Lifestyle and Occupational Factors Associated with Premenstrual Dysphoric Disorder Symptoms in Chinese Nurses: A Cross-Sectional Study

Background: Premenstrual dysphoric disorder (PMDD) impairs quality of life in reproductive-aged women. Clinical nurses facing high occupational stress and irregular work schedules may be particularly vulnerable. Identifying modifiable risk factors in this population is crucial for developing effective prevention strategies. Aims: This study aimed to investigate associations between lifestyle factors, work patterns (specifically night shifts), and PMDD symptoms among Chinese female nurses. Methods: A cross-sectional study was conducted among 1,031 Chinese female nurses. Assessments included the Chinese version of the Core Symptoms of Premenstrual Dysphoric Disorder Questionnaire (CTDP-C), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and Medical Staff Stressor Scale (MSSS). Results: The prevalence of PMDD symptoms was 42.4% in Chinese female nurses. Higher PMDD risk was associated with a body mass index (BMI) of 24–27.9 kg/m 2 ( p < .05), weekly exercise <30 min ( p < .05), a history of alcohol use ( p < .05), and ≥ two night shifts/week ( p < .001). CTDP-C scores showed strong positive correlations with depression ( r = 0.702), anxiety ( r = 0.680), poor sleep quality ( r = 0.493), and occupational stress scores ( r = 0.500) (all p < .01). Multivariate regression confirmed BMI, exercise, alcohol use, night shift frequency, and physical health conditions as significant predictors. Conclusions: PMDD symptoms are highly prevalent among Chinese nurses, influenced by modifiable lifestyle and occupational factors. These findings highlight the need to integrate screening (night shifts, alcohol use) into occupational health exams. Nurse administrators should implement shift optimization, wellness programs, and stress management to protect reproductive mental health.