Iranian Journal of Nursing and Midwifery Research1735-906631320260729513523ENDepartment of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranEnvironmental and Occupational Hazards Control Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranResearch Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Community Health Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran2026072920260729<p><strong>Background: </strong>Menstrual distress encompasses a range of uncomfortable symptoms associated with the menstrual cycle, which significantly impacts women’s quality of life. This cross‑sectional study investigates the influence of occupational hazards, anxiety, and sleep quality on menstrual distress among nurses in an Iranian hospital in 2024. <strong>Material and Methods: </strong>The study was a case‑control design. Data for this study were collected using a demographic questionnaire, the Spielberger State‑Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index, and an occupational hazards assessment worksheet. The modified Moos Menstrual Distress Questionnaire was also used to measure menstrual distress. To analyze the relationships among demographic factors, anxiety, sleep quality, and menstrual distress, structural equation modeling was employed. <strong>Results: </strong>The study found significant associations between menstrual distress and various factors: a history of miscarriage (<em>p </em>= 0.038), smoking (<em>p </em>= 0.023), exposure to high noise levels (<em>p </em>= 0.040), vibration from equipment (<em>p </em>= 0.003), cold environments (<em>p </em>= 0.028), rotating shifts (<em>p </em>= 0.024), and patient handling (<em>p </em>= 0.01). Additionally, state and trait anxiety (<em>r </em>= 0.612, <em>p </em>&lt; 0.001) and sleep quality (<em>r </em>= 0.518, <em>p </em>&lt; 0.001) were closely linked to menstrual distress. <strong>Conclusions: </strong>Adverse working conditions and occupational stress can significantly impact the physical and mental health of nurses, which diminishes their quality of life. Future research should explore the biological mechanisms involved and develop interventions to alleviate menstrual distress among nurses<em>.</em></p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2400http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2400/70707987