Stress Linked to Painful Menstrual Periods

Women who experience painful menstrual periods may benefit from learning stress reduction techniques, according to a new study.

Painful periods — called dysmenorrhea — are a common problem affecting 43 percent to 90 percent of women in various populations, say the researchers, who included Xiaobin Wang, MD, MPH, ScD, of Children’s Memorial Hospital in Chicago.

“Approximately 10-15 percent of women have severe, disabling dysmenorrhea (search), which can contribute to school absenteeism, lost work time, and reduced quality of life,” write Wang and colleagues in the December issue of the journal Occupational & Environmental Medicine.

Studying stress can be tricky since people perceive and deal with stress differently. What overloads one person might be no big deal for someone else, making it tough to gauge stress scientifically.

Wang and colleagues tried to work around that problem while studying female textile workers in Anqing, China, a city in the country’s booming Anhui province.

The 388 participants were all young (20-34 years old), healthy, married nonsmokers wishing to get pregnant. They worked various shifts in dusty, noisy settings to manufacture textiles.

For the study, the women kept diaries rating their daily stress levels and recording any pain during their menstrual cycles.

After tracking the women through more than 1,100 menstrual cycles, the researchers saw a clear link between stress and painful periods.

Overall, about 44 percent of participants reported painful periods, which were defined as at least two days of abdominal or low-back pain during menstrual bleeding within a menstrual cycle.

After adjusting for other influences, women reporting high stress levels during the preceding month were 2.4 times as likely to have painful periods in their next menstrual cycle as those with low stress.

Those with medium stress levels were 1.2 times as likely to have painful periods in their next cycle compared with low-stress participants.

The combination of high stress and a history of painful periods had the strongest impact.

Women with high stress in their preceding cycle and a history of dysmenorrhea had more than nine times the risk of experiencing painful periods in their next cycle than women with low stress and no history of dysmenorrhea, write the researchers.

Timing also mattered.

Stress experienced during the first two weeks of a woman's menstrual cycle (starting on the first day of bleeding) had a stronger impact than stress felt during the menstrual cycle’s last two weeks.

It’s not practical to try to totally eliminate stress, but it is possible to learn to handle it better.

Stress reduction programs might help, especially for women with a history of painful periods, the researchers conclude.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: Wang, L. Occupational & Environmental Medicine, December 2004; vol 61: pp 1021-1026. News release, BMJ Specialist Journals.