Objective: Premenstrual syndrome (PMS) is a common disorder during reproductive years that adversely impacts women’s physical, emotional, and interpersonal functioning. The present study aimed to conduct a phenomenological exploration of the factors influencing premenstrual syndrome among female physical education students, with a particular emphasis on the role of lifestyle and physical activity.

Methods: This study adopted a qualitative design using Corbin and Strauss’s (2008) grounded theory approach. The target population consisted of all female physical education students with premenstrual syndrome residing in the city of Sirjan. Using purposive sampling, 15 participants were selected until theoretical saturation was achieved. Data were collected through semi-structured interviews and analyzed using a three-stage coding process (open, axial, and selective coding).

Results: Data analysis yielded a comprehensive paradigmatic model structured around causal conditions (the developmental process and lived experience of the syndrome), contextual conditions (familial and educational factors), intervening conditions (individual and situational characteristics), strategies (self-management, self-care behaviors, and support-seeking), and consequences (individual and interpersonal outcomes). Structured physical activity and lifestyle modification emerged as core strategic and moderating factors, playing an essential role in regulating emotional distress, mitigating physical symptom severity, and enhancing self-efficacy.

Conclusion: The findings indicate that a comprehensive understanding of premenstrual syndrome requires a multifaceted, biopsychosocial perspective. Targeted physical activity and systematic self-care can serve as effective, sustainable, non-pharmacological interventions to promote psychological well-being, regulate negative affect, and improve quality of life among female university students.