The abdominal or low back pain that many women experience during their monthly menstrual periods may partly be due to stress, new study findings suggest.

The study authors write that they found “a significant association” between stress and menstrual pain, which is called dysmenorrhea.

“It is suggested that stress reduction may be one way to help this common condition,” study co-author Dr. Xiaobin Wang, of Children’s Memorial Hospital in Chicago, told AMN Health.

Up to 90 percent of women experience dysmenorrhea. For 10 percent to 15 percent of these women, the pain is so severe and disabling that it can cause them to miss school or work and to have a lower quality of life, according to various reports.

Increasing research points to an association between psychosocial stress and preterm delivery and other problems in pregnancy, but few studies so far have looked at the possible link between stress and painful periods.

To investigate, Wang and her colleagues studied 388 Chinese women between the ages of 20 and 34, all of whom were newly married and intended to become pregnant. The women were asked to keep a daily diary for 12 months - or until they conceived - in which they recorded their level of work-related or personal stress and each instance of pain that occurred during their menstrual periods.

Dysmenorrhea occurred at a higher incidence in women who perceived their stress levels as medium or high than for those who reported having low stress levels. About 22 percent of women with low stress said they experienced painful periods, in comparison with almost 29 percent of those with medium stress and about 44 percent of women with high stress.

The risk of painful menses also seemed to be influenced by the phase of the menstrual cycle in which the women felt stressed, the researchers note in their report in the journal Occupational and Environmental Medicine.

Women who reported medium or high stress levels during the follicular phase alone - roughly the first two weeks of the menstrual cycle - were about twice as likely as those with low stress to report painful menses during the following cycle. Those who experienced medium or high levels of stress during both the follicular and luteal phases, or the entire menstrual cycle, were more than six times as likely to report painful menses in the following cycle.

The greatest risk of painful periods, however, was found among women who reported both a prior history of the condition and high stress. These women were10 times more likely to experience subsequent pain than were those who had no history of painful menses and reported low stress in the previous cycle.

Not all women experience painful periods, and some experience pain only occasionally. The reason for this is unknown. “It could be a combination of both environmental risk factors, such as stress, and individual susceptibility,” Wang said.

Based on their study findings, the researchers recommend that stress reduction programs target reproductive-aged women, particularly those with a history of painful menses. Such programs “may be considered as possible preventive strategies to reduce the occurrence of dysmenorrhea, as well as the resulted absenteeism and reduced work productivity,” Wang and her team write.

SOURCE: Occupational and Environmental Medicine, December 2004.