Study links depression to increased menstrual pain

Study links depression to increased menstrual pain | Image Credit: © Monkey Business - © Monkey Business - stock.adobe.com.

There is an association between depression and increased period pain, according to a recent study from Xi'an Jiaotong-Liverpool-University (XJTLU), China.¹

The odds of depression are increased 2-fold among women compared to men, with physical symptoms often more severe in this population. This disparity is greater during reproductive years, leading to significant impacts on the well-being of millions of individuals.¹

Early treatment of dysmenorrhea is crucial for preventing adverse health outcomes, including endometriosis.² A review highlighted the significant prevalence of endometriosis in adolescent girls with severe dysmenorrhea, at 35.3% vs 13.3% among the general population of adolescent girls.

Endometriosis has also been reported as the main cause of secondary dysmenorrhea, defined as menstrual pain linked to organic pelvic pathology. Dysmenorrhea may also present as primary dysmenorrhea, defined as pelvic pain without any organic source. Determining dysmenorrhea type may allow for improved detection and treatment of endometriosis.²

Data about the link between mental health and reproductive health remains lacking. Investigators evaluated this association using a 2-sample, bidirectional, and multivariate Mendelian randomization (MR) approach.³

Genetic variants linked to dysmenorrhea and depression were identified using genome-wide association study (GWAS) data. Afterward, colocalization analysis of shared genetic influences was performed.³

Target genes were identified during analysis of expression quantitative trait locus (eQTL) data obtained from public databases. Interactions among identified proteins were assessed through a protein–protein interaction (PPI) network developed using the STRING database.³

The assessment included approximately 608,000 cases, 600,000 of whom were European and 8000 were East Asian.¹ Sleeplessness was considered as a potential mediator of the link between depression and dysmenorrhea.

The MR analysis highlighted increased odds of dysmenorrhea among women with depression, with an odds ratio of 1.51.³ However, no impact toward depression was noted from dysmenorrhea.

Single-nucleotide polymorphisms were noted in several genes during the genetic analysis of GWAS and eQTL data, including GRK4, TRAIP, and RNF123. This highlighted a potential impact of depression on reproductive function through these pathways.³

A more detailed display was available through analysis in the PPI network. During Colocalization analysis, rs34341246 (RBMS3) was identified as a potential shared causal variant.³

These results indicated a significant impact of depression on dysmenorrhea, along with highlighting the key genes and proteins driving this association. Investigators concluded there is a need for clinical and public health approaches to provide depression screening and potential prevention strategies among women with dysmenorrhea.³

"Our findings provide preliminary evidence that depression may be a cause, rather than a consequence, of dysmenorrhea as we did not find evidence that period pain increased the risk of depression,” said Shuhe Liu, PhD student at XJTLU and lead author of the study.¹

"We found that increased sleep disturbances could exacerbate menstrual pain,” Liu added. “Addressing sleep issues may therefore be crucial in managing both conditions. However, more research is required to understand the intricate links between these factors.”¹

References:

1. Depression can cause period pain, new study suggests. EurekAlert. November 26, 2024. Accessed November 27, 2024. https://www.eurekalert.org/news-releases/1065511
2. Martire FG, Piccione E, Exacoustos C, Zupi E. Endometriosis and adolescence: The impact of dysmenorrhea. J Clin Med. 2023;12(17):5624. doi:10.3390/jcm12175624
3. Shuhe Liu, Zhen Wei, Daniel F Carr, John Moraros, Deciphering the genetic interplay between depression and dysmenorrhea: a Mendelian randomization study, Briefings in Bioinformatics. 2024;26(1). doi:10.1093/bib/bbae589

This article was initially published by our sister publication, Contemporary OB/GYN.