Self-compassion and premenstrual syndrome symptoms in women: a descriptive correlational study

Abstract

Background

With the monthly menstrual cycle, women may experience physical, emotional, and behavioral changes, and these changes can significantly impact their daily functioning and quality of life. Among these changes premenstrual syndrome represents a common and multifaceted condition characterized by a range of physical and psychological symptoms. The purpose of the study was to examine the relationship between self-compassion and women’s experience of premenstrual syndrome symptoms.

Method

This is a descriptive and correlational study and data were collected online through “Google Forms” by reaching women of reproductive age on social media platforms between December 2023 and December 2024. The study was conducted with 353 women who met the inclusion criteria. The data were collected using a Descriptive Information Form, the Premenstrual Syndrome Scale (PMSS) and the Self-Compassion Scale. The data were analyzed using descriptive statistical methods, independent sample t test, one-way analysis of variance (ANOVA), tukey test, pearson correlation and multiple regression analysis.

Results

The mean total score of the women who participated in the study was found to be 133.49 and the mean total score of the self-compassion scale was found to be 2.91. The prevalence of PMS in women was 55%. There was a negative and highly significant relationship between the total score of the PMSS and the total score of the self-compassion scale (r: -0.700, p < 0.001). According to the results of the regression analysis, being married (β = 0.152) and self-compassion (β=-0.698) were significant predictors of PMSS. Together these two variables explained 49.5% of the variance in the total PMSS score.

Conclusion

This study highlights self-compassion as an important psychological factor associated with women’s experience of premenstrual syndrome symptoms within a descriptive correlational framework.

Background

The menstrual cycle is a physiological phenomenon in women that begins with menarche and continues with monthly periods until menopause and is an important indicator of women’s health [1, 2]. Along with monthly menstruation, women experience physical, emotional, and behavioral changes that can significantly impact their daily functioning and quality of life. Among these changes premenstrual syndrome represents a common and multifaceted condition characterized by a range of physical and psychological symptoms [3].

Premenstrual Syndrome (PMS) is defined as a health problem characterized by a combination of physical, emotional, psychological and behavioral symptoms which occur in a cyclical and recurring pattern during the late luteal phase of the menstrual cycle, and which subside within two to four days after menstruation [4, 5]. In a meta-analysis study conducted with 18,803 women to determine the prevalence of PMS in the world in general, the prevalence was found to be 47.8%. According to the results of the study, the lowest prevalence, 12%, was in France, and the highest, 98%, was in Iran. In the same study, the prevalence of PMS in Turkey was found to be 49.7% [6]. In another study researching the prevalence of PMS in Turkey, it was found in 52.2% of women [7].

In PMS, emotional symptoms are observed, such as depression, outbursts of anger, irritability, crying spells, anxiety, decreased concentration, insomnia, and decreased sexual desire. Along with these emotional symptoms, appetite changes, tenderness in the breasts, a feeling of bloating, headaches and abdominal pain are also common physical symptoms of PMS [5]. These symptoms can have a negative effect on women’s work life [8, 9], family relationships [10, 11], quality of life [3, 12] and mental health [3, 13].

The etiology of PMS is not fully understood, but it is thought that many biological, physiological, environmental, social, and cultural factors may affect the emergence of PMS [14–16]. It is known that factors such as stress and strain [17], certain personality traits [18], anger, impulsivity, hopelessness, emotional intensity [19], humor styles [20], and individuals’ perspectives on stressful situations influence the severity of PMS symptoms. In this context, self-compassion, which reflects individuals’ ability to respond to personal difficulties with kindness and understanding, may represent an important psychological factor associated with the experience of PMS symptoms.

Self-compassion is an attitude to the self that enables individuals to calm down in the face of events beyond their control, to approach themselves with compassion rather than being critical, and to cope functionally. After an event, individuals with self-compassion approach themselves with compassion in the face of their shortcomings rather than blaming themselves [21]. Instead of focusing on mistakes and blaming themselves, seeing these mistakes as part of life experience, and being aware that others may also go through these processes will help individuals to cope with problems [22]. It is stated that self-compassion can play a protective role in helping women to have a more positive outlook on life in the face of negative events, and to overcome difficulties [23].

