Contents
Download PDF
pdf Download XML
190 Views
9 Downloads
Share this article
Research Article | Volume 15 Issue 3 (March, 2025) | Pages 910 - 917
A cross-sectional study of Menstrual Cycle Pattern and it's correlation with quality of sleep
 ,
 ,
 ,
 ,
 ,
1
House Surgeon at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
2
Professor and Head, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
3
First Year Student, Department of Anthropology, Vivekananda College for Women, Kolkata, West Bengal, India
4
Second Professional Year MBBS Student at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh India
5
Final Professional Year Part I MBBS Student at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh India
Under a Creative Commons license
Open Access
Received
Feb. 19, 2025
Revised
March 5, 2025
Accepted
March 16, 2025
Published
March 31, 2025
Abstract

The Menstrual Cycle shows a constant change in the levels of estrogen and progesterone in the body. This might influence the quality of sleep. To investigate this, a 10 item Questionnaire was prepared covering various aspects of an individuals Menstrual cycle including number of days, painful Menstrual cycle, heavy menstrual bleed etc. The Sleep Quality Scale was also used. It is a 28 item Questionnaire detecting acute sleep problems. 115 women were interviewed based on these questionnaires through Google forms, after taking informed consent. The responses were interpreted and analyzed using MS Excel. Factors like Clots in menses, Increased bleeding duration/Intensity (HMB), Absence of Menstruation (Dysmenorrhea), Painful periods and Vaginal Discharge found to increase the score of acute sleep disturbances.  There could have been lack of generalisability in this study for it was conducted on a limited population only inclusive of women in the menstrual age group. Further studies on similar grounds can be conducted on larger populations inclusive of post-menopausal women as well, to get a comprehensive understanding on how the hormones influence the sleep cycle.

 

Keywords
INTRODUCTION

Menstruation and sleep, both are essential cycles for every woman belonging to the reproductive age group. Menstruation is the cyclic shedding of blood from the endometrial layer of the Uterus (1). Menstrual cycle, of 21 to 30 days span is controlled by several hormones like Gonadotrophin Releasing Hormone, Follicle Stimulating Hormone, Luteal Hormone, Progesterone and Oestrogen (1).The sleep cycle on the other hand, is regulated by different parts of human brain like hypothalamus , hippocampus, amygdala, thalamus and reticular formation (1). During menstruation, women often suffer from troubled sleep cycle. The altered oestrogen and progesterone level may cause the interrupted sleep (1). Mental anxiety, stress and different life style changes also contribute to sleep disturbances (1). On the other hand, the irregularity of menstrual cycle directly affects one's quality of life.Durations of periods and amount of bleeding differ from person to person. Obese ladies are more prone to menstrual irregularities (2). Women doing  heavy physical work are more likely to have prolonged menstrual cycles (3). Short sleep duration, overstrain and stress may cause heavy bleeding and other menstrual irregularities (4). A cross-sectional study on 12-25 age group pointed out that premenstrual symptoms and dysmenorrhea are associated with insomnia, although sleep hour has hardly any affect on most menstrual symptoms (5). Poor sleep pattern  during pre-menstrual and menstrual phases are more frequent in PMS and the EEG shows increased sleep spindle activity in the luteal phase (6). Circadian rhythm may be hampered and daytime dizziness increases in the luteal phase (7). Woosley et al (8) revorded moderate to severe dysmenorrhea in patients with persistent problems of falling asleep and staying awake. Sleep is more disturbed in the pre-menstrual phase compared to other phases (9). Kocabey et al (10) proposed that high premenstrual syndrome assessment scale (PMSAS) has low sleep quality scale; dysmenorrhea and other menstrual symptoms have lower sleep efficiency, but the difference is insignificant in participants with HMB. Khotimah et al (11) reported that 7.3% females with good-quality sleep have abnormal menstrual cycle, whereas 18.7% with disturbed sleep show irregular menstrual pattern.

 

The present study aims to assess the correlation, if any, between the menstruation cycle during the last one month and the sleep hygiene. The work distinguishes itself from most of the previous works in its samples,  population and the questionnaire.

