Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity Journal Educational of Nursing (JEN) Vol.
9 No.
1 January Ae June 2026.
page 33-44 p-ISSN : 2655-2418.
e-ISSN : 2655-7630 journal homepage: https://ejournal.
DOI: https://doi.
org/10.
37430/jen.
Article history:
Received: December 16th 2025
Revised: December 17th 2025
Accepted: December 22th 2025
RELATIONSHIP BETWEEN ACADEMIC STRESS LEVELS AND MENSTRUAL
CYCLE REGULARITY AMONG FEMALE STUDENTS AT VOCATIONAL
HIGH SCHOOL AL AZHAR
Silviatul Amalia1.
Sri Aningsih2 Rustida Institute Of Health Sciences.
Banyuwangi.
Indonesia Email : viaamalia40031@gmail.
Abstract Adolescent girlsAo reproductive health can be reflected through the regularity of their menstrual cycles, which are influenced by biological and psychological factors such as academic stress.
Stress can disrupt the regulation of reproductive hormones through the activation of the hypothalamic pituitary adrenal (HPA) axis, potentially leading to menstrual irregularities.
This study aimed to determine the relationship between academic stress levels and menstrual cycle regularity among adolescent girls at Vocational High School Al Azhar.
This study used a crosectional methodology and a quantitative analytic observational design.
200 female students in grades XAeXII who were chosen using complete sampling made up the study population.
validated menstrual cycle questionnaire and the Perceived Stress Scale (PSS) were used to gather The Chi-Square (NA) test was used to analyze the data.
The results showed that most respondents were 17 years old .
5%) and had normal nutritional status .
5%).
The majority experienced mild stress .
%) and had normal menstrual cycles .
5%).
However, statistical analysis revealed a significant relationship between academic stress levels and menstrual cycle regularity .
= 0.
The higher the academic stress level, the greater the likelihood of experiencing menstrual irregularities.
Therefore, school-based promotive and preventive interventions such as stress management education, healthy sleep patterns, and balanced lifestyle programs are recommended to support adolescent reproductive health .
Keywords : Academic Stress.
Adolescent Girls.
Menstrual Cycle.
Reproductive Health
INTRODUCTION
One indicator of teenage girls' rather than just the absence of disease or infirmity related to the menstrual cycle.
which denotes a state of complete .
A normal menstrual cycle typically physical, mental, and social well-being lasts between 21 and 35 days.
Among Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity disorder, a more severe form of PMS quality of life and interfere with their marked by intense psychological distress ability to learn and attend school .
The hypothalamic pituitary-adrenal (HPA) axis becomes physically active in response to prolonged stress, increasing between psychosocial factors, including cortisol release.
Such neuroendocrine academic stress, and both the frequency changes may disrupt the regulation of reproductive hormones (GnRH.
LH, and severity of menstrual symptoms in FSH), causing menstrual disturbances Multicenter .
Three to eight percent of women Recent physiological amenorrhea, or altered reviews have revealed that psychological menstrual pain patterns.
Stressful factors academic pressure, examinations, and incidence of irregular menstrual cycles, reported as key contributors to these university students .
disturbances in adolescent populations .
Approximately 70Ae80% of women Over the past century, numerous do not experience difficulties performing studies have investigated the impact of daily activities during menstruation.
However.
A comprehensive review premenstrual syndrome (PMS), often found that dysmenorrhea is significantly with severe symptoms.
Physical and associated with academic difficulties, emotional symptoms of PMS typically including absenteeism, lack of classroom participation, poor concentration, and menstruation and may include bloating, decreased academic performance .
cramps, fatigue, breast tenderness, and Over the past century, numerous studies headaches, as well as mood changes.
A comprehensive review 20Ae30% difficulties .
found that dysmenorrhea is significantly associated with academic difficulties.
Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity including absenteeism, lack of classroom participation, poor concentration, and preventive and promotive strategies.
decreased academic performance .
WomenAos reproductive health is Many female students avoid seeking particularly crucial, especially regarding medical assistance and instead self- medicate with over-the-counter pain experienced by adolescent girls may relievers to manage menstrual pain .
affect both their current and future This study is grounded in the high Stress Therefore, prevalence of menstrual disturbances healthcare providers should be better among adolescent girls, which have been educated on stress management strategies shown to be closely associated with to help adolescents maintain regular menstrual cycles.
