Assessment & Evaluation in Higher Education

Vol. 30, No. 4, August 2005, pp. 343352

The relationship between perceptions of

pre-menstrual syndrome and
degree performance1
Sarah L. Earl-Novella* and Donna C. Jessopb
aUniversity

of California, USA; bUniversity of Sussex, UK

Assessment
10.1080/0260293042000318109
CAEH300402.sgm
0260-2938
Original
Taylor
402005
30
School
DonnaC.Jessop
00000August
and
&
ofArticle
Francis
Social
(print)/1469-297X
Francis
& Evaluation
2005
SciencesUniversity
Ltd
Ltd in Higher
(online)
Education
of SussexFalmerBrightonBN1 9SNUKd.jessop@sussex.ac.uk

This paper explores whether female undergraduates self-reported experiences of pre-menstrual

syndrome (PMS) were associated with degree performance, operationalized as degree class
outcome, in a sample of high achieving students (N = 55). Students reported that PMS was
disruptive to academic work (comprising lectures, seminars, writing essays, reading, examinations
and interviews) but no association was found between degree performance and either the number
of PMS symptoms reported or the reported disruption to each aspect of academic work.

Introduction
There is a widely recognized national trend for girls to outperform boys at all levels
of compulsory schooling (Epstein et al., 1998; Francis, 2000). Furthermore, the
numbers of women entering university has risen at a fast rate so that they now constitute 55% of the total student population in Britain (HESA, 2001), although marked
differences in the proportions of men and women in different subject areas persist
(Sutherland, 1994; Solnick, 1995; Holdstock, 1998). Interestingly, however, student
academic performance at university is characterized by a gendered distribution of
degree classes with men being proportionately over-represented at the first and third
class level and women at the upper- and lower-second class level (Rudd, 1984;
McCrum, 1994; McNabb et al., 2002). Therefore, while the apparent educational
success of women is reflected in the fact that female undergraduates now outperform
their male counterparts in terms of good degrees (first or upper second class
honours) obtained (Smith & Naylor, 2001; McNabb et al., 2002), women are still less
likely to attain a first class degree.

*Corresponding author. Center for Studies in Higher Education, University of California, Berkeley,
South Hall Annex #4650, Berkeley, CA 94720. Email: snovell@berkeley.edu
ISSN 0260-2938 (print)/ISSN 1469-297X (online)/05/04034310
2005 Taylor & Francis Group Ltd
DOI: 10.1080/02602930500099136

344 S. L. Earl-Novell and D. C. Jessop

Many hypotheses have been presented within the literature on higher education to
account for gender differentials in first class performance and the current paper
focuses on one of these which relates to pre-menstrual syndrome (PMS). PMS
refers to physical and psychological symptoms which regularly recur during the two
weeks leading up menstruation (the luteal phase of the menstrual cycle). While the
exact cause of PMS is not known, it has been suggested that it may be caused by
hormone imbalances at this time in the cycle (BUPA, 2003). Common symptoms
include feeling bloated, weight gain, discomfort in the back, lower abdomen or
breasts, irritability, depression, aggression, anxiety and tension, tiredness and loss of
concentration (BUPA, 2003). While the majority of women experience such cyclical
changes to some extent, it has been estimated that in excess of one in three women
suffer excessively from such symptoms and are hence defined as suffering from PMS
(National Association for Premenstrual Syndrome, 2003; Womens Health, 2003).
It has been suggested that PMS may influence degree performance (Rudd, 1984;
McCrum, 1994). Obtaining a first class degree is typically characterized by a consistently high standard of performance. As academic performance is often assessed by a
number of examinations and pieces of coursework, it is reasonable to assume that the
symptoms of PMS may influence performance in at least some of these. Furthermore,
the effects of PMS may be especially deleterious in the case of single event examining (McCrum, 1994, 1996), where exams are concentrated in one week (Topping,
1995), if the symptoms of PMS coincide with the period of examination. While many
higher education institutions do not practice single event examining, PMS may still
substantially affect degree performance if end-of-year examinations are held over
several consecutive days. Indeed, McCrum states, there can be no doubt that PMS
must have, on average, a perverse effect on the academic performance of women with
respect to men in examinations: the only question is of what magnitude (1994, p.
23). The possible interference of PMS with academic performance is, therefore,
problematic (Boyle, 1997), particularly in a climate in which male and female first
class achievement remains inequitable (Earl-Novell, 2003).
Most studies relevant to the potential effects of PMS on academic performance
have examined performance fluctuations across different phases of the menstrual
cycle rather than focusing on the pre-menstrual phase explicitly (for an excellent
review of these studies see Richardson, 1991). Nonetheless, there is some evidence
that the pre-menstrual phaseand by extension PMSmay be associated with worse
performance. For example, Dalton (1968) found that women scored lower average
marks, were less likely to pass and were less likely to attain a distinction-rate when O
level and A level examinations were sat either during the four days leading up to
menstruation or during menstruation.
By contrast, other research has found no association between the premenstrual
phase and performance (Sommer, 1972; Bernstein, 1977; Asso, 1986; Epting &
Overman, 1998). For example, Asso (1986) compared final year examination results
within and between individuals and found no significant fluctuations in degree
performance between the premenstrual (defined as the five days before the onset of
menstruation) and non-premenstrual phases.

