Painful Periods May Be Fibromyalgia Risk Factor for Women

Painful Periods May Be Fibromyalgia Risk Factor for Women
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Dysmenorrhea, or painful menstrual periods, may be a risk factor for women in the development of fibromyalgia, a large study in Taiwan suggests.

Future studies are needed to identify in more detail the causes and prevention strategies of dysmenorrhea as it relates to fibromyalgia, according to the researchers. But personalized medicine for the treatment of painful periods may be important in reducing the risk of fibromyalgia among women, they said.

The study, “Hormonal Contraceptive Treatment May Reduce the Risk of Fibromyalgia in Women with Dysmenorrhea: A Cohort Study,” was published in the Journal of Personalized Medicine.

Experiencing painful periods is the most common gynecological condition for women of reproductive age and might be a general risk factor for chronic pelvic pain — and non-pelvic pain, such as fibromyalgia, scientists say. According to a theory that could explain this link, recurrent pain in dysmenorrhea induces changes in the brain that might lead to fibromyalgia later in life.

To learn more, researchers at the China Medical University, in Taiwan, used the Longitudinal Health Insurance Database 2000, from the Taiwan National Health Research Institutes Database, to assess if women with dysmenorrhea are at higher risk of fibromyalgia. The team also investigated whether treatment for painful periods reduces the risk of fibromyalgia.

The study included 38,243 women newly diagnosed with dysmenorrhea and 38,243 matched women without the condition, all of whom were followed from January 2000 to December 2011. In both groups, the women’s mean age was 27.2 and the mean follow-up duration was nearly 7.7 years.

Additional health conditions such as obesity, menstrual migraines, depression, anxiety, and sleep problems were analyzed, as were tobacco use and the influence of medications. Such medications included nonsteroidal anti-inflammatory drugs (NSAIDs) — common pain relievers such as aspirin, ibuprofen, and naproxen sodium — antidepressants, anticonvulsants, and hormonal contraceptives.

Statistical models were used to assess the risk of fibromyalgia, accounting for potential confounding variables such as age, additional health conditions, and medication use.

Among the dysmenorrhea group, 1,991 women had endometriosis, a condition characterized by the overgrowth of the endometrium — which lines the inside of the uterus — outside this organ.

Women with painful periods more likely to also be diagnosed with obesity (1.54 vs. 1.01%), menstrual migraines (3.45 vs. 1.54%), depression (3.10 vs. 2.14%), anxiety (9.34 vs. 5.66%), and sleep problems (14.8 vs. 7.33%) than those without dysmenorrhea.

They also had a higher proportion of NSAID use (97.2 vs. 90.6%), antidepressants (10.8 vs. 7.48%), and hormonal contraceptives (34.3 vs. 23.8%).

The overall prevalence (2.45 vs. 1.68%) and the incidence rate — 3.16 vs. 2.19 per 1,000 person-years — of fibromyalgia was higher among women with painful periods than in those without this condition.

Adjusting for confounding factors, the risk of fibromyalgia was 1.40 times higher in women with painful periods. Patients ages 50 or older were at a significantly higher risk for fibromyalgia than those who were younger, as were women with menstrual migraines and who used NSAIDs.

In addition, taking NSAIDs was associated with a greater likelihood of having fibromyalgia regardless of having or not having painful periods. Antidepressants and hormonal contraceptives also were associated with a risk of fibromyalgia, as both women taking or not taking these types of therapy showed a higher susceptibility to fibromyalgia than those without painful periods and not receiving either treatment.

However, treatment with hormonal contraceptives lowered the risk of fibromyalgia in women with painful periods, from 1.49 times to 1.31 times.

Among the study’s limitations, according to the researchers, were a lack of detailed patient information, as well as lack of information regarding treatment efficacy, and severity of both painful periods and fibromyalgia.

“These results indicate that dysmenorrhea may be a risk factor of fibromyalgia, whereas personalized medicine for treatment of dysmenorrhea may be the key to reduce the risk of fibromyalgia. Future studies are needed to identify the causes and prevention strategies in detail,” the researchers concluded.

Diana holds a PhD in Biomedical Sciences, with specialization in genetics, from Universidade Nova de Lisboa, Portugal. Her work has been focused on enzyme function, human genetics and drug metabolism.
Total Posts: 27
José is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimer’s disease.
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Diana holds a PhD in Biomedical Sciences, with specialization in genetics, from Universidade Nova de Lisboa, Portugal. Her work has been focused on enzyme function, human genetics and drug metabolism.
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