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Asian Journal of Healthy and Science

p-ISSN: 2980-4302

e-ISSN: 2980-4310

Vol. 2 No. 5 May, 2023

DETERMINANT OF PREMENSTRUAL SYNDROME COMPLAINTS ON

WOMEN WORKERS

A. Muflihah Darwis,

Itma Anna,

Andi Meinar Dwi Rantisari,

Suci Rahmadani,

Andi Nirwana Badiu

1,4

Public Health Faculty, Hasanuddin University, Makassar, Indonesia

State Health Polytechnic of Palangka Raya, Palangka Raya, Indonesia

Faculty Of Pharmacy, Megarezky University, Makassar, Indonesia

Faculty of Ushuluddin and Philosophy, State Islamic University of Makassar,

Makassar, Indonesia

Email: amuflihah@unhas.ac.id

Abstract

Pre-Menstrual Syndrome (PMS) complaints occur in women with different

complaints and causes. This research aimed to determine the determinants of Pre-

Menstrual Syndrome complaints in women workers in Makassar City. This type of

research is analytics observational, with 203 women workers as a sample that was

obtained through the purposive sampling technique. The research was conducted in

Makassar City by distributing online questionnaires. This study showed that as many

as 188 respondents (92.60%) had experienced PMS complaints with determinants of

marital status, exercise, depression, consumption of foods high in salt, and

knowledge about PMS. This study concludes that there is no relationship between

marital status, exercise, depression, physical trauma, consuming high salt, and

knowledge of PMS complaints. This study suggests that women workers, especially

in Makassar City, can increase their knowledge about PMS and how to prevent it,

improve sleep patterns, exercise regularly, avoid the consumption of foods high in

salt, and increase the consumption of fruits and vegetables. Furthermore, the

company should identify women workers who experience PMS complaints to carry

out valid complaints. Women workers can find out the determinants of premenstrual

syndrome complaints, and women workers can increase their knowledge about

premenstrual syndrome and prevent the causes of premenstrual syndrome.

Keywords: determinant; pre menstrual syndrome; women worker

INTRODUCTION

The reproductive period experienced by women is different from that of men.

Puberty in women is followed by reproductive development, one of which is the

beginning of menstruation. Many women experience physical discomfort for a few

days before their menstrual period. Pain during menstruation is followed by

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premenstrual syndrome (PMS). PMS is a collection of physical and emotional

symptoms that occur a few days before menstruation in the luteal phase of the

menstrual cycle (Christie et al., 2018). As many as 80-90% of reproductive women

will complain of various symptoms, such as breast tenderness, bloating, acne, and

constipation, that will warn their period (Rodiani & Rusfiana, 2016). Based on data

from Nuvitasari et al., (2020), which conducted a study of 3000 women, it was found

that around 90% of women experienced PMS before menstruation.

A study conducted by Ahmad (2020) on ICU nurses at the hospital Makassar

City showed a relationship between PMS variables on PMS variables of nurse

performance with a p-value = 0.001. When approaching menstruation, some nurses

experience complaints such as lower abdomen pain, back pain, muscle joints, and

feeling overwhelmed in dealing with patient demands, so the treatment process for

patients is not optimal. These circumstances quite affect a person's performance.

Symptoms that arise in women during PMS vary. The complaints usually occur

one week to a few days before the arrival of menstruation and disappear after

menstruation. But sometimes, these complaints continue until menstruation stops

(Rodiani & Rusfiana, 2016). As many as 20-40% of women of reproductive age

experience severe symptoms of PMS and 5% are very stringent, which interferes with

their lives, so they need to take menstrual leave (Mustafa, 2012). The Indonesian

government has regulated the right to menstrual leave for women workers in Law

No. 13 of 2003 concerning Manpower in article 81, where women workers during

their menstruation period can be given leave rights on the first and second day of

menstruation.

The cause of PMS most often is suspected due to hormonal disorders.

Hormonal changes experienced by women affect mood changes (Anindyajati et al.,

2021). Furthermore, various risk factors can increase the occurrence of PMS,

including parity, marital status, age, stress, diet, nutritional deficiencies, and physical

activity. Women who have given birth to several children experience increasing

severe PMS. With increasing age, especially between 30-45 years old, PMS

complaints are disturbing. Stress, eating habits (such as high sugar), lack of nutrients

(especially B6), and lack of exercise and physical activity can aggravate premenstrual

syndrome (Putri, 2017).