The relationship between perceptions of pre-menstural syndrome

345

Richardson (1989) explored female students subjective perceptions of both their

experience of PMS and its influence on various aspects of academic work (specifically: lectures, seminars, essay writing, reading, examinations and interviews). Out
of 44 identified premenstrual symptoms, mood swings, irritability, weight gain,
lethargy, tension and general aches and pains were those most frequently cited as
being regularly experienced during the seven to 10 days before the onset of
menstruation. Moreover, participants perceived that PMS disrupted all the aspects
of academic work to a certain degree, with the most disruption being reported for
exam performance and the least for performance in lectures. Thus this research
demonstrates that female undergraduates perceive that PMS disrupts their
academic performance.
The current study aims to extend the findings of Richardson (1989) by exploring
whether self-reports of PMS and the disruption it causes to various aspects of
academic work are associated with first class degree performance, and hence could
potentially contribute to the apparent pattern of gender inequality in first class degree
performance.
Method
Analytic strategy
The study aims to explore whether female degree performance is associated with
perceptions of PMS using the University of Sussex as a case study. The aims of the
analyses were twofold. First, to determine whether female students self-reported
symptoms of PMS were associated with degree performance (as measured by degree
class outcome). Second, to determine whether participants perceptions of the
disruption caused by PMS to various aspects of academic work (lectures, seminars,
writing essays, reading, examinations and interviews) were associated with degree
performance.
Participants
Fifty-five female undergraduate students took part in the study: 42 (76%) of the
sample were young students (under 21-years-old at time of entry) and 13 (24%)
were mature students (aged 21 or over at time of entry). Participants were selected
to take part if they achieved 64% or above in at least one of their three years of
study. The rationale underlying these selection criteria was to collect a range of
data on high achieving students. The high achieving cohort is of interest because
it catches those students who are within the margins of a high upper second class
degree as well as those who are definitely in the first band. Students have, in the
past, been eligible under certain conditions for reclassification if they achieved a
grand mean of 67% or above, irrespective of disciplineso the cohort includes not
only those in the first band but any student who could conceivably obtain a first
class degree. Although this limits the ability range under consideration, the PMS