Understanding how to academic stress, through neuroendocrine manage stress will support adolescent mechanisms involving activation of the girls in preserving their reproductive hypothalamicAepituitaryAeadrenal well-being.
Based on this background.
Unlike
(HPA)
this study aimed to investigate the predominantly focused on university relationship between academic stress levels and menstrual cycle regularity stress, or specific menstrual symptoms among female students at Vocational such as dysmenorrhea and premenstrual High School Al Azhar.
syndrome, this research offers novelty by specifically examining the relationship
RESEARCH METHODS
between academic stress levels and menstrual cycle regularity among female This study employed a cross- students in a vocational high school setting, a population that has received quantitative approach to determine the limited attention.
Consequently, this relationship between academic stress context-specific levels and menstrual cycle regularity evidence that academic pressure in among female students at Vocational vocational education environments may High School Al Azhar in 2025.
The directly affect adolescent reproductive health, highlighting the importance of students in grades XAeXII, with total school-based stress management and resulting in Data were collected using Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity the Perceived Stress Scale (PSS) and a RESULTS AND DISCUSSION validated menstrual cycle questionnaire RESULTS .
alidity Ou 0.
reliability Ou 0.
The The Chi-Square (NA) test was used to "Relationship Between Academic Stress examine the data, and a significance level Levels and Menstrual Cycle Regularity of p < 0.
05 was used.
Among Adolescent Girls at SMK Al Rustida The STIKES Research Ethics Committee Azhar" are presented in this part.
The granted ethical approval for the study, first day of data collecting was October which was carried out in October 2025 at 10, 2025.
Before filling out the surveys.
SMK Al Azhar in Sempu District, participants received written informed Banyuwangi consent and a briefing on the study's (No.
0009/EC/KEPK/X/2.
Table 1.
Characteristics of Respondents Characteristics Usia 15 years 16 years 17 years 18 years Body Mass Index (BMI) Underweight (<18.
Normal .
5Ae22.
Overweight .
Ae24.
Obese (Ou.
Amount Sleep Duration <8 hours Ou8 hours Amount Menstrual Complaints Yes Amount Menstrual Cycle Normal .
Ae35 day.
Irregular (<21 or >35 day.
Amount Academic Stress Normal Mild Moderate Severe Very Severe Amount Frequency .
Percentage (%) Source: Primary Data, 2025 Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity The research results show that the percentage .
5%) reported menstrual majority of respondents are 17 years old complaints such as period pain or .
5%),
Based on the cycle pattern.
Based menstrual cycles .
Ae35 day.
, while respondents had a normal BMI .
5%),
5% experienced cycle irregularities.
indicating good nutritional condition.
Regarding academic stress levels, the Most respondents had a sleep duration of majority of respondents were in the mild Ou8 hours per day .
5%), indicating stress category .
%), followed by sufficient rest patterns.
Additionally, the normal stress .
%), and moderate stress .
%), while no respondents experienced menstruation .
5%), while only a small Table 2.
Relationship Between Academic Stress Levels and Menstrual Cycle Regularity Menstrual Cycle Stress Level Normal Irregular P value Normal Mild Moderate Severe Very Severe 0,005 The analysis results show that the teenagers at SMK Al Azhar, according to majority of respondents with mild stress the results of the Chi-Square statistical .
2%) experienced abnormal menstrual test, which showed a p-value of 0.
cycles, while respondents with normal < 0.
6%) and moderate stress .
%) academic stress are associated with a were more likely to have normal higher likelihood of irregular menstrual menstrual cycles.
There is a high Therefore, higher levels of association between the menstrual cycle and academic stress levels among female Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity DISCUSSION The psychological stress can easily disturb academic stress and menstrual cycle Larasati .
According developmental phase where hormonal irregularity among adolescent girls .
= balance is not yet fully stable, making Stress can affect the menstrual cycle changes in the menstrual cycle .
This because when the body experiences Nuraini's .
stress, the nervous system triggers the research, which shows that adolescents activation of the hypothalamic-pituitary- with high stress have a 2.
4 times greater adrenal (HPA) axis, which then increases risk of experiencing menstrual cycle the production of stress hormones like disorders compared to those who are not This can inhibit ovulation and stressed.
cause irregular or delayed cycles because Efendi et al.
explain that stress hormones disrupt the balance of stress can affect cortisol and prolactin hormones that Therefore, even with normal nutritional menstruation .
