.171 (fisher exact)	2	0.052
	Joint	2	4
	Extended	1	1
3	Programme
	BSc Nursing	6	53	0.141	1	0.707
	MBBS	8	57	0.141	1	0.707
4	Batch
	II year	8	49	0.768(fisher exact)	2	0.233
	III year	3	27
	IV years	3	34
5	Menstrual status
	Regular	11	92	0.214(fisher exact)	1	0.435
	Irregular	3	18	0.214(fisher exact)	1	0.435
6	Duration of Menstruation
	˂3 days	2	14	0.919 (fisher exact)	2	0.465
	4-5 days	9	80
	6-9 days	3	16

There is no significant association (p>0.05) with baseline variables and emotional dysregulation grades.

DISCUSSION:

The Present study reveals that majority of the student belong to the age group of 20-23 years (52.4%), 93.5% are from nuclear family. Out of that 84.1% had regular menstrual status and 71.8% had 4-5 days cycle. According to a similar study done among undergraduate nursing students in Bangalore, showed that the majority of participants from the age group of 18years and had regular periods in 73% of cases, while 19% had cycles lasting between three and five days.¹⁰

The majority (88.7%) of participants in the present study had poor levels of emotional dysregulation. In contrast to the previous study, a cross-sectional survey conducted among 250 first-year students from Telangana's medical, engineering, and degree-granting institutions in the academic year 2016–17 reveals a low level of emotional control.¹¹

The majority of individuals in the current study displayed one or more premenstrual symptoms. Participants most frequently noted discomfort, backaches, joint pain, and muscular soreness. In a cross-sectional descriptive research of 804 non-medical female students, discovered that 72.5% of the female students had premenstrual syndrome, with fatigue (28%) and irritability (27%) being the most prevalent symptoms.¹²

Premenstrual symptoms and emotional dysregulation have a weak but significant positive relationship in the current study (r=0.446, p = 0.001). Similar studies were carried out with 616 Israeli students to determine the link between emotional control and premenstrual dysphoric disorder. The outcome demonstrates that two variables have a weak relation but statistically significant (p 0.0001).¹³

The estimated p values in the current study is more than 0.05, indicating that there is no significant association between baseline variables and emotion dysregulation.

CONCLUSION:

According to the study, the majority of young adults have trouble in controlling their emotions and suffer from severe premenstrual symptoms including back pain and discomfort. As a result, there will be a significant absentee rate at universities. Giving kids counselling and raising awareness of how to treat premenstrual symptoms symptomatically can help them stay in school and improve their academic performance by reducing absenteeism.

A person who is emotionally unstable will find it difficult to handle challenging circumstances. They may make poor decisions as a result of having low self-esteem. As members of the medical profession, it was assumed that they would be able to advise their patients by maintaining appropriate emotional control. It is always preferable to support young adults by providing support through counselling, helpline or any other method that will enhance their quality of life both personally and professionally.

REFERENCES:

1. Bonnie RJ, Stroud C, Breiner H, et al. Young Adults in the 21st Century. In: Committee on Improving the Health of S, Board on Children and Youth, Institute of Medicine, eds. Investing in the Health and Well-Being of Young Adults. National Academies Press; 2015. Accessed June 14, 2022.

2. Menstruation [Internet]. National Library of Medicine. Accessed June 14, 2022. Available from: https://medlineplus.gov/menstruation.html

3. Henz A, Ferreira CF, Oderich CL, et al. Premenstrual syndrome diagnosis: A comparative study between the Daily Record of Severity of Problems (DRSP) and the Premenstrual Symptoms Screening Tool (PSST). Rev Bras Ginecol Obstet. 2018; 40(1): 20-25. doi:10.1055/s-0037-1608672. Epub November 13, 2017. PMID: 29132173.

4. Selvarajan S, Ajmal H. Premenstrual syndrome and its association with emotional dysregulation: a comparison between medical and non-medical students. Int J Community Med Public Health. 2019; 6(5): 1913-1916. doi:10.18203/2394-6040.ijcmph20191413.

5. Akgül S, Kanbur N. Premenstrual disorder and the adolescent: clinical case report, literature review, and diagnostic and therapeutic challenges. Int J Adolesc Med Health. 2015; 27(4): 363-368. doi:10.1515/ijamh-2014-0051.

6. Contributors WE. What is emotional dysregulation? [Internet]. Web MD. Accessed June 14, 2022. Available from: https://www.webmd.com/mental-health/what-is-emotional-dysregulation

7. Pinar G, Colak M, Oksuz E. Premenstrual syndrome in Turkish college students and its effects on life quality. Sex Reprod Healthc. 2011; 2: 21-27. doi:10.1016/j.srhc.2010.10.001.

8. Farrokh-Eslamlou H, Oshnouei S, Heshmatian B, Akbari E. Premenstrual syndrome and quality of life in Iranian medical students. Sex Reprod Healthc. 2015; 6(1): 23-27. doi:10.1016/j.srhc.2014.06.009.

9. Victor SE, Klonsky ED. Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-18) in five samples. Available from: https://www2.psych.ubc.ca/~klonsky/publications/DERS18.pdf.

10. Patel SB. A study to evaluate the effectiveness of guided imagery technique in alleviating premenstrual syndrome among first year BSC nursing students in selected nursing colleges at Bangalore. Published September 2017. Available from: https://www.proquest.com/docview/1950385884?pq-origsite=gscholar&fromopenview=true.

11. Narukurthi P, Macharapu R, Gade V, Mallepalli PK, Sateesh R. A study to examine the relationship between emotion regulation and resilience among first-year undergraduates. J Educ Health Promot. 2023; 5

12. Vijayalakshmie I, Manoharlal M, Selvakumar K, Rekha K. Prevalence of premenstrual syndrome among female population: A qualitative analysis. Published August 17, 2018.

13. Reuveni I, Dan R, Segman R, et al. Emotional regulation difficulties and premenstrual symptoms among Israeli students. Arch Womens Ment Health. 2016; 19: 1063-1070. doi:10.1007/s00737-016-0656-y.

14. Wu M, Liang Y, Wang Q, Zhao Y, Zhou R. Emotion dysregulation of women with premenstrual syndrome. Sci Rep. 2016; 6: 38501. doi:10.1038/srep38501. PMID: 27922107; PMCID: PMC5138621.

Received on 19.02.2025 Revised on 11.06.2025

Accepted on 18.08.2025 Published on 21.02.2026

Available online from February 23, 2026

Asian J. Nursing Education and Research. 2026;16(1):5-9.

DOI: 10.52711/2349-2996.2026.00002

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.