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Neuropsychological function is related to irritable bowel syndrome in women with premenstrual syndrome and dysmenorrhea



There is increasing evidence demonstrating the co-occurrence of primary dysmenorrhea (PD), premenstrual syndrome (PMS), and irritable bowel syndrome (IBS) in women. This study aimed to investigate whether women who have symptoms of IBS in addition to PD and PMS also report more severe or frequent menstruation-associated symptoms and psychological complications compared to women with PD and PMS alone.


The study group included 182 female University students aged 18–25 years. IBS was diagnosed using the Rome III criteria. The severity of PMS and PD was determined using a 10-point visual analog scale and PSST (Premenstrual Syndrome Screening Tool), respectively. Neuropsychological functions including cognitive function, depression score, anxiety score, stress, insomnia, daytime sleepiness, quality of life and personality were assessed using standard questionnaires.


Of the 182 young females, 31 (17.0%) had IBS. Average days of bleeding during the menstrual cycle and mean pain severity on the PSST scale were significantly greater in the group with IBS compared to the non-IBS group (p < 0.01). The non-IBS individuals scored more favorably than the women with IBS with respect to severity of depression, insomnia, daytime sleepiness (p < 0.05). The PSST scores were significantly correlated with scores for depression (r = 0.29; p < 0.001), anxiety (r = 0.28; p < 0.001), stress (r = 0.32; p < 0.001), insomnia (r = 0.34; p < 0.001) and daytime sleepiness (r = 0.31; p < 0.001); while, they were negatively correlated with cognitive abilities (r = − 0.20; p = 0.006) and quality of life (r = − 0.42; p < 0.001). Linear regression analysis showed that the PSST scores were possibly significant factors in determining the scores for depression, anxiety, stress, quality of life, insomnia and daytime sleepiness (p < 0.05).


IBS is related to psychological comorbidities, in particular depression, sleep problems and menstrual-associated disorders. IBS may exacerbate the features of PMS which should be taken into account in the management of PMS.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.


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We are grateful to all study participants. This work was supported by Birjand University of Medical Science (BUMS), Iran.


This study was supported by grants [grant nu#5109(Afsane Bahrami)] from Birjand University of Medical Sciences, Birjand, Iran.

Author information




AB performed all analyses and drafted the manuscript. AB, SK, MA and SM coordinated the fieldwork of the study. MS, AA, MA, NZ and HR provided methodological feedback. AB, ZH, and GF supervised the overall research project and helped to draft the manuscript. All of the authors have read and confirmed the final manuscript. All authors state that they have no conflicts of interest.

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Correspondence to Afsane Bahrami.

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Ethical approval was obtained from the Birjand University of Medical Sciences and informed written consent was completed by all participants (code:IR.BUMS.REC.1398.160).

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Informed consent was obtained from all individual participants included in the study.

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Ayadilord, M., Mahmoudzadeh, S., Hoseini, Z.S. et al. Neuropsychological function is related to irritable bowel syndrome in women with premenstrual syndrome and dysmenorrhea. Arch Gynecol Obstet 302, 915–923 (2020).

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  • Cognitive abilities
  • Anxiety
  • Depression
  • Insomnia
  • Quality of life