Exercise addiction as a risk factor for pre-menstrual syndrome among early adult varsity elite sportswomen
DOI:
https://doi.org/10.15561/20755279.2025.0606Keywords:
early adult, elite athletes, exercise addiction, premenstrual syndrome, studentsAbstract
Background and Study Aim. Menstrual issues are increasingly reported among female athletes, particularly those competing at elite levels. Premenstrual syndrome (PMS) has emerged as one of the conditions that may affect their wellbeing and athletic performance. Despite the use of various approaches to manage PMS, their relative effectiveness in mitigating its detrimental effects remains a matter of practical interest. This study examined the relationship between exercise addiction (EA) and PMS among early adult varsity elite sportswomen. Materials and Methods. Participants were recruited from university sports teams through coordination with official varsity sports departments, resulting in a final sample of 161 early adult varsity elite sportswomen (Mage = 22.0, SD = 1.609) who met all eligibility criteria. Data were collected in person using a demographic information form together with two validated measurement instruments, the Premenstrual Symptoms Screening Tool (PSST) and the Exercise Addiction Inventory (EAI), which were administered in their original English versions to assess PMS symptoms and tendencies toward exercise addiction. Results. Descriptive analyses indicated that symptoms of exercise addiction were highly prevalent in the sample, with 80.1 percent of participants reporting some symptoms and 19.9 percent classified as at risk, while PMS levels were similarly elevated, with 94.4 percent of athletes experiencing severe PMS and 5.6 percent reporting moderate PMS. Hierarchical regression showed a strong positive association between EA and PMS, indicating that higher EA levels were linked to more severe PMS symptoms even after controlling for financial status. Conclusions. These findings highlight the need for more sustainable training strategies. Such strategies may support healthier menstrual wellbeing in early adult varsity elite sportswomen and help prevent addictive exercise patterns.References
Itriyeva K. Premenstrual syndrome and premenstrual dysphoric disorder in adolescents. Current Problems in Pediatric and Adolescent Health Care, 2022;52(5): 101187. https://doi.org/10.1016/j.cppeds.2022.101187
Gao M, Gao D, Sun H, Cheng X, An L, Qiao M. Trends in Research Related to Premenstrual Syndrome and Premenstrual Dysphoric Disorder From 1945 to 2018: A Bibliometric Analysis. Frontiers in Public Health, 2021;9: 596128. https://doi.org/10.3389/fpubh.2021.596128
Prado RCR, Willett HN, Takito MY, Hackney AC. Impact of Premenstrual Syndrome Symptoms on Sport Routines in Nonelite Athlete Participants of Summer Olympic Sports. International Journal of Sports Physiology and Performance, 2022; 1–6. https://doi.org/10.1123/ijspp.2022-0218
Babapour F, Elyasi F, Shahhosseini Z, Hosseini Tabaghdehi M. The prevalence of moderate–severe premenstrual syndrome and premenstrual dysphoric disorder and the related factors in high school students: A cross‐sectional study. Neuropsychopharmacology Reports, 2023;43(2): 249–254. https://doi.org/10.1002/npr2.12338
Ayyub S, Agrawal M, Sharma V, Aravind A. The Effect of Physical Activity on Premenstrual Syndrome: A Systematic Review. Annals of Neurosciences, 2025;32(4): 315–320. https://doi.org/10.1177/09727531241297012
Brown D, Smith DM, Osborn E, Wittkowski A. The experiences and psychological impact of living with premenstrual disorders: a systematic review and thematic synthesis. Frontiers in Psychiatry, 2024;15: 1440690. https://doi.org/10.3389/fpsyt.2024.1440690
Lin PC, Ko CH, Lin YJ, Yen JY. Insomnia, Inattention and Fatigue Symptoms of Women with Premenstrual Dysphoric Disorder. International Journal of Environmental Research and Public Health, 2021;18(12): 6192. https://doi.org/10.3390/ijerph18126192