More than 90% of this sample reported that they had experienced at least one

premenstrual symptom in the past four weeks; of these, 91.2% had experienced

physical symptoms such as breast pain, headache, joint/muscle pain, bloating,

weight gain; 84.5% experienced fatigue/lack of energy; 93.9% experienced anger or

irritability. Women workers who experienced moderate to severe premenstrual

symptoms reported significantly lower attendance scores than those with mild and

no premenstrual symptoms. It is concluded that premenstrual symptoms affect their

performance (Hardy & Hunter, 2021).

RESEARCH METHODS

This study is analytical and observational. The population in this study were all

women workers who worked in Makassar City. The number of samples in this study

was 203 samples. The sampling technique was carried out to represent the population

in the city of Makassar, namely as many as 203 respondents obtained through

purposive sampling technique with the criteria of women aged 15-64 years, having a

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job, working in Makassar city, and willing to be interviewed. The data collection

technique was by distributing an online questionnaire (google form) to obtain

information about the conducted. The data was then processed manually using the

Statistical Package of the Social Science (SPSS) program. The data analysis of the

data used in univariate analysis and bivariate analysis.

RESULTS AND DISCUSSION

Table 1 shows that from 203 respondents, there were 72 respondents (93.50%)

with single status experiencing PMS complaints, 109 respondents (91.60%) who were

married experiencing PMS complaints, and seven respondents who were divorced

(100%) and suffering from PMS. After analyzing the Chi-Square test, it was found

that the p-value = 0.661 > 0.05, so there was no relationship between marital status

and PMS complaints in women workers in Makassar City. There were 203

respondents; 173 respondents (93.5%) in the sports category experienced PMS

complaints, while 15 respondents (83.3%) in the non-sports category experienced

PMS complaints. After analyzing the Chi-Square test, it was found that the p-value

= 0.115 > 0.05 and that there was no relationship between exercise habits and PMS

complaints in women in Makassar City.

Figure 1 shows 19 types of PMS symptom complaints in women workers in

Makassar City. The complaints of PMS symptoms experienced by women workers

in Makassar City consisted of irritability among as many as 188 respondents (92.60%)

and type swelling of the hands or feet of as many as ten respondents (4.90%).

Figure 2 showed that from 203 respondents, 51 respondents (98.10%) in the

depression category experienced PMS complaints, while 137 respondents (90.70%)

in the non-depressed category experienced PMS complaints. After analyzing the Chi-

Square test, it was found that the p-value = 0.081 > 0.05, so Ha was rejected and

H0 was accepted, and there was no relationship between depression and PMS

complaints in women workers in Makassar City.

Table 2 showed that from 203 respondents, 51 respondents (98.10%) in the

depression category experienced PMS complaints, while 137 respondents (90.70%)

in the non-depressed category experienced PMS complaints. After analyzing the Chi-

Square test, it was found that the p-value was 0.081 > 0.05, Ha was rejected, and H0

was accepted, and there was no relationship between depression and PMS

complaints in women workers in Makassar City.

Table 3 showed that from 203 respondents, there were 95 respondents (93.10%)

in the category of consuming high-salt foods as many as 1-3 times/week

experiencing PMS complaints, 25 respondents (92.60%) in the category of

consuming high-salt foods 4-6 times/week experienced PMS complaints, 41

respondents (95.30%) in the category of consuming high-salt foods every day, and 27

respondents (87.10%) in the category of never consuming high-salt foods experienced

PMS complaints and experienced PMS complaints. After analyzing the Chi-Square

test, it was found that the p-value was 0.596 > 0.05. It showed no relationship

between consuming high-salt foods and PMS complaints in women workers in

Makassar City.

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Table 4 showed that from 203 respondents, there were 137 respondents

(93.20%) in the category of having good PMS knowledge who experienced PMS

complaints, while there were 51 respondents (91.10%) in the category of having PMS

knowledge who had fewer PMS complaints. After analyzing the Chi-Square test, it

was found that the p-value = 0.605 > 0.05, which means that Ha was rejected and

H0 was accepted, so there was no relationship between knowledge and PMS

complaints in women workers in Makassar City.

Premenstrual Syndrome (PMS) is a physical and mental symptom that appears

when a woman is about to experience her menstrual cycle that causes discomfort.