Considering the personality traits associated with PMS and the characteristics of self-compassionate individuals, self-compassion is also thought to be a feature that may affect the experience of PMS symptoms. Although previous studies have examined the positive effects of mindfulness-based practices, including self-compassion, on women experiencing premenstrual syndrome [24, 25], no studies have directly focused on the relationship between self-compassion and premenstrual syndrome symptoms. Self-compassion, which involves responding to oneself with kindness and understanding, recognizing negative experiences as part of the shared human experience, and maintaining emotional balance, may be associated with women’s experience of PMS symptoms. Given the limited scope of the literature in this area, the present study was designed to address the following research questions: What is the level of PMS symptoms experienced by women? What is the level of self-compassion among the women? Is there a relationship between women’s self-compassion and their experience of PMS symptoms?

Materials and methods

Study design

The research was conducted as a descriptive and correlational study to examine the relationship between self-compassion and women’s experience of premenstrual syndrome symptoms.

Setting and characteristics of the study

Following ethics committee approval, data were collected online via Google Forms by contacting women of reproductive age through social media platforms. Participants were provided with an electronic informed consent form explaining the purpose of the study, voluntary participation, confidentiality, and the right to withdraw at any time. Only women who provided informed consent were able to access and complete the questionnaire. Data collection was conducted between December 2023 and December 2024.

Research population and sample

The population of the study consisted of women between the ages of 18 and 49 who were menstruating. Premenstrual syndrome symptoms were evaluated across a sample of menstruating women, as PMS symptoms may vary in severity and are not limited to clinically diagnosed cases. Power analysis was performed with the program package G*Power 3.1.9.4 [26] to determine the sufficient number for the research sample. Previous studies were taken as a reference in calculating effect size [27, 28], specifically, one of the referenced studies employed the same premenstrual syndrome measurement tool used in the present study, while the other utilized the same self-compassion scale. Based on these studies, a medium effect size (Cohen’s f² = 0.15) was assumed for the power analysis conducted using G*Power 3.1.9.4. This approach is considered appropriate for estimating effect size when prior studies have used identical measurement instruments assessing conceptually related constructs. For the two-tailed hypothesis, the minimum required sample size was calculated as 343 participants with an alpha level of 0.05 and a statistical power of 0.80. During the data collection phase, 353 women were recruited.

Criteria for inclusion in the research

The inclusion criteria were being between the ages of 18 and 49 years, participating voluntarily in the research, being literate, being able to use a smartphone, and having a regular menstrual cycle. Premenstrual syndrome symptoms were assessed across all participants, as PMS symptoms may vary in severity and are not limited to individuals with a clinical diagnosis.

Criteria for exclusion from the research

Exclusion criteria included pregnancy, breastfeeding, hormone replacement therapy, and other gynecological or medical conditions that could affect menstrual regularity. In addition, women having a diagnosed mental illness, including depression, anxiety disorders, or other psychiatric conditions, or receiving psychotropic medication or psychological therapy were excluded from the study.

Data collection tools and ethical considerations

Ethical approval and consent to participate

In order to conduct the study, ethics committee approval was obtained from the Non-Interventional Research Ethics Committee of İzmir Bakırçay University, numbered 71,326 and dated 13 December 2023. The purpose of the study was stated in the informed consent form on Google Forms to women who were eligible for the research sample, and it was explained that the information collected would be confidential and would not be used anywhere outside the research. Women who checked the “I consent” box and agreed to participate in the study voluntarily were asked to complete the form. Participants’ personal information such as name and surname or email address was not requested. The Decleration of Helsinki principles were followed throughout the study.

Data collection tools

A Descriptive Information Form, the Self-Compassion Scale and the Premenstrual Syndrome Scale were used to collect data.

The Descriptive Information Form was based on a literature review by the researchers, and consisted of 12 questions covering the sociodemographic, obstetric and menstrual period characteristics of the women who volunteered to participate in the study [29–32].

The Self-Compassion Scale (SCS) was developed by Neff (2003a) [21]. Validity and reliability work on the Turkish scale was done by Akın et al. (2007). The Self-Compassion Scale consists of 26 items and six subscales: self-kindness (items 2, 6, 13, 17, 21), self-judgment (items 4, 7, 15, 20, 33), common humanity (items 1, 8, 12, 22), isolation (items 5, 11, 19, 25), mindfulness (items 9, 14, 18, 23), and over-identification (items 3, 10, 16, 24). In the original scale development study, Cronbach’s alpha values for the subscales ranged from 0.72 to 0.80, and the Cronbach’s alpha value for the total scale was reported as 0.91 [33]. In the present study, Cronbach’s alpha values for the subscales ranged from 0.81 to 0.90, and the Cronbach’s alpha value for the total scale was found to be 0.97.

