Highlight
- •Dysmenorrhea increased the risk of developing chronic pain in menstruating women.
- •Dysmenorrhea was associated with developing chronic pain in more body regions.
- •Dysmenorrhea was associated with developing chronic pain of greater interference.
- •Early management of dysmenorrhea may reduce the burden of chronic pain in women.
Abstract
Despite emerging evidence of associations between dysmenorrhea, enhanced pain sensitivity,
and functional neuroimaging patterns consistent with chronic pain, it is unknown whether
dysmenorrhea is prospectively associated with chronic pain development. Gaining a
better understanding of this relationship could inform efforts in prevention of chronic
pain. Using data from the national Midlife in the United States cohort, we examined
the prospective association between dysmenorrhea and chronic pain development during
a 10-year follow-up (starting 10 years after dysmenorrhea was measured) among 874
community-dwelling women aged 25-74 at baseline (when dysmenorrhea was measured).
We fit modified Poisson regression models adjusting for sociodemographic, lifestyle
and psychosocial factors. Among women who were menstruating at baseline, self-reported
dysmenorrhea was associated with a 41% greater (95% confidence interval [CI] = 6%-88%)
risk of developing chronic pain. Women with dysmenorrhea also developed chronic pain
in more body regions (≥3 regions vs 1-2 regions vs none, odds ratio [OR] = 1.77, 95%
CI = 1.18-2.64) and experienced greater pain interference (high-interference vs low-interference
vs none, OR = 1.73, 95% CI = 1.15-2.59). Among women who had stopped menstruation
at baseline, we did not find evidence of an association between their history of dysmenorrhea
and subsequent risk of chronic pain development. Results suggest dysmenorrhea may
be a general risk factor for chronic pain development among menstruating women.
Perspective
This study supports the temporality of dysmenorrhea and chronic pain development in
a national female sample. Dysmenorrhea was also associated with developing more widespread
and disabling pain among women who were still menstruating. Early management of dysmenorrhea
may reduce the development and severity of chronic pain in women, although further
research is required to determine whether dysmenorrhea is a causal risk factor or
a risk marker of chronic pain.
Key Words
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Article info
Publication history
Published online: March 21, 2021
Accepted:
March 8,
2021
Received in revised form:
February 12,
2021
Received:
October 21,
2020
Identification
Copyright
© 2021 by United States Association for the Study of Pain, Inc.