MATERIALS AND METHODS

Hypotheses: To find out how the menstrual pattern of an individual influences her sleep.

 

Sample Collection Technique: Google Forms

Inclusion Criterion: Menstruating women

Exclusion Criterion: Pre-menarche girls, post-menopausal women.

 

Sample Size: 115

Study Population: Women from the age-group 14-50, Post-Menarcheal and Pre-Menopausal.

 

Ethical Approval: Since no intervention, pharmacological or invasive, were performed, institutional ethical clearance was not required for survey based study.

 

Tools used:

  1. A Questionnaire of 10 items to understand every minute details of the subject's menstrual pattern, from the age of menarche to duration, intensity of bleeding, occurrence of pain, and various irregularities in the cycle (12).

 

  1. The Sleep Quality Scale is a 28 item Questionnaire that measures sleep quality in the general population. It assesses the various aspects of sleep including daytime symptoms, restoration after sleep, problems in initiating sleep, problems in maintaining sleep, difficulty in waking up or feeling refreshed in the mornings (13).

 

Methods: 115 females of the age-group 14-50, who attained menarche but did not attain menopause yet, were interviewed on the basis of the two above mentioned questionnaires, through Google Form based on what they had observed in the last 1 month. Informed consent was taken from all participants. Their responses were recorded and analyzed using MS Excel.

RESULTS

PCOD Diagnosis

Response

Mean Total_Score

No

35.64

Yes

33.47

Clots in Menses

Response

Mean Total_Score

No

32.81

Yes

39.84

 

Prolonged Cycle Length

Response

Mean Total_Score

No

35.36

Yes

34.18

 

Heavy Menstrual Bleeding

Response

Mean Total_Score

No

33.62

Yes

39.78

 

Shorter Cycles with Heavy Bleeding

Response

Mean Total_Score

No

34.99

Yes

35.90

 

Reduction in Bleeding Intensity

Response

Mean Total_Score

No

35.54

Yes

33.46

 

 

Absence of Menstruation

Response

Mean Total_Score

No

34.56

Yes

37.83

 

Continuous Bleeding

Response

Mean Total_Score

No

35.09

Yes

34.71

 

 

Painful Periods/Dysmenorrhea

Response

Mean Total_Score

No

30.46

Yes

38.62

 

Vaginal Discharge

Response

Mean Total_Score

No

30.85

Yes

40.00

 

 

DISCUSSION

The present study found that clots in menses can impact the quality of sleep negatively. Increased bleeding duration/Intensity (HMB). This synchronises with the findings of Kathryn et al (4), who observed that short sleep duration can cause Heavy Menstrual Bleeding. Absence of Menstruation (without lactation or pregnancy) was also found to negatively influence sleep quality. Similar to the findings of Woosley et al (8) painful periods or dysmenorrhea increased acute sleep disturbances. Vaginal Discharge also significantly increased the score of sleep disturbances. These alterations could possibly be due to the changes of oestrogen and progesterone levels in the body (1).

CONCLUSION

Factors found to increase the score of acute sleep disturbances were Clots in menses, Increased bleeding duration/Intensity (HMB), Absence of Menstruation (Dysmenorrhea), Painful periods and Vaginal Discharge.

There could have been lack of generalisability in this study for it was conducted on a limited population only  inclusive of women in the menstrual age group. Further studies on similar grounds can be conducted on larger populations inclusive of post-menopausal women as well, to get a comprehensive understanding on how the hormones influence the sleep cycle.