Yi SJ, Kim M, Park I. Investigating influencing factors on premenstrual syndrome (PMS) among female college students. BMC Women’s Health, 2023;23(1): 592. https://doi.org/10.1186/s12905-023-02752-y
Prasad D, Wollenhaupt-Aguiar B, Kidd KN, De Azevedo Cardoso T, Frey BN. Suicidal Risk in Women with Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Systematic Review and Meta-Analysis. Journal of Women’s Health, 2021;30(12): 1693–1707. https://doi.org/10.1089/jwh.2021.0185
Taim BC, Ó Catháin C, Renard M, Elliott-Sale KJ, Madigan S, Ní Chéilleachair N. The Prevalence of Menstrual Cycle Disorders and Menstrual Cycle-Related Symptoms in Female Athletes: A Systematic Literature Review. Sports Medicine, 2023;53(10): 1963–1984. https://doi.org/10.1007/s40279-023-01871-8
Moro S, Holopainen E, Kosola S. Associations of adolescent academic performance, sports, disordered eating, and menstrual dysfunction. European Journal of Public Health, 2024;34(Supplement_3): ckae144.2111. https://doi.org/10.1093/eurpub/ckae144.2111
Granda D, Szmidt MK, Surała O, Malczewska-Lenczowska J. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among highly trained and elite female athletes: a systematic review and meta-analysis. Biology of Sport, 2025;42(3): 211–225. https://doi.org/10.5114/biolsport.2025.148542
Yi T, Bae M. Prevalence of Premenstrual Syndrome in Korean Female National Athletes and Associated Risk Factors. The Korean Journal of Sports Medicine, 2021;39(1): 10–18. https://doi.org/10.5763/kjsm.2021.39.1.10
Rezaeian N. Comparison of prevalence of premenstrual syndrome in athlete and non-athlete students. International Journal of Public Health Research, 2015;3:234–8.
Leal Filho W, Kovaleva M, Tsani S, Țîrcă DM, Shiel C, Dinis MAP, et al. Promoting gender equality across the sustainable development goals. Environment, Development and Sustainability, 2023;25(12): 14177–14198. https://doi.org/10.1007/s10668-022-02656-1
Eshetu N, Abebe H, Fikadu E, Getaye S, Jemal S, Geze S, et al. Premenstrual syndrome, coping mechanisms and associated factors among Wolkite university female regular students, Ethiopia, 2021. BMC Women’s Health, 2022;22(1): 88. https://doi.org/10.1186/s12905-022-01658-5
Lee W, Lee S, Ahn J, Lee RS, Kang SK. Premenstrual syndrome incidence rate and risk factors among the working population in the Republic of Korea: a prospective cohort study. BMC Women’s Health, 2022;22(1): 265. https://doi.org/10.1186/s12905-022-01852-5
Al-Shahrani AM, Miskeen E, Shroff F, Elnour S, Algahtani R, Youssry I, et al. Premenstrual Syndrome and Its Impact on the Quality of Life of Female Medical Students at Bisha University, Saudi Arabia. Journal of Multidisciplinary Healthcare, 2021;14: 2373–2379. https://doi.org/10.2147/JMDH.S327893
Weinstein A, Szabo A. Exercise addiction: A narrative overview of research issues. Dialogues in Clinical Neuroscience, 2023;25(1): 1–13. https://doi.org/10.1080/19585969.2023.2164841
Juwono ID, Tolnai N, Szabo A. Exercise Addiction in Athletes: a Systematic Review of the Literature. International Journal of Mental Health and Addiction, 2022;20(5): 3113–3127. https://doi.org/10.1007/s11469-021-00568-1
Godoy-Izquierdo D, Navarrón E, López-Mora C, González-Hernández J. Exercise Addiction in the Sports Context: What Is Known and What Is Yet to Be Known. International Journal of Mental Health and Addiction, 2023;21(2): 1057–1074. https://doi.org/10.1007/s11469-021-00641-9
Back J, Josefsson T, Ivarsson A, Gustafsson H. Psychological risk factors for exercise dependence. International Journal of Sport and Exercise Psychology, 2021;19(4): 461–472. https://doi.org/10.1080/1612197X.2019.1674902
Scully D, Kremer J, Meade MM, Graham R, Dudgeon K. Physical exercise and psychological well being: a critical review. British Journal of Sports Medicine, 1998;32(2): 111–120. https://doi.org/10.1136/bjsm.32.2.111
