Journal for Quality in Women's Health DOI : https://doi.
org/10.
30994/jqwh.
https://jqwh.
ISSN: 2615-6660 .
2615-6644 .
Vol.
8 No 2.
September 2025.
Page 135-140 STRESS.
NUTRITION.
AND SLEEP QUALITY AS
DETERMINANTS OF MENSTRUAL CYCLE REGULARIY
AMONG ADOLESCENTS
Nita Dwi Astikasari1.
Tety Ripursari2 1,2 D3 Midwifery Study Program.
Strada Indonesia University.
Jawa Timur City.
Indonesia Email:
strada@gmail.
2tetty30578ripursari@gmail.
0009-0000-0051-3728.
Phone number: 62
ABSTRACT
Menstrual cycle irregularity is a common reproductive health issue among adolescents.
Various factors, including psychological stress, nutritional status, and sleep quality, have been reported to Influence the regularity of the menstrual cycle.
this studi to analize the relationship between stress levels, nutritional status, and sleep quality with menstrual cycle regularity in adolescents.
The results.
The study showed that 40% of respondents experienced irregular menstrual cycles.
Stress was significantly associated with menstrual irregularity .
=0.
, adolescents with high stress were 3.
1 times more likely to have irregular cycles.
Poor nutrition was also correlated .
=0.
, with undernourished adolescents being 2.
4 times more likely to experience irregular cycles.
Poor sleep quality had a significant relationship as well .
=0.
, with poor sleepers being 2.
9 times more likely to have irregular cycles.
This study concludes that stress, nutritional status, and sleep quality are significantly associated with menstrual cycle regularity in adolescents, with stress being the most dominant factor.
Adolescents with high stress, malnutrition, and poor sleep are at higher risk of menstrual cycle irregularity.
It is recommended that adolescents maintain reproductive health through stress management, a balanced diet, and good sleep Health workers and schools need to provide education and support to help adolescents maintain menstrual cycle regularity.
Keywords : Adolescents.
Menstrual Cycle.
Nutrition.
Stress
Journal for Quality in Women's Health | 135
Journal for Quality in Women's Health
INTRODUCTION
Adolescence is a crucial period of human development characterized by psychosocial changes.
One of the most development in females is the establishment of a regular menstrual cycle, which reflects the maturity and balance of the reproductive system.
regular menstrual cycle is considered a vital sign of reproductive health, while irregular cycles may indicate underlying health or lifestyle problems (WHO.
Menstrual cycle irregularities are commonly experienced by adolescents, ranging from delayed menarche, oligomenorrhea, polymenorrhea, to The prevalence of adolescents is reported to be between 30Ae 50% in various countries, indicating a significant public health issue (Harlow & Campbell, 2.
These irregularities may not only affect reproductive health but also the psychological well-being Several factors are believed to influence menstrual cycle regularity.
Stress is one of the most frequently reported psychological contributors, as it interferes with the hypothalamicpituitary-ovarian (HPO) axis and Adolescents often face academic pressure, social challenges, and familyrelated stress, all of which may impact their menstrual health.
Nutritional status is another undernutrition and overnutrition can alter the secretion of reproductive hormones, leading to irregular ovulation and menstrual disturbances.
Sleep quality also plays a significant role, as inadequate or poor-quality sleep can disrupt circadian rhythms and hormonal balance, particularly melatonin and gonadotropins, which are crucial for menstrual regulation (Kumar et al.
Previous studies have shown similar associations.
Raval et al.
reported that high stress was strongly linked to irregular menstrual cycles among Indian adolescents.
Li et al.
demonstrated a significant relationship between poor sleep patterns and menstrual disturbances in Chinese Frisch .
highlighted that undernutrition and low body fat percentage can lead to hypothalamic These findings confirm the multifactorial nature of menstrual however, most of the Indonesia, and very few integrated the three factorsAistress, nutrition, and sleep qualityAitogether in one analysis.
Indonesia, reproductive health issues remain a Many menstruation and its determinants, while lifestyle patterns such as poor diet, irregular sleep, and high stress levels are increasingly prevalent.
Despite its importance, menstrual health has often been overlooked in adolescent health programs, which tend to focus more on early marriage, pregnancy prevention.
Therefore, investigating lifestyle-related factors such as stress, nutrition, and sleep quality in relation to menstrual cycle regularity is highly relevant for developing comprehensive adolescent health strategies.
This study aimed to analyze the association between stress.
Journal for Quality in Women's Health | 136 Journal for Quality in Women's Health nutritional status, and sleep quality with 3.
RESULTS
menstrual cycle regularity among Distribution of Respondents by The findings are expected to Characteristics evidence-based Characteristich Amount Prosentase (%) reproductive health promotion and to Age encourage schools, health workers, and Mean A SD families to provide greater support in Grade X maintaining adolescent well-being.
Grade XL
METHODS
12Ae13 years 74 Design and sample: A cross-sectional Stress Level Low study was conducted involving 94 .
Moderate 55.
female adolescents who were students of High senior high schools (SMA/sederaja.
in Kediri city.
Respondents were selected Sleep quality Good using Variables:Independent: stress Poor level, nutritional status, sleep quality.