The scale is a five-point Likert type, scored as (1) Never, (2) Rarely, (3) Often, (4) Usually, and (5) Always. A high total score on the scale indicated a high level of self-compassion. A high score obtained on a sub-scale meant possession of the characteristics assessed by that sub-scale. In calculating the sub-scale score means, the scores of the sub-scale items were added together and divided by the number of items. To calculate the total score in this study, the items of the negative subscales, self-judgment, isolation, and over-identification, were reversed and the mean scores of the six subscales were taken, and in this way, the total self-compassion/self-sensitivity score was obtained. In interpreting the total score, scores between 1 and 2.5 indicated low self-compassion, scores between 2.5 and 3.5 indicated moderate self-compassion, and scores between 3.5 and 5.0 indicated high self-compassion [33]. Permission to use the scale was obtained by email from Ahmet Akın.

The Premenstrual Syndrome Scale (PMSS) was developed by Gençdoğan (2006). It measures premenstrual symptoms and their severity. The scale consists of 44 items and nine sub-scales and is a Likert-type scale. In scoring the scale, “Never” scores 1, “Rarely” scores 2, “Sometimes” scores 3, “Often” scores 4, and “Always” scores 5. The total of all the scores obtained on the nine sub-scales gives the PMSS total score. The PMSS sub-scales are depressive mood, anxiety, fatigue, irritability, depressive thoughts, pain, appetite changes, sleep changes, and bloating. In the original scale development study, Cronbach’s alpha values for the subscales ranged from 0.76 to 0.91, and the Cronbach’s alpha value for the total scale was reported as 0.76 [34]. In the present study, Cronbach’s alpha values for the PMSS subscales ranged from 0.87 to 0.96, and the Cronbach’s alpha value for the total scale was found to be 0.98.

In applying the PMSS, the person is asked to make a retrospective evaluation by visualizing themselves as being in the period one week before menstruation. The lowest possible score on the scale is 44, and the highest is 220. A higher score on the scale indicates a greater intensity of PMS symptoms. The cutoff point of the scale is 132; a score of 132 or above is interpreted as the presence of PMS [34]. Permission to use the scale was obtained by email from Başaran Gençdoğan.

Statistical analysis

Prior to data analysis, the dataset was examined for completeness and quality. Because all questionnaire items were set as mandatory in the online survey system, no missing data were present. However, responses were screened for data quality, and questionnaires containing clearly invalid or non-informative responses were excluded from the analysis.

Analysis of research data was performed with the use of the program package Statistical Package for Social Sciences (SPSS) 25.0. In evaluating descriptive data, numerical values, percentages, means and standard deviations were used. Skewness and kurtosis values were examined for the normal distribution of the scale, and values in the range of ± 1.0 or ± 1.5 were preferred. Examining the values relating to the measurements, it was seen that the skewness and kurtosis values ​​of the total score of the scale exhibited a normal distribution (Self-Compassion Scale: Skewness: 0.125, Kurtosis: -1.031; Premenstrual Syndrome Scale Skewness: -0.187, Kurtosis: -1.080). In the analysis of the research data, the independent groups t test was used to compare two groups, and the one-way ANOVA test was used to compare three or more groups. The Tukey test was used to examine the difference between groups in the ANOVA test. A total score of 132 or more on the Premenstrual Syndrome Scale meant that PMS was present. To examine the distribution of total scores on the Self-Compassion Scale according to the presence of PMS, Premenstrual Syndrome Scale scores of 132 points and above were grouped as having PMS, and scores between 44 and 131 were grouped as not having PMS, and the distribution of total scores on the Self-Compassion Scale was examined. The relationship between the total scores of the Premenstrual Syndrome Scale and the Self-Compassion Scale was examined using the Pearson correlation coefficient. Correlation coefficients (r) of 0.00-0.19 were interpreted as no relationship or a negligible relationship, 0.20–0.39 as a weak relationship, 0.40–0.69 as a moderate relationship, 0.70–0.89 as strong relationship, and 0.90-1.00 as a very strong relationship. A 5% margin of error was considered in the interpretation of all analysis results. Prior to the linear regression analysis, assumptions of normality, linearity, multicollinearity, and independence of errors were examined and found to be acceptable. Prior to the regression analysis, univariate analyses were conducted to identify variables significantly associated with PMSS scores. Variables showing statistically significant associations in correlation analyses or group comparisons, including self-compassion, marital status, and parity, were entered into the linear regression model. Other sociodemographic and menstrual-related variables, such as age, education level, employment status, income level, menstrual pain, and attitudes toward menstruation, were examined in univariate analyses but were not included in the regression model due to lack of significant association with PMSS scores.