Griffiths MD, Urbán R, Demetrovics Z, Lichtenstein MB, De La Vega R, Kun B, et al. A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sports Medicine - Open, 2015;1(1): 5. https://doi.org/10.1186/s40798-014-0005-5
Lichtenstein MB, Melin AK, Szabo A, Holm L. The Prevalence of Exercise Addiction Symptoms in a Sample of National Level Elite Athletes. Frontiers in Sports and Active Living, 2021;3: 635418. https://doi.org/10.3389/fspor.2021.635418
Takeda T, Imoto Y, Nagasawa H, Muroya M, Shiina M. Premenstrual Syndrome and Premenstrual Dysphoric Disorder in Japanese Collegiate Athletes. Journal of Pediatric and Adolescent Gynecology, 2015;28(4): 215–218. https://doi.org/10.1016/j.jpag.2014.07.006
Fernandez-del-Valle M, Quesnel DA, Mitchell JJ, Robert-McComb JJ. Screening for Eating Disorders, Dysfunctional Exercise, and Menstrual Dysfunction in Female Athletes. In: Robert-McComb JJ, Zumwalt M, Fernandez-del-Valle M (eds) The Active Female, Cham: Springer International Publishing; 2023. p. 183–210. https://doi.org/10.1007/978-3-031-15485-0_12
Laar RA, Shi S, Ashraf MA. Participation of Pakistani Female Students in Physical Activities: Religious, Cultural, and Socioeconomic Factors. Religions, 2019;10(11): 617. https://doi.org/10.3390/rel10110617
Yousra A-S, Al-Wahaibi A, Benn T. Women’s participation in physical education, physical activity, and sport in Oman. In: De D’Amico RL, Jahromi MK, Guinto MLM, [eds]. Women and Sport in Asia. 1st edn Routledge; 2021. P. 136-47. https://doi.org/10.4324/9781003131885
Steiner M, Macdougall M, Brown E. The premenstrual symptoms screening tool (PSST) for clinicians. Archives of Women’s Mental Health, 2003;6(3): 203–209. https://doi.org/10.1007/s00737-003-0018-4
Gallon CW, Ferreira CF, Henz A, Oderich CL, Conzatti M, Ritondale Sodré De Castro J, et al. Leptin, ghrelin, & insulin levels and food intake in premenstrual syndrome: A case-control study. Appetite, 2022;168: 105750. https://doi.org/10.1016/j.appet.2021.105750
Silva EAD, Pires DA. Prevalence of premenstrual syndrome and its psychological effects among university students who participate and do not participate in resistance training. Revista Brasileira de Ciências do Esporte, 2021;43: e007420. https://doi.org/10.1590/rbce.43.e007420
Boyacioğlu NE, Gökdemi̇R F, Keser Özcan N. Investigation of Factors Related to Menstrual and Premenstrual Symptoms. Archives of Health Science and Research, 2021;8(1): 46–55. https://doi.org/10.5152/ArcHealthSciRes.2021.20057
Terry A, Szabo A, Griffiths M. The Exercise Addiction Inventory: A New Brief Screening Tool. Addiction Research & Theory, 2004;12(5): 489–499. https://doi.org/10.1080/16066350310001637363
Lev Arey D, Sagi A, Blatt A. The relationship between exercise addiction, eating disorders, and insecure attachment styles among recreational exercisers. Journal of Eating Disorders, 2023;11(1): 131. https://doi.org/10.1186/s40337-023-00855-3
Landolfi E. An Investigation of Exercise Behaviour Patterns Amongst Varsity Athletes. Journal of Concurrent Disorders, 2022; https://doi.org/10.54127/HHDT5954
Wicker P, Dallmeyer S, Breuer C. Elite Athlete Well-Being: The Role of Socioeconomic Factors and Comparisons With the Resident Population. Journal of Sport Management, 2020;34(4): 341–353. https://doi.org/10.1123/jsm.2019-0365
Bamber D, Cockerill IM, Carroll D. The pathological status of exercise dependence. British Journal of Sports Medicine, 2000;34(2): 125–132. https://doi.org/10.1136/bjsm.34.2.125
Maharam N, Mohamad Shalan NAA, Abdullah NF. Nutritional Knowledge and Calorie Intake Among University Athlete with Risk of Female Athlete Triad. Jurnal Sains Sukan & Pendidikan Jasmani, 2022;(11): 82–87. https://doi.org/10.37134/jsspj.vol11.sp.10.2022
Heikura IA, Stellingwerff T, Areta JL. Low energy availability in female athletes: From the lab to the field. European Journal of Sport Science, 2022;22(5): 709–719. https://doi.org/10.1080/17461391.2021.1915391
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