Title: Prevalence and effects of menstrual disorders on quality of life of female undergraduate
students in Makerere University College of Health Sciences, a cross sectional survey
Version: 1 Date: 23 Jul 2022
Reviewer's report:
This is a valuable and interesting study. However, to make this study more valuable, there are
some points that should be made clear.
1 Tittle: Prevalence and effects of menstrual disorders on quality of life of female undergraduate
students in Makerere University College of Health Sciences, a cross sectional survey
That is clear.
2 Abstract
Objective, Method, Result, Conclusion are clear.
Keyword is write correctly in alphabetical order, but please add the word “undergraduate
student” being the keyword.
3 Introduction
In line 46-48: Menstrual disorders refer to abnormalities of menstruation that include
menstrual cycle irregularities; irregular menstrual cycle, heavy menstrual bleeding, infrequent
menstruation, frequent menstruation, intermenstrual bleeding, amenorrhea [1], dysmenorrhea,
and premenstrual syndrome [?]. please insert the reference.
In my opinion, the factors affecting the quality of life in a person are unlikely to be the pattern
of menstruation only. But stress management or coping style, as in the previous study found
most medical students use adaptive coping strategies but gender, GPA, religion and medical
illness had significant correlation with adaptive coping strategies (ref: Naruttha Norphun,
Jarurin Pitanupong, Aimorn Jiraphan. Siriraj Med J 2020; 72: 238-244) and other confounding
factors such as mental health problems (ref: The Relationship between Mental Health with
the Level of Empathy Among Medical Students in Southern Thailand: A University-Based
Cross- Sectional Study. Katti. Siriraj Med J 2021; 73: 832-840) or burnout that the previous
study found of the participants, 29.6% had poor mental health, 63.5% and 39.7% reported a
high level of emotional exhaustion and depersonalization scores that mean having burnout (ref:
Factors associated with the improvement of the empathy levels among clinical-year medical
students in Southern Thailand: a university-based cross-sectional study. BMC Psychol. 2022
May 21;10(1):128) are common problems that affect quality of life among medical students.
Additionally, depression or received mistreatment (ref: The Prevalence and Factors Associated
with Mistreatment Perception among Thai Medical Students in a Southern Medical School.
Siriraj Med J 2019; 71: 310-317) is confounding factors that also affect QoL among medical
student.
Therefore, the authors should review all these factors and divide into consideration in the study
design. However, I find that these mentioned confounding factors were not ruled out in this study
design, so you should mention them in the discussion as research weaknesses. And I think it's
hard to tell that only factor of menstrual disorders were highly negative effects on quality of life.
4 Study design:
It is a cross-sectional study. But it is unclear whether the data collection is using processes? face-
to-face and self-assessment on paper? or online process (using Google form)? or using another
process. Please be clear about the process of data collection.
About  Questionnaire, I find that WHOQOL -100 was written in line 115-124 and it was rewritten
again in line 140-150, therefore, please write a more concise and clearly write down the tools
used in the study by including the reliability of the tool.
5 Population:
In this study, was the sample data collected from all undergrad students? This mention will
confirm that there is no selection bias.
In addition, if the participants are LB and are taking the hormonal pill, would these subjects be
excluded from the study? And these will affect the study result, Please clarify and discuss.
6 Tool:
This study tried to validate tool. So please tell us the reliability values of the tool.
7 Statistical analysis
That’s clear.
8 Result:
That’s clear.
9 Discussion
Could this study have exaggerated prevalence poor quality of life? Because there are no
excluding subjects with confounding factors such as depression, perceived mistreatment, poor
mental health , poor coping stategy or burnout from the study which these factors can affect
the outcome of quality of life. Then, these are the weaknesses of the research, that should be
mentioned.
Additionally, it's hard to tell that factor of menstrual disorders were highly negative effects on
quality of life.
10 Reference
Some references, (such as ref 23,28) is too old. Please use the updated references, check and
write the reference format correctly.
11 Other
Gramma in all part should be re-check and should be written more concisely, Thanks