The Association of Reproductive Hormones During the Menstrual Period with Primary Dysmenorrhea

Junying Jiang; Yan Zhuang; Shuting Si; Haoyue Cheng; Xialidan Alifu; Minjia Mo; Haibo Zhou; Hui Liu; Yunxian Yu

doi:10.2147/IJWH.S421950

The Association of Reproductive Hormones During the Menstrual Period with Primary Dysmenorrhea

Int J Womens Health. 2023 Oct 9:15:1501-1514. doi: 10.2147/IJWH.S421950. eCollection 2023.

Authors

Junying Jiang^#¹, Yan Zhuang^#², Shuting Si², Haoyue Cheng², Xialidan Alifu², Minjia Mo², Haibo Zhou², Hui Liu³, Yunxian Yu²

Affiliations

¹ Department of Women's Health, Yiwu Maternity and Children Hospital, Yiwu, People's Republic of China.
² Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People's Republic of China.
³ Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou City, People's Republic of China.

^# Contributed equally.

Abstract

Objective: This study aimed to investigate the association of reproductive hormones with primary dysmenorrhea in Chinese women.

Methods: A case-control study was conducted and patients with primary dysmenorrhea and non-dysmenorrhea participants were recruited. Oxytocin, PGF_2α, vasopressin, estriol and estradiol were respectively measured in plasma collected three to five days after menstruation. Restricted cubic spline and multiple logistic regression models were adopted to analyze the association between hormones and primary dysmenorrhea.

Results: There were 604 participants enrolled in our study including 300 patients with primary dysmenorrhea. After adjustment for the potential confounders, oxytocin levels (Q₃: OR (95% CI) = 0.50 (0.27~0.95) (p=0.035); Q₄: 0.34 (0.17~0.66) (p=0.001)) and PGF_2α levels (Q₃: 0.45 (0.24~0.87) (p=0.017); Q₄: 0.43 (0.22~0.84) (p=0.013)) were respectively associated with an decreased risk of primary dysmenorrhea, but estradiol (Q₂: 2.18 (1.13~4.19) (p=0.020); Q₃: 2.17 (1.12~4.19) (p=0.022)) and vasopressin (Q₃: 2.88 (1.48~5.63) (p=0.002); Q₄: 3.20 (1.65~6.22) (p<0.001)) with an increased risk of primary dysmenorrhea, respectively. Among patients with primary dysmenorrhea, the higher estriol level was associated with higher frequent dysmenorrhea (Q₂: 3.12 (1.32~7.34) (p=0.009); Q₃: 4.97 (2.08~11.85) (p<0.001)) and always dysmenorrhea (Q₂: 2.51 (1.03~6.11) (p=0.041); Q₃: 3.10 (1.25~7.73) (p=0.015)). Similarly, high estriol levels were associated with the higher degree of pain significantly only when hormone levels were at a high level (Q3: 2.06 (1.03~4.18) (p=0.043)).

Conclusion: Higher serum vasopressin and estradiol concentrations as well as lower oxytocin and PGF_2α levels were associated with higher risk of primary dysmenorrhea. Estrogen showed a reverse U-shape association on the frequency and degree of pain among patients with primary dysmenorrhea.

Keywords: primary dysmenorrhea; reproductive hormone; restricted cubic spline.

Grants and funding

Science and Technology Research Plan of Jinhua (2019-4-142), Chinese National Natural Science Foundation (81973055), National Key Research and Development Programme of China (2021YFC2701901), Major research and development projects of Zhejiang Science and Technology Department (2018C03010), Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province (2020E10004) and Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang (2019R01007).