[Up to 90% of people who menstruate experience pain during their periods. A new study suggests that depression may be causing period pain, rather than the other way around. The study, published in Briefings in Bioinformatics, found that the mood disorder increases the odds of menstrual pain by 1.51 times, or 51%.
The researchers used a “clever approach” called Mendelian randomization, which looks at genetic data to see if having certain genes linked to depression also makes people more likely to have menstrual pain. They analyzed the genetic data of around 600,000 people from European populations and 8,000 from East Asian populations.
The study found several genetic pathways and proteins that connect depression to reproductive function. The researchers also found that sleeplessness, experienced by some people with depression, may worsen the link between depression and menstrual pain.
However, other experts are skeptical about the study’s broader assertions. “I think it’s still a stretch” to say that depression is causing period pain, said Dr. Claudio Soares, president of the Menopause Society. Dr. Anne-Marie Amies Oelschlager, professor of obstetrics and gynecology at the University of Washington School of Medicine, also pointed out that the study assumes there are no environmental factors that could influence someone’s depression status, period pain, or genetics.
The relationship between depression and period pain is complex. Many people with depression or other mood disorders experience pain more acutely, and the study’s findings do not infer that one is causing the other. Amies Oelschlager noted that some level of pain during menstruation is normal for many people.
The study also found that sleeplessness, experienced by some people with depression, may worsen the link between depression and menstrual pain. Dr. Hugh Taylor, the Anita O’Keeffe Young Professor and chair of the department of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine, noted that in animal models, endometriosis, a secondary cause of dysmenorrhea, can lead to depression.
Experts offered practical advice for managing depression and painful periods. Amies Oelschlager suggested that if the pain is not alleviated by treatments such as ibuprofen or heating pads, one should seek out an evaluation for mood disorders and secondary causes of dysmenorrhea. She also recommended exercise, yoga, stress-reduction techniques, dietary changes, and good sleep quality and quantity to manage depression.
The study’s findings expand the important but often overlooked discussion around mental health and period pain. “I’m excited about the potential for some of these larger database-style studies, especially as more genetic testing is advancing,” Amies Oelschlager said.
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