STDs usually attack women aged 20 - 30 (Nurrahmaton, 2021). Approximately 75%

of women experience PMS symptoms, and 30% of women require treatment

(Nurmiaty & Sudargo, 2011). The cause of this syndrome is still unclear. However,

some theories state that PMS is closely related to hormonal factors such as sex

hormones and steroids in women. The connection is that some women become more

sensitive to progesterone and estrogen hormones. Furthermore, there is a theory that

women who experience PMS have lower serotonin levels (Christie et al., 2018).

There are more than 150 symptoms associated with PMS, both in terms of

physical and psychological symptoms. Complaints usually include feeling lazy, tired

easily, body weakness, increasing appetite and liking sour foods, being easily

irritable, emotionally unstable, sensitive, and other negative feelings and weight gain

because the body stores large amounts of water. The head hurts, and the waist feels

sore to fainting (Ramadhani, 2016). Experiencing physical symptoms such as breast

tenderness, headache, joint/muscle pain, bloating, weight gain, fatigue/lack of

energy, experiencing anger or irritability (Hardy & Hunter, 2021). Menstrual

symptoms interfere with cooperation with coworkers, professional functioning

deficiency and stress due to symptom burden, diverse experiences without a clear

pattern, adjusted self-management with and without drug use, and stress because of

symptom burden and use of medication for self-management (Yu et al., 2021).

Relationship of Marital Status with PMS Complaints on Women Workers In

Makassar City

Marital status has implications for women's health, including PMS complaints.

PMS complaints can be different between married women and unmarried women.

Some women have not changed in PMS complaints before and after getting married.

The chi-square test results showed no relationship between marital status and PMS

complaints (p = 0.661>0.05). The results of this study were in line with Mufida's

(2015) research that there was no effect of marital status on premenstrual syndrome.

Julianne Holt-Lunstad from Young University suggested that in maintaining one

reproductive health, a harmonious marriage plays a major role in this (Mufida, 2015).

However, the study's results were not in line with research conducted by Faiqah &

Faiqah & Sopiatun, (2018) that married women experience more PMS than single

women (Faiqah & Sopiatun, 2018).

The Relationship of Sports Habits with PMS Complaints in Women Workers in

Makassar City

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Exercise has a very positive effect on blood circulation in the body, especially

for women workers who spend a lot of time at work. The results of this study showed

that there was no relationship between exercise and PMS complaints (p = 0.115>

0.05). It is in line with the study conducted by Fatul, (2017) that there was no

relationship between premenstrual syndrome and the level of physical activity (p =

0.678 > 0.05) (Fatul, 2017). This study was not in line with research conducted by

Nurrahmaton, (2021) that obtained the results of the chi-square test p = 0.000 < 0.05,

which means that there was a relationship between sports and PMS respondents at

SMP IT Foundation Hj. Fauziah Binjai in 2019 (Nurrahmaton, 2021). A lack of

exercise routine can aggravate premenstrual syndrome because physical activity can

increase oxygen transport in muscles, reduce cortisol levels, and improve the

psychological state (Anggriawan, 2015).

Relationship between depression and PMS complaints in women workers in

Makassar City

Many occupational factors can cause depression for women workers. It affects

the reproductive health of women workers. The chi-square test results showed no

relationship between depression and PMS complaints (p = 0.081>0.05). This

research is not in line with research conducted by (Ilmi & Utari, 2018). This study

showed that psychological events in patients could exacerbate PMS. Psychological

conditions can be in the form of anxiety or stress (Ilmi & Utari, 2018). Hormonal

factors are the main factors causing PMS, an imbalance between estrogen and

progesterone hormones, and changes in serotonin levels. Depression can affect the

hormone system, affecting overall body function (Pratiwi, 2016).

Relationship of Habits of Consumption of High-Salt Foods with PMS Complaints

on Women Workers in Makassar City

The chi-square test results showed no relationship between consuming foods

high in salt (p = 0,596>0,05) and PMS complaints. The results of this study were not

in line with research conducted by Ramadhani, Setiawan & Evayanti (2016). The

results of the chi-square statistical test of the study obtained p = 0.014 so that there

was a statistically significant relationship between eating habits high in salt and

glucose and the incidence of PMS in adolescent girls at SMPN 5 Bandar Lampung

in 2015 (Ramadhani, 2016). Increasing the consumption of fibrous foods such as

vegetables and fruits can reduce PMS complaints (Ilmi & Utari, 2018).