Results

The main findings of the study indicated a strong negative correlation between self-compassion and PMSS total scores. Linear regression analysis showed that self-compassion and marital status were significant predictors of premenstrual syndrome symptoms. Detailed descriptive and subscale-level results are presented below.

Table 1 presents the descriptive characteristics of the participants. Most women were married, had an undergraduate degree or higher, and were employed. The majority reported an income level equal to their expenses and lived in a provincial area.

Table 1.

Sociodemographic characteristics of the participants (n = 353)

Variables	n	%
Marital status Married Single Other	225 122 6	63,7 34,6 1,7
Education High school and below Undergraduate degree or higher	76 277	21,5 78,5
Working status Working Nonworking	199 154	56,4 43,6
Income status In come less than expenses Income equals expenses Income more than expenses	89 212 52	25,2 60,1 14,7
Place of residence Province District and village	267 86	75,6 24,4
Total	353	100
Min/MaxX̄/SS
Age	18/49	28,68/7,98

Menstruation-related characteristics are summarized in Table 2. The mean age at menarche, menstrual cycle length, and duration were within expected ranges. Most participants perceived menstruation as a natural physiological process, while a smaller proportion described it as a discomforting experience or as having a significant negative impact on their lives.

Table 2.

Menstruation-related characteristics of the participants (n = 353)

Variables	n	%
Pain during menstrual period Yes No	262 91	74,2 25,8
Giving birth Yes No	115 238	32,6 67,4
Thoughts about menstruation Natural physiological process It doesn’t matter whether it happens or not Discomforting event Event with a significant negative effect	275 10 47 21	77,9 2,8 13,3 5,9
Total	353	100
	Min/Max	X̄/SS
Menarche age	10/17	13.07/1,28
Menstrual cycle lenght	15/60	28.45/4,63
Menstrual duration	2/10	5.65/1,28

Table 3 presents the total and subscale mean scores of the Self-Compassion Scale. Overall, participants demonstrated a moderate level of self-compassion. Among the subscales, relatively higher mean scores were observed for isolation and self-judgment, whereas lower mean scores were found for self-kindness and over-identification.

Table 3.

Total and subscale mean scores of the Self-Compassion scale

Subscales	Mean	Standard Deviation	Min	Max
Self-judgment	2,78	0,83	1	5
Isolation	2,89	0,90	1	5
Over-identification	2,55	0,83	1	5
Self-kindness	2,52	0,76	1,20	4,80
Common humanity	2,57	0,86	1,25	4,50
Mindfulness	2,63	0,67	1,00	4,75
Self-Compassion Total	2,91	0,73	1,55	4,46

Table 4 presents the total and subscale mean scores of the PMSS. The mean total PMSS score was 133.49 ± 37.82, and based on the cutoff score, 55% of the participants reported clinically significant premenstrual syndrome symptoms. At the subscale level, appetite changes, bloating, pain, and fatigue were the most frequently reported symptoms, whereas anxiety and depressive thoughts were reported less frequently.

Table 4.

Total and subscale mean scores of the PMSS and prevalence of individual premenstrual symptoms

Subscales	Mean	Standart Deviation	Min	Max	PMS symptom prevelance %
Depressive mood	21,23	6,58	7	35	%65,7
Anxiety	17,77	6,19	7	32	%51,3
Fatigue	20,68	5,49	6	30	%77,9
Irritability	14,47	5,52	5	25	%64,9
Depressive thoughts	17,96	6,44	7	35	%49,9
Pain	10,19	2,86	3	15	%81,6
Appetite changes	11,51	3,06	3	15	%89,2
Sleep changes	9,30	3,05	3	15	%67,1
Bloating	10,34	2,92	3	15	%84,4
PMSS Total	133,49	37,82	44	212	%55

Symptom prevalence indicates the proportion of participants reporting the presence of each premenstrual symptom, independent of the PMSS cutoff score

Table 5 shows the distribution of mean total scores on the Self-Compassion Scale according to the women’s experience of PMS. Examining the distribution of the total mean scores of the Self-Compassion Scale according to the presence of PMS, it was found that the total mean score of the Self-Compassion Scale of women experiencing PMS was significantly lower than that of women who did not experience PMS. In addition, when the total mean scores for the sub-scales of the scale were examined, it was determined that the mean scores of the self-judgment, isolation, and over-identification sub-scales of women experiencing PMS were significantly higher than those of women who did not experience PMS. It was found that women who did not experience PMS had significantly higher mean scores for self-kindness, common humanity, and mindfulness than women who experienced PMS.