REFERENCES
  1. Barrett KE, Barman SM, Brooks HL, Yuan JJ. 2019. Ganong's review of medical physiology. 26th ed. New York: McGraw-Hill Education
  2. Shim, J., Han, S. & Baek, J, 2024. Factors influencing menstrual regularity among female workers: a cross-sectional analysis study. BMC Women's Health. 24: 299. https://doi.org/10.1186/s12905-024-03142-8
  3. Sihan Song, Choi, H, Pang Y, Kim O, Park HY., 2022. Factors associated with regularity and length of menstrual cycle: Korea Nurses' Health Study. BMC Womens Health. 22(1) :361. doi: 10.1186/s12905-022-01947-z
  4. Kathryn E. R. Kennedy, Chidera Onyeonwu, Sara Nowakowski, Lauren Hale, Charles C. Branas, William D. S. Killgore, Chloe C. A. Wills, Michael A.Grandner, 2021, Menstrual regularity and bleeding is associated with sleep duration, sleep quality and fatigue in a community sample. Journal of Sleep Research, 31(1): e13434. doi: https://doi.org/10.1111/jsr.13434
  5. Arafa, A., Mahmoud, O., Abu Salem, E. Mohamed, A, Association of sleep duration and insomnia with menstrual symptoms among young women in Upper Egypt. Middle East Curr Psychiatry 27 (2) .doi: https://doi.org/10.1186/s43045-019-0011-x
  6. Alzueta E & Baker FC.,2023. The Menstrual Cycle and Sleep. Sleep Med Clin, 18(4) : 399-413. doi: 10.1016/j.jsmc.2023.06.003.
  7. Shibui, K, Uchiyama, M, Okawa, M, Kudo, Y, Kim, K, Liu, X, Kamei, Y, Hayakawa, T, Akamatsu, T, Ohta, K, Ishibashi, K, 2000, Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle, Biological Psychiatry, 48(11): 1062-1068, doi: https://doi.org/10.1016/S0006-3223(00)00912-4.
  8. Woosley, J. A., & Lichstein, K. L., 2014. Dysmenorrhea, the Menstrual Cycle, and Sleep. Behavioral Medicine, 40(1) : 14–21. doi: https://doi.org/10.1080/08964289.2013.829020
  9. Romans, S. E, Kreindler, D, Einstein, G, Laredo, S, Petrovic, M. J, Stanley, J, 2015. Sleep quality and the menstrual cycle. Sleep Medicine. 16 (4): 489-495, doi:https://doi.org/10.1016/j.sleep.2014.12.001.
  10. Kocabey, H. A, Akman,. O, Kasim, I, 2024, The Impact of Menstrual Disorders on Sleep Quality in Adolescents: An Observational Study, Journal of Pediatric and Adolescent Gynecology, 37 (6): 579-585, doi: https://doi.org/10.1016/j.jpag.2024.08.005
  11. KhotimahFatmaningsih, N, TrisyaniKoeryaman, M, Rosidin, U, 2024, Relationship of sleep quality with menstrual cycle in teenagers. Indonesian Journal of Global Health Research. 6(5)
  12. Padubidri VG, Kumar S. Howkins & Bourne: Shaw's Textbook of Gynaecology. 18th ed. India: Elsevier; 2022
  13. Yi, H., Shin, K., & Shin, C. (2006). Development of Howell, A. J., Digdon, N. L., Buro, K., & Sheptycki, A. R. the sleep quality scale.  Journal of Sleep Research, (2008). Relations among mindfulness, well-being, and 15 (3), 309–316. sleep.  Personality and Individual Differences, 45 , 773–777.
  14. Hall JE, Guyton AC., 2021. Textbook of Medical Physiology. 14th ed. Philadelphia: Elsevier;
Recommended Articles
Research Article
Imaging of Upper Airways for Pre-Anaesthetic Evaluation and Laryngeal Afflictions: An Original Research Study
Published: 30/05/2025
Download PDF
Research Article
Study of Early Extubation in Congenital Heart Disease with Severe Pulmonary Hypertension
...
Published: 29/05/2025
Download PDF
Research Article
Efficacy of Nebulized Ketamine, Clonidine, and Dexmedetomidine in Preventing Postoperative Sore Throat: A Systematic Review and Meta-Analysis
...
Published: 28/05/2025
Download PDF
Research Article
To Estimate the Correlation between Serum Uric Acid to Creatinine Ratio and Proteinurea in Diabetes Mellitus Patients
...
Published: 31/05/2025
Download PDF
Chat on WhatsApp
Copyright © EJCM Publisher. All Rights Reserved.