Physiologically, chronic stress can status, the cycle can still be disrupted due suppress the release of GnRH, which is essential for initiating ovulation, and lead respondents had a normal BMI, but the progesterone hormones necessary for a group with mild to moderate stress .
Prolonged stress has also been linked to an increased risk of menstrual disorders, .
The experienced more irregular cycles .
This international study by Mittiku et al.
including changes in the duration and .
which reported a relationship intensity of menstrual bleeding.
This aligns with the study by Amalia et al.
deprivation, and irregular lifestyle and .
, which found that stress disrupts gonadotropin-releasing hormone (GnRH) university students in Ethiopia.
They activity, affecting hormonal balance .
stated that chronic stress activates the Most respondents were 17 years old an hypothalamic-pituitary-adrenal (HPA) axis and reduces estrogen secretion.
Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity leading to prolonged cycles or even which plays a role in regulating the temporary amenorrhea .
menstrual cycle .
The results of this study support the findings of Adiwinoto described by Bhardwaj.
Yadav, and et al.
that academic stress is Tanej.
, stating that adolescents significantly associated with menstrual with high stress levels have an odds ratio irregularities, especially in students with high academic pressure and unbalanced .
This rest time .
occurs because stress increases cortisol Increased stress leads to chronic and suppresses the release of luteinizing activation of cortisol, which inhibits hormone (LH) and follicle-stimulating GnRH pulsations in the hypothalamus, thereby disrupting the secretion of LH Additionally.
Salsabila .
and FSH.
As a result, the follicular phase research found that stress triggered by becomes longer and menstrual cycles academic pressure, such as exams or become irregular .
This finding is grade demands, can lead to changes in also consistent with Meriati.
Masthura, sleep patterns, reduced nutritional intake, and NursaAoadah .
, who reported and increased physical fatigue, all of that 62% of adolescents with academic which contribute to hormonal imbalances stress experienced menstrual cycles > 35 .
This pattern aligns with Calcaterra This shows that psychological et al.
, who showed that energy factors have a real influence on hormonal imbalance and physiological stress can balance in adolescents .
From a lead to decreased leptin levels and behavioral perspective, stress can also impaired ovarian function in adolescent affect eating patterns, physical activity, girls .
and sleep habits.
A study by Putri et al.
(FSH),
This study also observed that the .
confirms that maladaptive coping majority of respondents slept for more behaviors, such as staying up late or than 8 hours, but a small percentage still excessive caffeine consumption, can experienced cycle disturbances.
This may worsen menstrual cycle dysfunction .
be influenced by sleep quality, not just Overall.
A study by Liu et al.
strengthen the evidence that academic showed that even with sufficient sleep, emotional stress can reduce sleep quality and disrupt neuroendocrine function.
Therefore, interventions focusing on Journal Educational of Nursing (JEN) Vol.
9 No.
Silviatul Amalia | Relationship Between Academic Stress Levels and Menstrual Cycle Regularity stress management, reproductive health education, and lifestyle balance need to 1080/26410397.
Amalia.
Budhiana, and W.
be enhanced in the school environment Sanjaya.
AoHubungan Stres Dengan .
Gangguan Siklus Menstruasi Pada Remaja
CONCLUSIONS
Wacana Kesehat.
, vol.
8, no.
2, p.
75, 2023,
The study concludes that higher PutriAo, doi: 10.
52822/jwk.
Maity et al.
AoAcademic and Social Impact Menstrual irregularities among adolescent girls.
Disturbances in Female Medical This Students: A Systematic Review neuroendocrine mechanisms involving and Meta-AnalysisAo.
Front.
Med.
HPA axis activation and disrupted 9, no.
February, pp.
1Ae18.
Therefore, school-based promotive and preventive strategies including stress 3389/fmed.
Shah and D.
Christian, management education, adequate sleep AoAssociation hygiene, and balanced nutrition are socioAcdemographic, dietary and lifestyle factors with Premenstrual reproductive health.
Syndrome (PMS) undergraduate medical students of ACKNOWLEDGEMENTS The researchers would like to Ahmedabad.
GujaratAo.
Fam.
express their gratitude to SMK Al Azhar Med.
Prim.
Care, vol.
9, no.
for granting research permission and support, and to all participants who 4103/jfmpc.
jfmpc_1553_20.
contributed to this study .
5719Ae5724.
Hashim et al.
AoPrevalence of primary dysmenorrhea and its REFERENCES