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Peer-reviewedCC BY-NCInternational journal of women's health

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

  • Changmin Niu1,2
  • Nuo Shen2
  • Miaochen Long2
  • Fan Yang1,3
  • Shikun Ma4
  • Yuxin Gao2
  • Wenxuan Zhu2
  • Yidi Kong2
  • Xueyu Lu2
  • Caixia Xiao2
  • Lu Chen5
  • Junli Yan6
6 affiliations
  1. 1Department of Gynaecology and Obstetrics, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
  2. 2School of Nursing, Faculty of Medicine, Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
  3. 3School of Basic Medical Sciences•School of Public Health, Faculty of Medicine, Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
  4. 4Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou, Jiangsu, People's Republic of China.
  5. 5Department of Anesthesiology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
  6. 6Department of Nursing, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
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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.

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Cite

BibTeXRIS
BibTeX
@article{niu2026identification,
  title = {{Identification of Symptom Clusters and Core Symptoms of Menstrual Distress in Reproductive-Age Women: A Network Analysis.}},
  author = {Changmin Niu and Nuo Shen and Miaochen Long and Fan Yang and Shikun Ma and Yuxin Gao and Wenxuan Zhu and Yidi Kong and Xueyu Lu and Caixia Xiao and Lu Chen and Junli Yan},
  journal = {International journal of women's health},
  year = {2026},
  month = oct,
  doi = {10.2147/ijwh.s630715},
  url = {https://europepmc.org/article/MED/42928763},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Identification of Symptom Clusters and Core Symptoms of Menstrual Distress in Reproductive-Age Women: A Network Analysis.
AU  - Changmin Niu
AU  - Nuo Shen
AU  - Miaochen Long
AU  - Fan Yang
AU  - Shikun Ma
AU  - Yuxin Gao
AU  - Wenxuan Zhu
AU  - Yidi Kong
AU  - Xueyu Lu
AU  - Caixia Xiao
AU  - Lu Chen
AU  - Junli Yan
PY  - 2026
DA  - 2026/10/21
JO  - International journal of women's health
DO  - 10.2147/ijwh.s630715
UR  - https://europepmc.org/article/MED/42928763
AB  - 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.
SN  - 1179-1411
ER  -