Table 5.

Comparison of Self-Compassion scores by PMS status

Variables	Self-judgement X̄±SD	Isolation X̄±SD	Over-identification X̄±SD	Self-kindness X̄±SD	Common humanity X̄±SD	Mindfulness X̄±SD	Total X̄±SD
With PMS (55%) Without PMS (45) Test value p	3,24 ± 0,66 2,21 ± 0,66 14,544 < 0,001	3,41 ± 0,62 2,27 ± 0,79 15,018 < 0,001	3,01 ± 0,62 1,99 ± 0,71 14,242 < 0,001	2,19 ± 0,61 2,91 ± 0,74 -10,005 < 0,001	2,23 ± 0,76 3,00 ± 0,79 -9,225 < 0,001	2,38 ± 0,56 2,94 ± 0,67 -8,550 < 0,001	2,52 ± 0,53 3,39 ± 0,66 -13,732 < 0,001

X̄ Mean, SD Standart deviation, t t test indipendent groups

Table 6 shows the relation between the women’s total and sub-scale mean scores on the Self-Compassion Scale and their total and sub-scale mean scores on the PMSS. When the relationship between the total Self-Compassion Scale and PMSS scores was examined, a negative, highly significant relationship was found between self-compassion and premenstrual syndrome (r: -0.700, p < 0.001). When the relationships between the total score of PMSS and the mean scores of the sub-scales of the Self-Compassion Scale were examined, it was found that there was a highly significant positive relationship between the total score of the PMS and the self-judgment sub-scale of the Self-Compassion Scale (r: 0.735, p < 0.001), a highly significant positive relationship between the total score of the PMS and the isolation sub-scale of the Self-Compassion Scale (r: 0.726, p < 0.001), and a highly significant positive relationship between the total score of the PMS and the over-identification sub-scale of the Self-Compassion Scale (r: 0.735, p < 0.001). A moderately significant negative relationship was found between the total PMS score and the self-kindness sub-scale of the Self-Compassion Scale (r: -0.572, p < 0.001), a moderately significant negative relationship was found between the total PMS score and the common humanity sub-scale of the Self-Compassion Scale (r: -0.493, p < 0.001), and a moderately significant negative relationship was found between the total PMS score and the mindfulness sub-scale of the Self-Compassion Scale (r: -0.495, p < 0.001). In line with these findings, it was found that as self-compassion increased, the severity of PMS decreased.

Table 6.

Correlations between the total and subscale scores of the SCS and PMSS

Subscales		1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17
1	r	1	0,926	0,923	0,914	0,920	0,915	0,841	0,795	0,850	0,872	-0,700	0,735	0,726	0,735	-0,572	-0,493	-0,495
	p		< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
2	r		1	0,848	0,806	0,871	0,832	0,708	0,684	0,723	0,771	-0,646	0,661	0,671	0,727	-0,521	-0,454	-0,433
	p			< 0.001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
3	r			1	0,783	0,833	0,840	0,772	0,681	0,751	0,762	-0,681	0,739	0,710	0,686	-0,560	-0,465	-0,495
	p				< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
4	r				1	0,799	0,769	0,827	0,756	0,825	0,794	-0,670	0,697	0,687	0,664	-0,554	-0,506	-0,488
	p					< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
5	r					1	0,878	0,672	0,640	0,737	0,746	-0,612	0,607	0,588	0,682	-0,524	-0,454	-0,442
	p						< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
6	r						1	0,695	0,640	0,710	0.783	-0,580	0,618	0,620	0,650	-0,460	-0,372	-0,389
	p							< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
7	r							1	0,745	0,764	0,737	-0,605	0,657	0,632	0,599	-0,501	-0,425	-0,431
	p								< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
8	r								1	0,691	0,753	-0,664	0,715	0,715	0,647	-0,517	-0,491	-0,476
	p									< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
9	r									1	0,756	-0,589	0,632	0,605	0,563	-0,495	-0,432	-0,431
	p										< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
10	r										1	-0,556	0,581	0,608	0,591	-0,445	-0,358	-0,404
	p											< 0,001	< 0,001	< 0,001	< 0.001	< 0.001	< 0.001	< 0.001
11	r											1	-0,930	-0,910	-0,887	0,931	0,884	0,878
	p												< 0,001	< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
12	r												1	0,911	0,855	-0,779	-0,726	-0,730
	p													< 0,001	< 0,001	< 0,001	< 0,001	< 0,001
13	r													1	0,838	-0,754	-0,696	-0,703
	p														< 0.001	< 0,001	< 0,001	< 0,001
14	r														1	-0,752	-0,661	-0,688
	p															< 0,001	< 0,001	< 0,001
15	r															1	0,905	0,877
	p																< 0,001	< 0,001
16	r																1	0,825
	p																	< 0,001
17	r																	1
	p

