Decoding the Menstrual Health Exposome: An Integrated Multidimensional Assessment of Lifestyle, Dietary Patterns, Psychological Stress, Anthropometric Indices, and Reproductive Determinants of Menstrual Disorders in Young Women

Background: Menstrual disturbances may reflect nutritional, anthropometric, and psychological determinants. This study evaluated menstrual characteristics and associations of menstrual patterns with dietary quality, body consumption, weight variation, and perceived stress.

Purpose: To evaluate menstrual health and its association with dietary, anthropometric, lifestyle, and psychological factors among young women
Methods: A multicenter analytical cross-sectional study was conducted among 314 menstruating women aged 15-30 years recruited from academic, healthcare, and community settings across Punjab, India. BMI characterized anthropometric status, and dietary quality was assessed using the Healthy Eating Assessment Tool (HEAT), and perceived stress using the Perceived Stress Scale (PSS). Associations were assessed using categorical tests.

Results: Participants had a mean age of 22.07 ± 2.91 years and mean age at menarche of 12.50 ± 1.28 years. Dysmenorrhea was reported by 40.8% of participants. BMI distribution comprised 18% underweight, 59% normal weight, 18% overweight, and 5% obese participants. Dietary quality was poor/fair in 40.5% and good/excellent in 59.6%. Dietary category was significantly associated with menstrual pattern (p = 0.010). Moderate or high stress affected 72%, and menstrual irregularity increased across low, moderate, and high stress categories (31.8%, 46.7%, and 56.8%, respectively; p = 0.0124). BMI and weight variation were also significantly associated with menstrual regularity.

Conclusions: Menstrual health reflects interactions between reproductive, metabolic, nutritional, and psychological factors. Poorer dietary quality, altered weight status or variation, and greater perceived stress were associated with less favourable menstrual patterns. Prospective multicenter studies across diverse Indian populations are warranted to establish temporality and evaluate the effectiveness of lifestyle interventions.