DOCTOR'S VIEW ARCHIVE
Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.
Painful menstrual periods, medically known as dysmenorrhea, affect 40 to 90% of women of reproductive age. While gynecological conditions ranging from uterine fibroids to endometriosis can cause painful menstrual periods, dysmenorrhea may also occur in the absence of any underlying abnormality. Dysmenorrhea is the most common gynecologic disorder in women during their reproductive years.
Dysmenorrhea may be, at least in part, related to lifestyle stress, according to researchers. One study to investigate the effects of stress on menstrual pain involved 388 newly-married childless women, age 20-34, working in the textile industry in China. All of these women expressed a desire to become pregnant.
The women kept records of their menstrual cycles as well as diaries of their daily stress levels (rating their stress as "low", "medium", or "high") during the 12-month study or until they became pregnant. The women also answered questions about their degree of symptoms and discomfort during menstrual cycles.
The perception of stress and the degree of dysmenorrhea in each menstrual cycle were based on the diaries kept by the women. The women were classified as having dysmenorrhea if they experienced two or more days of abdominal or lower back pain during a menstrual cycle.
Interestingly, dysmenorrhea was twice as common in women who reported high levels of stress in the preceding menstrual cycle -- 44% of the women with high stress developed dysmenorrhea compared to 22% of women with low stress.
Lifestyle stress in the first half of the menstrual cycle (the follicular phase of the cycle) seemed more strongly associated with dysmenorrhea than did stress in the second half (the luteal, phase) of the cycle.
Many women report that psychological stress worsens their menstrual pain. Chronic lifestyle stress can have wide-ranging effects on the body, including suppression of the immune system. Psychological stress can also worsen symptoms or delay healing in myriad medical conditions including asthma, cardiovascular disease, infections, and diabetes.
Reference: Wang L, Wang X, Wang W, Chen C, Ronnennberg AG, Guang W, Huang A, Fang Z, Zang T, Wang L, Xu X. Stress and dysmenorrhoea: a population based prospective study. Occup Environ Med 2004; 61: 1021-6.