Abstract
Background: Premenstrual Syndrome (PMS) involves recurring emotional and behavioral symptoms before menstruation, often intensified by stress, anxiety, depression, and poor sleep. While previous studies show significant impacts, many lacks broader applicability. This study aimed to examine the association between obesity, menstrual irregularities, and PMS-related psychological and behavioral symptoms among medical students. Methods & Materials: This cross-sectional study at Dhaka Medical College Hospital included 80 female students (18–25 years) with regular cycles, divided into non-obese and obese groups. Data on socio-demographics, reproductive history, lifestyle, and psychological factors were collected via questionnaire, and PMS severity was assessed using a validated tool. Analysis used SPSS 26 with appropriate statistical tests (p < 0.05). Ethical approval and informed consent were obtained. Results: Obese participants had higher age, weight, and BMI, longer and heavier menstrual flow, and greater PMS severity (PMSS 113.83 ± 12.54 vs. 62.5 ± 14.31). Psychological symptoms (anxiety 85% vs. 50%, depression 97.5% vs. 47.5%) and behavioral issues (social withdrawal 60% vs. 22.5%, impaired work 77.5% vs. 35%) were also more frequent, showing a strong link between obesity and PMS severity. Conclusion: Obesity was associated with higher PMS severity, more psychological and behavioral symptoms, longer and heavier menstrual flow, and increased clinical complaints, highlighting the need for weight management and supportive interventions to improve well-being.

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