346 S. L. Earl-Novell and D. C. Jessop

hypothesis is offered as an explanation of female first class under-performance (see,
for example, McCrum, 1994) and, consequently, a very specific cohort is of interest here. Participants were studying one of the following seven disciplines: sociology, history, English, law, economics, computer science and biology.
Unfortunately, it was not feasible to examine the possible confounding factor
regarding different disciplines assessment strategies and their impact on the relationship between perceptions of PMS and degree performance. This is because the
marks arrays displayed conflated scores only (e.g., unseen examination and coursework scores) and, consequently, even though different disciplines were examined
by more than one mode of assessment, de-conflated data corresponding to each
assessment mode was not available.
Measures
Symptoms of PMS. Following Richardson (1989), participants were asked to indicate
(by responding yes or no) whether they regularly experienced each of a range of 42
pre-menstrual symptoms during the seven to 10 days before the onset of menstrual
bleeding. The symptoms were taken from a checklist designed by Lever et al. (1979)
that articulated various symptoms in user-friendly, everyday language.
Perceptions of disruption to academic work. Again following Richardson (1989),
participants were asked to indicate the extent to which pre-menstrual symptoms
disrupted each of the following aspects of academic work: lectures, seminars, writing
essays, reading, examination and interviews. Responses were given by marking a cross
on a 50-mm analogue scale ranging from no effect to total disruption. Each participant was given a score for disruption to each aspect of academic work, calculated by
measuring the distance of their cross from the left anchor point (no effect). Consequently, the possible range of scores for each aspect of academic work was zero to five,
with higher scores indicating greater levels of disruption.
Degree performance. Degree performance was operationalized in terms of degree
class outcome.
Results
Sixteen (29.1%) participants were awarded a first class degree, 37 (67.3%) an upper
second and 2 (3.6%) a lower second. (Participants awarded a lower second were
excluded from the analyses due to the small numbers involved.)
Symptoms of PMS
The percentage of participants reporting that they experienced each of the symptoms
of PMS is given in Table 1.

The relationship between perceptions of pre-menstural syndrome

347

Table 1. Percentage of participants (N = 55) reporting each of the 42 pre-menstrual symptoms

Symptom
Weight gain
Skin disorder
Painful breasts
Swelling
Eye diseases
Asthma
Epilepsy
Dizziness
Faintness
Cold sweats
Nausea
Sickness
Hot flushes
Fuzzy vision
Headache
Migraine
Backache
General aches/pains
Sleeplessness
Forgetfulness
Confusion

%
58.2
45.5
52.7
52.7
0
0
0
20.0
16.4
5.5
27.3
9.1
18.2
7.3
30.9
1.8
47.3
52.7
5.5
20.0
14.5

Symptom
Lowered judgement
Difficulty concentrating
Accidents
Poor coordination
Poor academic performance
Poor work performance
Lethargy
Need to stay at home
Avoiding social activities
Decreased efficiency
Food cravings
Drinking too much alcohol
Taking too many pills
Mood swings
Depression
Anxiety
Restlessness
Irritability
Aggression
Tension
Loss of sex drive

%
22.6
48.1
14.5
29.1
9.1
14.5
56.4
40.0
38.2
36.4
54.5
9.1
3.6
70.9
61.8
65.5
37.0
81.8
38.2
56.4
29.1

For each participant an overall PMS score was calculated by summing the number of
symptoms that they reported experiencing. An independent samples t-test was
conducted to determine whether participants who obtained a first class degree
differed from those who obtained an upper second in their overall PMS scores. There
were no significant differences (t (49) = 1.42, ns) between these two groups in the
number of symptoms they reported.
Secondary analyses were conducted to explore whether specific pre-menstrual
symptoms were associated with degree performance. Only one specific symptom of
PMS met the following criteria: firstly, that the symptom could be hypothesized to
influence degree performance and second, that the symptom was experienced by at
least 30% of the sample. This was difficulty concentrating. Although it is possible
that other symptoms such as lethargy and forgetfulness may well impede degree
performance, these symptoms were excluded from the analyses due to the small
numbers of women experiencing them. Consequently, a chi-square analysis was
conducted to determine whether there was an association between degree class
outcome (first or upper second) and reporting frequently experiencing the premenstrual symptom difficulty concentrating (yes or no). This analysis revealed no
significant association between these two variables (2 (1, N = 52) = .36, ns, Cramers
V = .08).

