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High Stress Levels Double Risk of Painful Periods

Study confirms what doctors, women have long suspected

THURSDAY, Nov. 18, 2004 (HealthDayNews) -- Women who are stressed are twice as likely to have painful menstrual periods as those who are not.

That distinction is detailed in a new report in the December issue of Occupational and Environmental Medicine.

"Stress has been linked to a variety of other [adverse] health outcomes," said study co-author Dr. Xiaobin Wang, a pediatrician at Children's Memorial Hospital in Chicago. But she believes the new research is the first prospective study -- which follows subjects over time -- to link stress to painful periods.

Wang and her team asked 388 healthy and newly married women to keep daily diaries charting their stress levels, rating them as low, medium or high, for up to 12 months. The women were aged 20 to 34 when the study began; none had children but all hoped to become pregnant. They also supplied data on their menstrual cycles, their pain, their use of birth control and other information. All the women were textile workers in China.

Reported levels of medium and high stress were greatest among those with painful periods. The rate of painful periods among women reporting high stress was 44 percent, but it was just 22 percent for those reporting low stress. That result held up even after taking into account other factors that could have had an effect on period pain, the study found.

Exactly how stress translates into painful periods isn't known and was beyond the scope of the study. "We can only speculate," Wang said. "Stress can affect hormone levels, for example progesterone and prostaglandins."

The study confirms what doctors and some women have suspected for years, said Dr. William A. Growdon, chairman of the obstetrics and gynecology department at Santa Monica UCLA Medical Center in Los Angeles.

And the hormonal explanation makes sense, he added. "Prostaglandins are potent stimulators of smooth muscle contraction," he said. The higher the prostaglandin levels in the body, the more likely women are to experience monthly cramps.

Growdon emphasized that painful periods are common and also very easily treated.

Reducing the level of prostaglandins is the key to reducing pain, he said. That can be accomplished by taking a nonsteroidal anti-inflammatory drug such as ibuprofen, which inhibits prostaglandin synthesis, or by taking birth control pills, he said.

Addressing the issue of stress is important, but "it's hard to write a prescription for stress reduction," Growdon said.

The medical literature has come up with conflicting findings about the effect of stress on period pain, he added. "In a study in the late '80s, they were not able to show stress [effects] in medical students," he said. Yet other studies, also referred to in Wang's report, have found a link between high stress levels and severe period pain.

"Different people have different responses to stress," Growdon said. "People have different tolerances for pain."

Among the limitations in the Wang study, Growdon added, is that the researchers didn't ask about the source of the stress, so it's impossible to determine if it originated at home, on the job, from personal relationships or from professional ones.

Women who aren't on birth control pills and have painful periods might consider taking preventive medication, with their doctor's approval, Growdon said. "Take ibuprofen, even a day before the period is scheduled to begin," he suggested, for optimal pain relief.

More information

To learn more about stress, visit the American Institute of Stress.

SOURCES: Xiaobin Wang, M.D., pediatrician, The Mary Ann and J. William Smith Child Health Research Program, Children's Memorial Hospital, Chicago; William A. Growdon, M.D., chairman, Obstetrics and Gynecology Department, Santa Monica UCLA Medical Center, and clinical associate professor, obstetrics and gynecology, UCLA David Geffen School of Medicine, Los Angeles; December 2004 Occupational and Environmental Medicine
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