Menstrual health is increasingly recognized as a critical health issue by the World Health Organization, encompassing physical, psychological, and social dimensions. Approximately 1.8 billion women globally experience menstruation, with severe hormonal fluctuations leading to premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD), which significantly affects quality of life. This study investigates PMS symptoms among university students in Monastir (Tunisia) through a descriptive cross-sectional design involving 150 participants. Data was collected via a semi-structured questionnaire, assessing sociodemographic information and PMS symptoms using the validated A-PMS diagnostic tool. Results indicated that 100 % of participants experienced PMS, with 69.3 % reporting moderate to severe physical symptoms such as fatigue and pain, while 65.3 % noted significant psychological symptoms including anxiety and mood swings. Over half of the students reported mild impacts of PMS on relationships and academic performance, with 48 % experiencing absenteeism due to symptoms. Despite the prevalence of symptoms, the majority did not seek medical help. The findings highlight the critical need for educational institutions and healthcare professionals to address PMS and implement support strategies, thereby enhancing the well-being and academic success of young women. This research underscores the importance of raising awareness and developing effective interventions for menstrual health in this population.