348 S. L. Earl-Novell and D. C. Jessop

Table 2. Summary of MANOVA comparing students awarded first class degrees and students
awarded upper second degrees on the reported extent of disruption caused by PMS to each aspect
of academic work
Aspect of academic work
Lectures
Seminars
Essays
Reading
Exams
Interviews

Mean 1 (SD1)

Mean 2 (SD2)

F-value

1.77 (1.09)
2.54 (1.20)
2.85 (1.34)
2.08 (1.44)
2.69 (1.65)
2.85 (1.68)

1.72 (.96)
2.28 (1.19)
2.21 (1.11)
2.00 (1.20)
2.45 (1.53)
2.69 (1.54)

.02
.43
2.60
.03
.22
.09

df = 1, 40; every p > .1

Note: 1 = first class degree; 2 = upper second degree. Higher scores represent greater reported disruption.

Perceptions of disruption to academic work

Participants mean scores for the reported extent of disruption caused to each aspect
of academic work by PMS are given in Table 2, categorized according to degree classification. Multivariate analysis of variance was utilized to determine whether
students awarded a first and students awarded an upper second differed on any of
these measures. The results indicated that there were no significant differences
between the two groups in reported disruption to any of the aspects of academic work
(Table 2).

Discussion
The study found no evidence that female students reported experiences of PMS are
associated with degree performance. Specifically, there was no evidence that high
achieving students who were awarded a first class degree differed from their counterparts who were awarded an upper second in terms of either the total number of PMS
symptoms reported or the specific symptom of difficulty concentrating. Furthermore, there were no significant differences between these two groups in the amount
of disruption which they reported being caused to each of a number of aspects of
academic work by PMS. It should be noted, however, that self-reports of disruption
to academic performance may not reflect objective levels of disruption, as people
often make faulty estimates of cognitive ability (Richardson, 1991). Nonetheless, the
study does not suggest that participants self-reported experiences of PMS impeded
degree performance, although it remains a possibility that both groups were impeded,
but more or less equally.
There are several potential explanations for these findings. Firstly, it is possible that
associations do exist between PMS and degree performance, but this study has failed
to capture these. One reason may be that the research was unable to determine
whether participants who reported, for example, that PMS disrupted their exam

The relationship between perceptions of pre-menstural syndrome

349

performance actually experienced PMS at the time when they sat the examinations
contributing to their overall degree result. Arguably, participants who reported that
PMS contributed to worse exam performance and who sat exams at the time when
they were premenstrual may have experienced worse outcomes, compared both to
those who reported no disruption and to those who reported disruption but were
fortunate enough not to have their exams coincide with their PMS. Consequently,
future research may benefit from including perceptions of disruption to PMS alongside actual coincidence of PMS and completion of assessed work to determine
whether these interact to influence degree performance. This was not feasible in the
current study as the data could be gathered from participants at only one time point
prior to their sitting their final exams. Furthermore, for those students who do experience PMS and report attendant implications for academic performance, it is likely
that their PMS would affect their preparation for exams and completion of assessed
coursework at some stage throughout their university careers, even if it does not coincide with exam performance per se.
Alternatively, it is possible that extreme PMS impedes the academic work and
degree performance of a small subset of individuals, while any potential detrimental
effects of less extreme PMS may be overcome by scholarly motivation (Bernstein,
1977). Arguably female undergraduates who experience extreme PMS may have
been excluded from the current study, as their PMS may have prevented them from
qualifying for the high achieving cohort. In addition, it is plausible that the PMS
sufferers who were included within the sample have developed successful strategies
for coping with PMS.
A possible limitation of the study is that certain personality types may be prone to
exhibit PMS symptoms and, by the same token, be more inclined to high achievement. In relation to the former, studies examining the relationship between scores on
personality dimensions and the perception of PMS symptoms are relatively scarce.
Research indicates, however, that arts undergraduates report more symptoms than
their science counterparts whilst students of the social sciences and professions are
intermediate in their reporting (Sheldrake & Cormack, 1976). Whilst the authors
suggest that these results confirm the stereotype of the arts students as more
emotional and neurotic in comparison with the more stable student from the
sciences or professions (1976, p. 171), Gannon (1981) asserts that this observation
is fuelled by bias given the association of paramenstrual symptoms with neuroticism
(cited in Richardson, 1991). It may, however, be useful for future research to incorporate an analysis of the role personality dimensions play in relation to the reporting
of PMS symptoms. Although not the specific interest of this paper, a discussion
concerning the relationship of certain personality types with high achievement can be
found in other research (see Earl-Novell, 2003; Farsides & Woodfield, 2003).
Moreover, it is possible that participants perceptions that PMS influences
academic performance are driven by the stereotypical belief that the menstrual cycle
will have negative implications for female cognitive ability. Sommer argues that there
is a prevailing bias: that the menstrual cycle interferes with a womans cognitive
control (1982, p. 109; also see Epting & Overman, 1998). The belief that the