1: PMS total, 2: Depressive mood, 3: Anxiety, 4: Fatigue, 5: Irritability, 6: Depressive thought, 7: Pain, 8: Appetite changes, 9: Sleep changes, 10: Bloating

11: Self Compassion Total, 12: Self-judgement, 13: Isolation, 14: Over-identification, 15: Self-kindness, 16: Common humabity, 17: Mindfulness, r: pearson korelasyon coefficient, p: significant

The women’s PMSS determinants were examined using multiple regression analysis (enter model). (Table 7). Categorical variables included in the model were coded as dummy variables (0: zero), and the predictive level of PMSS and risk factors for premenstrual syndrome were examined. When the regression analysis results were interpreted, it was determined that being married (β = 0.152) and self-compassion (β=-0.698) were determinants of PMSS, and that these two variables predicted 49.5% of the total scale score. In particular, a one-unit decrease in the self-compassion scale caused a 35.8-point increase in the PMSS score. In addition, it was determined in this evaluation that the status of not having given birth did not predict the total score of PMSS.

Table 7.

Determinants of PMSS total score (enter model)

Indipendent variables	Unstandardized Coefficients		β	t	p	95% CI
	B	SE
Marital Status (1: Married)	11,908	4,441	0,152	2,663	0,005	3,114–20,701
Giving Birth (1: No)	-6,704	4,648	-0,083	-1,442	0,150	-15,845– 2,438
Self-Compassion	-35,801	1,985	-0,698	-18,033	< 0,001	-39,706 – -31,897

95%CI: %95 confidence interval; SE, standard error; β, standard regression coefficient

Durbin–Watson = 1,976

F = 115,991, p < 0,001

R = 0,707 R² = 0,499 Adjusted R² = 49,5%

* The level of significance was set at p < 0.05

DISCUSSION

In the present study, women’s self-compassion levels were found to be at a moderate level. This finding is consistent with previous studies conducted with women, which similarly reported moderate self-compassion scores across different samples and cultural contexts [28, 35–39]. Although limited studies have reported subscale-level findings, available evidence suggests that self-compassion subscale scores also tend to fall within a moderate range, which is in line with the results of the present study [37].

Regarding premenstrual syndrome symptoms, the mean total PMSS score indicated a substantial symptom burden among participants, with notable variability across symptom domains. Depressive mood, fatigue, and anxiety emerged as prominent symptom areas, whereas other symptom domains showed relatively lower mean scores.

Previous studies have reported a wide range of mean PMSS scores across different populations, including university students, nursing students, and women of reproductive age [18, 30, 31, 40, 41]. The total PMSS scores reported in the literature vary considerably, and the findings of the present study are consistent with some of these studies while differing from others. Such variations may be related to differences in personal characteristics, cultural context, genetic factors, and daily life experiences of women.

The findings of the present study indicate that women experience varying degrees of premenstrual symptoms across multiple domains. In line with previous research, appetite changes, bloating, and pain were among the most commonly reported symptoms during the premenstrual period [29, 31, 42, 43]. Overall, the pattern of symptom distribution observed in this study is consistent with findings reported in the existing literature [27, 44–46].

In the present study, approximately half of the women were found to experience PMS. This finding is consistent with studies conducted among women of reproductive age, which have reported similar prevalence rates [7, 30]. In contrast, studies conducted with university student populations have generally reported higher prevalence rates of PMS [18, 27, 40, 46]. This difference may be related to age-related factors, as the literature suggests that PMS and its more severe symptoms are more commonly observed in younger women.

To our knowledge, this is the first study to directly examine the relationship between self-compassion and premenstrual syndrome symptoms in women. In the present study, a strong and highly significant negative correlation was observed between self-compassion and premenstrual syndrome symptoms. Higher levels of self-compassion were associated with lower levels of PMS symptoms among women. Self-compassion refers to individuals’ ability to approach themselves with understanding, compassion, and care in situations of perceived failure or inadequacy [47]. In this context, self-compassion may play an important role in how women experience and cope with premenstrual symptoms.

