Premenstrual Dysphoric Disorder: prevalence, symptomatology and coping practices amongst women attending Tertiary Educational Institutions in Machakos Subcounty, Kenya

Abstract

Background Premenstrual Dysphoric Disorder (PMDD), is a severe gender-specific mood disorder characterized by cognitive, affective and physical symptoms in the week before onset of menses, with compete symptom remission after the menses. The global prevalence of Premenstrual Dysphoric Disorder (PMDD) has been estimated at 5% although studies done in a number of countries place the prevalence at a range between 3 and 37%. There is paucity of data regarding this disorder in the African context, and the researcher found only four published African studies, done in Ethiopia and Nigeria, reporting a prevalence range of 6.1 to 36.1%. No published Kenyan study on PMDD was found. Study Objectives This study aimed at establishing the prevalence, symptomatology and coping practices regarding PMDD amongst women attending tertiary educational institutions in Machakos subcounty. Towards this end, the study specifically determined the prevalence of PMDD in women attending tertiary institutions in Machakos subcounty, identified common symptoms expressed by women with PMDD and found out what coping strategies are practiced by women with PMDD in Machakos subcounty. Methodology Data was collected from students attending the four major tertiary educational institutions with a national catchment within Machakos subcounty. Participants were drawn randomly from each one of the institutions through simple random sampling method to make up a sample of 351 women. Self-administered Questionnaires were used as data-collection tools for this study. The data collected was analyzed with SPSS version 25.0 Study Findings The study found PMDD prevalence rate of 31.3%, and an association between PMDD and Dysmenorrhoea. It was also established that most women with PMDD have physical symptoms in addition to affective ones. Further, it was found that majority of women with PMDD resort to over-the-counter painkillers rather than seeking medical help Discussion of Findings Similar studies done in various countries tend to show a variable prevalence rate of PMDD, possibly due to differences in methodology. Developed countries have a lower PMDD prevalence compared to developing ones. Generally, cross sectional studies tend to give higher rates. In addition, the intensity and expressivity of PMDD symptoms may be related to sociocultural background, family perspectives, religious beliefs, social tolerance and gender roles. The most accurate determination of prevalence rate should be Daily Rating of Severity of Symptoms, a prospective study Conclusions and Recommendations This study concluded that prevalence of provisional PMDD was 31%, with an association between PMDD and Dysmenorrhoea. There was no association between PMDD and age at menarche, contraceptive use nor regularity of menstrual cycle. Emotional lability, depressive symptoms and physical symptoms were commonly expressed by women with PMDD. Painkiller use was very prevalent in women with PMDD and medical attention was rarely sought. The study recommends further research in Kenya to accurately determine the prevalence rate of PMDD using a prospective design. Also needed is a study on knowledge, attitudes and practices of health providers regarding PMDD to provide baseline data in preparation for the much-needed training on diagnosis and management of PMDD. Finally, there is need for sensitization of community members on PMDD and the available medical interventions