Menstrual Reguler Dependent: menstrual cycle regularity.
Irreguler 40,0 Instruments:Stress: Perceived Stress Scale (PSS).
Of study showed that the mean Nutrition: BMI-for-age classification age of respondents was 16.
4 A 1.
(WHO standard.
Sleep quality:
Pittsburgh Sleep Quality Index (PSQI).
participants were in the midMenstrual adolescent stage.
Based on the level of questionnaire on menstrual history.
education, 54 respondents .
Exclusion criteria: adolescents with a were in grade X and 66 respondents history of chronic illness .
uch as .
0%) were in grade XI, which diabetes, thyroid disease, or PCOS), those taking hormonal therapy or respondents were from grade XI.
contraceptives, and those unwilling to Regarding the age at menarche, it was complete the questionnaire.
found that 74 respondents .
Exclusion criteria: adolescents with experienced their first menstruation at chronic illnesses .
iabetes, thyroid the age of 12Ae13 years.
This finding disorders.
PCOS, or anemi.
, those reflects that most respondents undergoing hormonal therapy or using experienced menarche within the contraceptives, and those unwilling or normal physiological range, which unable to complete the questionnaire.
commonly occurs between the ages of Data analysis: Chi-square tests and 11Ae14 years.
Knowledge logistic regression were performed to Menstrual Cycle Regularity among determine associations and dominant Adolescents Menstr Menstrual ual Cycle Cycle Regular Regular Journal for Quality in Women's Health | 137 Journal for Quality in Women's Health Considering that most respondents in this study were in the moderate stress Oligom Oligomeno category .
3%), school-based mental health interventions are urgently Table 3 Association of Stress, needed.
Nutritional status also showed a Nutrition, and Sleep Quality with significant association with menstrual Menstrual Cycle Regularity Undernourished Irregular n Variab
Regular n (%) times more likely to experience irregular
(%)
Stress Stress cycles compared to those with normal This supports Low previous evidence that low body mass Low 002 Ref.
=22 index .
and reduced body fat may .
decrease leptin levels, which are essential for maintaining hypothalamic Mode function and ovulatory cycles (Frisch.
Moder .
8Ae .
=52 .
In this study, 25.
5% of adolescents categorized as underweight, suggesting that nutritional counseling should be integrated into adolescent DISCUSSION The present study showed that 40% Furthermore, poor sleep quality was of adolescents experienced irregular found to be significantly related to menstrual cycles.
This prevalence is menstrual irregularity .
= 0.
, with consistent with previous reports adolescents having poor sleep being 2.
indicating that 30Ae50% of adolescents times more likely to experience irregular worldwide have menstrual disturbances (Harlow & Campbell, 2.
Such This finding is in line with Li et al.
and Baker et al.
, who emphasized the role of circadian rhythm reproductive health issue in adolescence.
Stress was significantly associated with reproductive hormone balance.
The high menstrual cycle irregularity .
= 0.
proportion of adolescents with poor with adolescents experiencing high sleep quality in this study .
stress being 3.
1 times more likely to have highlights the importance of health irregular cycles.
education regarding sleep hygiene.
The This result confirms the theoretical multivariate analysis identified stress as mechanism in which psychological the most dominant factor affecting stress disrupts the hypothalamicAe pituitaryAeovarian (HPO) axis, leading to Adolescents with high stress levels were altered gonadotropin-releasing hormone more likely to experience irregular cycles secretion and ovulatory dysfunction.
than those with poor sleep quality or Similar findings were reported by Raval This finding implies that et al.
in Indian adolescents.
psychological factors may play a Irregula Irregular Journal for Quality in Women's Health | 138 Journal for Quality in Women's Health stronger role than physical factors in findings to a wider adolescent determining menstrual health among population.
CONCLUSION
Overall, these resulths hight the 1.
Stress was significantly associated with menstrual cycle regularity .
= multifactorial determinants of menstrual Adolescents with high stress cycle irregularity.
the combination of levels .
2%) were more likely to high stress, poor nutrition, and experience irregular menstrual cycles inadequate sleep reflects the broader compared to those with low stress lifestyle challenges faced by adolescents levels .
2%).
Stress was identified as These results underline the the most dominant factor influencing importance of a holistic approach in menstrual irregularities (OR = 3.
adolescent health promotion that 95% CI: 1.
5Ae6.
includes stress management, balanced nutrition, and good sleep hygiene 2.
Nutritional status was significantly related to menstrual cycle regularity (WHO,2.
= 0.
Underweight adolescents Reproductive health programs .
3%) had a higher proportion of targeting adolescents should not only irregular cycles compared to those emphasize sexual and reproductive with normal nutritional status knowledge, but also incorporate .
9%).
interventions addressing lifestyle and Stress 3.
Sleep quality was also significantly associated with menstrual cycle regularity .
= 0.
Adolescents counseling, and sleep education could be with poor sleep quality .
9%) were integrated into school health curricula more likely to experience irregular and youth health services.
However, this cycles compared to those with good study also has limitations.
The crosleep quality .
2%).
sectional design does not allow for causal inference, and self-reported 6.
REFERENCE