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Identification of Symptom Clusters and Core Symptoms of Menstrual Distress in Reproductive-Age Women: A Network Analysis

Year: 2026

Type: article

Abstract: Background: Menstruation is a key indicator of women's health, yet current research often focuses on isolated symptoms or specific syndromes, overlooking how multiple symptoms interrelate. Purpose: This study adopted network analysis to clarify intercorrelations among menstrual distress symptoms, identify core symptoms and symptom clusters, and provide evidence for developing systematic and targeted management strategies for menstrual symptoms. Methods: This cross-sectional study recruited 723 women of reproductive-age through convenience sampling in Yangzhou, China, between July and October 2024. Descriptive analysis (SPSS 26.0) and exploratory factor analysis identified symptom clusters; network analysis (R 4.3.1) constructed the symptom network and identified core symptoms. Results: The study found that reproductive-age women had a menstrual symptom distress score of 20.35±11.01. The most common symptom was lower abdominal pain (75.1%), hypomenorrhea or hypermenorrhea (70.4%), irregular menstrual cycle (70.0%), emotional instability (66.1%),and bloating or breast tenderness (66.0%). Exploratory factor analysis identified five symptom clusters: abnormal menstruation, pain and discomfort, gastrointestinal symptoms, psychological and emotional, and behavioural changes. Network analysis revealed that menstrual insomnia or hypersomnia ranked highest in both strength centrality (2.089) and expected influence (2.177), indicating that this symptom served as a core symptom within the symptom network. Conclusion: Women of reproductive-age experience moderate menstrual symptom distress, with menstrual insomnia or hypersomnia as the core symptoms. Findings from this network analysis suggest that this symptom may be a potential focus for the development of comprehensive symptom management strategies. Future studies could explore whether symptom management strategies that include this core symptom are associated with better outcomes.

Source: International Journal of Women s Health

DOI: 10.2147/ijwh.s630715