Relationship of Knowledge with PMS Complaints on Women Workers in

Makassar City

Knowledge is captured through the five senses of an object so it can be

understood (Prihati et al., 2020). Knowledge is important in forming one behavior

(Thamrin et al., 2019). The chi-square test results showed no relationship between

knowledge and PMS complaints (p = 0.605>0.05). Based on the results of this study,

as many as 147 (72.40%) women workers in Makassar City already had good

knowledge about PMS. It is supported by all information, especially about health,

and it can be accessed by anyone through various sources, including print, written,

electronic media, school education, and counseling (Purwasih et al., 2017). The

absence of a relationship between knowledge and PMS complaints can be the good

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knowledge possessed by respondents is not applied to overcome Premenstrual

Syndrome (Husnida & Sutianingsih, 2016).

The epidemiological studies showed that approximately 20% of women of

reproductive age experience moderate to severe PMS symptoms. About 3 - 8% have

symptoms of a severe dysphoric disorder (PMDD, Premenstrual Dysphoric

Disorder). Women who experience severe PMS symptoms can interfere with their

daily activities, including social and personal functions, work performance, family

and social activities, and sexual relations. As many as 80% of women who experience

PMS report reduced productivity and work attendance for about one week per month

due to PMS symptoms (Ramadhani, 2016).

It showed the results of absenteeism because of MRS. Although 13.8% of

women (n=4514) reported absence due to MRS, 1,108 women (3.4%) reported

absence each cycle or nearly every cycle. The percentage of absenteeism in each cycle

or almost every cycle was 2.4% in the working group and 4.5% in the study group.

The average absence of MRS is due to symptoms related to menstrual cycles (Schoep

et al., 2019.)

More than 90% of this sample reported that they had experienced at least one

premenstrual symptom in the past four weeks; as many as 91.2% had experienced

physical symptoms such as breast pain, headache, joint/muscle pain, bloating,

weight gain; 84.5% experienced fatigue/lack of energy; 93.9% experienced anger or

irritability. Women staff who experienced moderate to severe premenstrual

symptoms reported significantly lower attendance scores than those with mild and

no premenstrual symptoms. It is concluded that premenstrual symptoms affect their

performance (Hardy & Hunter, 2021).

PMS problems can affect work productivity. Disrupted work productivity for

most workers will decrease company productivity (Thamrin. 2020). An online poll

conducted by Schoep et al., (2019) on 32,748 Dutch women aged 15-45 years showed

that a decrease in work productivity for nine days a year was caused by pain due to

PMS symptoms. Around 81% of Dutch women claim to be less productive because

they have to go to the toilet every hour, and they also find it difficult to concentrate

when menstrual symptoms come Schoep et al., (2019). Increasing work productivity

is one of the objectives of implementing Occupational Health and Safety (K3)

programs in the workplace. The impact of PMS symptoms experienced by women

workers is still underestimated in the workplace. The workplace should be more open

about this and make it one of the topics in implementing the OHS program. Although

the company must provide more budget for the K3 program, it is a form of profitable

investment for the company (Nai’em et al., 2020).

CONCLUSION

This research determined the determinants of PMS in women workers in Makassar

City. It can be concluded that there was no relationship between marital status, exercise,

depression, consumption high in salt, and knowledge of PMS complaints. This study

concluded that there were no relationship between marital status (p=0.661), exercise

(p=0.115), depression (p=0.081), physical trauma (p=0.639), consuming high in salt

(p=0.596), and knowledge (p=0.605) towards PMS complaints. This study suggests that

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women workers, especially in Makassar City. It can increase their knowledge about PMS,

and to prevent it, it improves sleep patterns, exercises regularly, avoids high salt

consumption, and increase consumption of fruits and vegetables. Furthermore, the

company should identify women workers who experience PMS complaints so that the

interventions can be carried out accurately. For company leaders or workplaces, in

collaboration with the government, implement the Productive Healthy Women's

Movement Program (GP2SP).

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A. Muflihah Darwis, Itma Anna, Andi Meinar Dwi Rantisari, Suci Rahmadani,

Andi Nirwana Badiu ( 2023 )

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