In the menstrual period, which starts with menarche and continues until menopause, which covers a significant part of a woman's life; It is seen that most women experience some physical, psychological and behavioral symptoms before menstruation (Biggs & Demuth, 2011; NAPS(The National Association for Premenstrual Syndromes),2018). Premenstrual syndrome (PMS) is a health problem that occurs in the luteal phase, decreases or regresses significantly with the onset of menstruation, and has more than 150 physical, psychological and behavioral symptoms such as breast tenderness, headache, anger outbursts, nervousness, anxiety, mood swings, eating disorders (NAPS, 2018; BJOG(An International Journal of Obstetrics and Gynaecology), 2017). In the first meta-analysis to determine the global prevalence of PMS, the worldwide prevalence of PMS was 47.8% (Direkvand-Mogdahan et al.,2014). In studies conducted with university students in various countries, the prevalence of PMS varies between 39.8% and 98.2% (Ghani & Parveen, 2016; Cheng et al.,2013; Hussein Shehadeh & Hamdan-Mansour, 2018; Kim & Park, 2020; Seedhom et al.,2013). Symptoms experienced in the premenstrual period cause mood/affective disorder, deterioration in daily living activities and social relations, an increase in negative health behaviors in women, and also lead to results such as low academic performance, decreased participation in classes, getting low grades in exams, and absenteeism in exams (Dennerstein et al., 2010; Matsumoto et al., 2013; Tolossa & Bekele, 2014). Since the etiology of premenstrual syndrome is unclear, no specific treatment method can be found and non-pharmacological therapies such as stress control, lifestyle changes, exercise and complementary therapies such as evening primrose oil, chasteberry and acupuncture are applied in its management (NAPS, 2018; BJOG, 2017; ACOG(The American College of Obstetricians and Gynecologists), 2015).~Psychiatrist Carl Gustav Jung discovered the psychic healing transformations created by painting mandala, one of the art therapy methods, through his own and his patients' experiences. Jung defined the mandala as the psychological expression of the unity of the self and believed that the mandala form represents psychic unity and integrity, and as a result, he made mandala coloring a part of his patients' therapeutic process (Davis, 2016).The repetitive pattern and symmetry of the mandala, which means circle in Sanskrit, is thought to have a healing and transformative effect along with meditative focus (Curry & Kasser, 2005; Brown & Ryan, 2003).Various studies have found that coloring mandala improves physical and psychological symptoms; It has been found to reduce anxiety and depression in cancer patients and children, pregnant women, and students (Store & Jakobsson, 2021; Flett et al., 2017; Gürcan & Atay Turan, 2021; Yakar et al., 2021; Amelia et al., 2020). However, when the literature is examined, although studies such as yoga, swimming, aerobic exercise, acupressure, and music therapy have been conducted to improve PMS symptoms, no study has been found showing the effect of mandala coloring on PMS (Maged et al., 2018; Mohebbi et al., 2018; Şolt Kırca & Kızılkaya, 2022; Tsai, 2016; Armour et al., 2018).
This research was planned as a randomized controlled experimental study in order to reduce premenstrual syndrome symptoms of women with premenstrual syndrome.