350 S. L. Earl-Novell and D. C. Jessop

menstrual cycle and, by extension, PMS have negative implications for female cognitive ability has been found to be relatively widespread. For example, an American
opinion poll, conducted in 1981, found that 35% of respondents thought that
menstruation affected a womans ability to think (cited in Pollitt, 2001). Richardson
goes one step further and states that academia itself is not immune from stereotypical
beliefs concerning the menstrual cycle and cognitive capacity. He suggests that:
the mistaken assumption that women suffer from reduced performance during the paramenstruum can be seen as having supported and as continuing to support the exclusion of
women from positions of power and authority. (1991, p. 333)

Whether or not this assumption is mistaken remains questionable but Richardson

acknowledges that gender inequity in higher education institutions is a consequence
of a variety of discriminatory structures and practices but he asserts that, the
menstrual cycle serves as a primary focus for attitudes towards the cognitive capacity
of women (1991, p. 334).
Although the study did not find an association between PMS and degree performance, participants nonetheless reported a certain amount of disruption to each
aspect of academic work assessed. Regardless of whether this reported disruption
reflects a real association between PMS and performance or is a product of female
and menstruation-related stereotypes, it is possible that such perceptions of disruption have a negative influence on academic self-confidence. Academic selfconfidence has been shown to be associated with first class degree performance and
possibly to contribute to the apparent gender inequality in first class performance
(Earl-Novell et al., forthcoming).
It should also be borne in mind that the study focused on pre-menstrual symptoms,
defined as those which are experienced for the seven to 10 days prior to menstruation.
It is possible that other phases of the menstrual cycle, specifically menstruation per
se, may have negative implications for performance (McCrum, 1994; cf. Sommer,
1982). Therefore, while the current study found no evidence that perceptions of PMS
and its impact on various aspects of academic performance were associated with degree
performance, this should not be accepted as proof that there is no association between
the menstrual cycle and academic performance. Until it is established definitively that
the menstrual cycle has no effect on performance, institutions of higher education
should avoid assessment procedures that could potentially disadvantage some women,
for example the consecutive sitting of examinations over a several day period.
Acknowledgement
The authors would like to thank J. Richardson for permission to replicate the questionnaire used in Richardson (1989).
Note
1.

This research was supported by an ESRC postgraduate training award R00429934129.

The relationship between perceptions of pre-menstural syndrome

351

Notes on contributors
Dr Sarah Earl-Novell completed her PhD in Sociology at the University of Sussex in
2003 before joining the Center for Studies in Higher Education at the University of California, Berkeley as a visiting postdoctoral fellow. Her current
interests include (i) patterns of academic performance in Higher Education and
(ii) factors facilitating and impeding doctoral persistence.
Dr Donna Jessop is a lecturer in health psychology at the University of Sussex and is
programme convenor of the Msc in Health Psychology. Her current research
interests include (i) the application of Terror Management Theory to health
psychology, in particular exploring the influence that fear of death and awareness of ones own mortality have on risk perceptions and health behaviours and
(ii) socio-economic inequalities in health, especially investigating the role that
student debt and financial concern have on academic performance and mental
and physical health.
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