Between Silence and Stress: Menstrual Health, Mental Well‐Being, and Academic Disruption Among International College Students

ABSTRACT Objective The current cross sectional secondary data analysis study aimed (1) to assess the extent to which international students report that premenstrual syndrome (PMS), painful periods, or menstrual cramping negatively impact their academic performance, and (2) to examine the associations between PMS, painful periods, or menstrual cramping and academic challenges as well as mental health outcomes including anxiety, depression, psychological distress, and suicidal ideation. Methods Data were drawn from a large national sample (N = 12 468) with an average age of 22 years (μ = 22.97, SD = 5.86). Descriptive analyses and univariate logistic regression analyses were undertaken using IBM SPSS Version 26. Results Approximately 11.0% (n = 1356) reported that menstrual health conditions negatively impacted their academic performance, and 1.2% (n = 153) indicated that these issues delayed their degree progress. Students experiencing high stress (OR = 1.74, 95% CI = [1.58, 1.92]), anxiety (OR = 1.87, 95% CI = [1.73, 2.03]), depression (OR = 2.20, 95% CI = [2.01, 2.41]), and suicidal ideation (OR = 1.84, 95% CI = [1.68, 2.01]) had significantly higher odds of reporting academic impediments. South Asian students had higher odds of reporting menstrual‐related academic disruption than other racial and ethnic identities (OR = 1.49, 95% CI = [1.31, 1.70]). Conclusion Menstrual health conditions, though significant, are an underrecognized determinant affecting academic performance and mental health among international college students. These findings call for culturally sensitive campus policies and interventions that address menstrual stigma and expand access to support services.