Increased self-compassion is a trait that enhances the experience of positive emotions, facilitates focus on the moment, and allows for the release of negative emotions. It also reduces the negative physiological effects of stress. This, in turn, helps preserve mental health in the long term [48]. Considering the physiological changes experienced in PMS, emotional and cognitive changes such as depressive thoughts, depressive mood, anxiety, and irritability, it can be said that self-compassion has a protective effect on these symptoms.

When the relationship between the PMS total score and the mean scores of the self-compassion scale sub-scale was examined, it was seen that there was a moderately significant negative relationship between the PMS total score and the self-kindness sub-scale of the self-compassion scale. Self-kindness is the acceptance and kindness of an individual towards his or her mistakes and shortcomings rather than being judgmental and critical [49]. Considering that psychological symptoms such as self-deprecation and lack of self-confidence are seen in PMS, it is an expected result that people with high levels of self-kindness are less likely to experience PMS symptoms. This result also explains the high positive correlation between the PMS total score and the self-compassion scale self-judgment sub-scale.

There was seen to be a moderately significant negative correlation between the total PMS score and the common humanity sub-scale of the self-compassion scale. Common humanity is the individual’s acceptance that other people have similar negative experiences to those he or she has and the awareness that he or she is not alone in negative life events [21]. Individuals with this awareness accept the negative experiences they have as a part of humanity, instead of being isolated from society. Considering that psychological symptoms such as loneliness and social avoidance are seen in PMS, it is an expected result that individuals who accept negative life experiences as a common part of humanity are less likely to experience PMS symptoms. This result also explains the high positive correlation between the PMS total score and the isolation sub-scale of the Self-Compassion Scale.

It was determined that there was a moderately significant negative correlation between the total PMS score and the mindfulness sub-scale of the self-compassion scale. Mindfulness is a concept that enables individuals to keep their emotions and thoughts in balance in the face of difficult events, and not to identify with these emotions and thoughts or to get carried away by them. Individuals with a high level of mindfulness accept their experiences as they are and do not interpret them as “good-bad” or “healthy-unhealthy” [50]. Mindful Awareness practices are among the practices that increase the individual’s level of mindfulness. It has been stated that Mindful Awareness practices increase self-esteem [51], positively affect psychological well-being [52], reduce depression and anxiety [53], and improve human relations [54]. There are also studies showing that mindfulness practices are effective in women experiencing PMS symptoms. These practices appear to reduce the physical and behavioral symptoms of PMS [55] and the depression and anxiety experienced with PMS [56]. At the same time, a study conducted in Turkiye found that mindfulness-based practices reduced women’s premenstrual symptoms [25]. These results support the negative relationship between mindfulness and PMS scale scores found in our study.

According to the regression analysis results obtained in the study, it was determined that being married and self-compassion were the determinants of PMS, and these two variables predicted 49.5% of the total score of the scale. Married women had higher PMS scores, and being married affected PMS at a weak level (β = 0.152). Being married slightly increased PMS in women. Some studies suggest that being married is associated with PMS severity and that being married is a risk factor for PMS [57, 58]. It may be thought that that the increased responsibilities, stress levels, and life changes that come with marriage may trigger PMS symptoms. On the other hand, there are also studies showing that single women experience more PMS symptoms [20, 59]. There are also studies showing that there is no difference in the incidence of PMS according to marital status [14, 30, 44]. It is thought that more studies should be conducted on this subject.

Increased self-compassion is associated with decreased PMS symptoms (β=-0.698). High self-compassion has the effect of making PMS symptoms milder; this effect is a strong determinant. A study on this topic was found which was conducted with university students in South Korea. This study indicated that self-compassion plays an important role in reducing PMS symptoms [60]. Self-compassion, which means being compassionate, understanding, and non-judgmental towards oneself, can be a protective factor against PMS and an effective factor in managing PMS symptoms.

The regression model used in the study explained 49.5% of PMS symptoms. This demonstrates that the model has strong explanatory power. However, it is important to remember that other factors affecting PMS symptoms (e.g., hormonal changes, lifestyle and genetic predisposition) also need to be considered.

