A communicative model of premenstrual syndrome with social determinants of health: a path analysis.

Introduction: Premenstrual syndrome (PMS) is characterized by the periodic emergence of physical, psychological, or behavioral symptoms that manifest following ovulation and subside with the commencement of menstruation. These symptoms may be intense enough to interfere with personal relationships, social engagements, or work performance. This study was undertaken to examine the relationship between social determinants of health (SDH) and premenstrual syndrome, taking into account the influence of social factors on health and disease, as well as the existing gap in knowledge regarding the impact of SDH on PMS, following the World Health Organization (WHO) model.

Method: A cross-sectional study was carried out involving 600 women who visited health centers in Tehran in 2024. The questionnaires utilized comprised demographic and obstetric forms, Perceived Social Support, Physical Activity, Socioeconomic Status, Intimate Partner Violence, and the Premenstrual Symptoms Screening Tool. Data analysis employed SPSS-27, while the relationship model was assessed through path analysis in LISREL-8.8.

Results: Path analysis revealed the direct impact of two intermediate factors on PMS: social support (B=-0.29) and physical activity (B=-0.35). Among the structural variables, socioeconomic status (B=-0.22) and age (B = 0.07) indirectly affected PMS. The model fit indices indicated a good fit (Chi-Square = 22.53, GFI = 0.99, RMSEA = 0.045, NFI = 0.95, NNFI = 0.94, CFI = 0.97, IFI = 0.97).

Conclusion: According to the path analysis PMS is prevalent in Iranian women which indicates the necessity of screening for this disorder. In order to alleviate PMS, healthcare providers should pay attention to this condition's risk and protective factors.