It was found in our study that the total mean score of the self-compassion scale in women experiencing PMS was significantly lower than in women who did not experience PMS. In addition, when the mean scores for the sub-scales of the SCS were examined, it was determined that the mean scores of the self-judgment, isolation, and over-identification sub-scales of women experiencing PMS were significantly higher than those of women who did not experience PMS. It was observed that the mean scores of self-kindness, common humanity and mindfulness of women who did not experience PMS were significantly higher than those of women who experienced PMS. Self-compassion is known to be a protective factor for mental health and psychological well-being and to reduce the effects of stress [61, 62]. Therefore, it can be said that self-compassion is also a protective factor for PMS and that it makes it easier to cope with PMS symptoms.

Strenghts and limitations

One of the strengths of this study is the examination of premenstrual syndrome symptoms as a continuous construct rather than a categorical diagnosis, which allowed for a more nuanced understanding of symptom variability among women. In addition, the inclusion of self-compassion as a psychological factor contributes to the literature by addressing a relatively underexplored area in relation to premenstrual syndrome symptoms. The use of validated measurement tools and the adequate sample size further strengthen the methodological rigor of the study.

Despite these strengths, several limitations should be considered. First, data were collected using an online survey, which may have limited the representativeness of the sample by excluding women without access to digital technologies or with lower digital literacy. Therefore, the findings may not fully reflect the experiences of all women in the general population. To address potential concerns regarding data reliability commonly associated with online data collection methods such as Google Forms, several measures were implemented in the present study. Participants were allowed to complete the questionnaire only once, inclusion criteria were clearly stated at the beginning of the survey, and incomplete or ineligible responses were excluded from the analysis. These procedures were applied to reduce potential biases associated with online self-report data collection. Furthermore, due to the correlational design of the study, causal interpretations of the findings cannot be made. In addition, the cross-sectional design of the study precludes causal interpretations of the observed relationships. Future studies using longitudinal designs and diverse data collection methods may provide a more comprehensive understanding of the factors associated with premenstrual syndrome symptoms.

Although women with diagnosed psychiatric conditions were excluded from the study, subclinical symptoms of depression, anxiety, or other psychological factors were not specifically measured and may have influenced the observed associations between self-compassion and premenstrual syndrome symptoms.

Conclusions

The findings suggest that women commonly experience premenstrual syndrome symptoms and that self-compassion represents an important psychological characteristic among the participants.

Women with PMS exhibited lower levels of self-compassion and higher levels of self-judgment, isolation, and over-identification compared to those without PMS. In addition, self-compassion was negatively associated with PMS symptoms. To our knowledge, this is the first study to directly examine the relationship between self-compassion and premenstrual syndrome symptoms in women.

Practical implications

From a practical perspective, the findings of this study suggest that self-compassion may represent a relevant psychosocial factor to consider in interventions targeting premenstrual syndrome symptoms. Interventions aimed at enhancing self-compassion, such as mindfulness-based or self-compassion–focused programs, may help women better manage the emotional and physical challenges associated with PMS. Health professionals, particularly nurses and mental health practitioners, may consider incorporating self-compassion–based approaches into supportive counseling or educational interventions for women experiencing premenstrual symptoms.

Additionaly; in line with these findings, it is recommended that studies be increased to determine the level of self-compassion in women aged 15–49. Besides that future research may benefit from employing experimental designs, such as randomized controlled trials examining mindfulness-based interventions or self-compassion–focused training programs. Such studies could help clarify the potential role of self-compassion–enhancing approaches in managing premenstrual syndrome symptoms. Relevant outcomes to be monitored in future studies may include PMS symptom severity, quality of life, and functional outcomes such as work or daily activity impairment.

Abbreviations

PMS

Premenstrual Sydrome

SCS

Self-Compassion Scale

PMSS

Prmenstrual Sydrome Scale

SPSS

Statistical Package for Social Sciences

Authors’ contributions

Büşra Çelik: Conceptualization, method, formal analysis, data curation, writing (original draft, reviewing, and editing). Pınar Tektaş: Conceptualization, method, formal analysis, data curation, supervision, writing (reviewing, and editing). The authors read and approved the final manuscript.

Funding

The authors received no funding for this study.

Data availability

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

Declarations

Ethics approval and consent to participate

Approval was given by the ethics committee of Izmir Bakırçay University Non-Interventional Clinical Research Ethics Committee to conduct the study (Decision no: 71326, Date: 13.12.2023). Permission for the scales to be used was obtained via e-mail from the researchers who developed them. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all participants prior to participation via an ‘I consent’ checkbox.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Clinical trial number

Not applicable.