The relationship between menstrual pain in adolescence and mental health in adolescence and early adulthood

Objectives: Approximately 70 % of adolescents worldwide experience menstrual pain (dysmenorrhea), with significant impacts on quality of life. This prospective study aimed to explore the relationship between mental health and dysmenorrhea in Australian adolescents. Design: Female adolescents in a nationally representative sample of Australian children (the Longitudinal Study of Australian Children) recruited in 2004 were included in the Kinder cohort (aged 4-5 years at enrolment). Participants: Survey data for 1600 participants from Wave 4 (age 10) to Wave 9C2 (age 21) were included in this study. Parents and adolescents completed questionnaires and interviews at each wave. Main outcome measures: For this study, questions included age of menstruation onset, dysmenorrhea severity, symptoms of anxiety and/or depression (parent-report and adolescent-report), and psychological distress (adolescent-report). Results: Adolescents with dysmenorrhea were more likely to have anxiety (odds ratios 1.75-1.82) and more likely to have depression (odds ratios 2.03-2.89) than adolescents without dysmenorrhea at ages 14, 16, and 18. Adolescents with dysmenorrhea at ages 14, 16, and 18 reported higher levels of psychological distress, with scores 2.99 to 3.34 points higher on a self-report measure (K10) in early adulthood than adolescents without dysmenorrhea (p < 0.001). Longitudinal analyses revealed that adolescents with dysmenorrhea were more likely to develop mental health concerns in later adolescence and early adulthood (chi 2 = 17.26, p < 0.001), while those with mental health concerns were not more likely to develop dysmenorrhea (chi 2 = 0.49, p = 0.48). Conclusion: This study highlights that adolescents who experience dysmenorrhea are at significantly greater risk of experiencing mental health problems both in adolescence and in early adulthood. Improved treatment for dysmenorrhea, menstrual education, mental health monitoring, and early intervention are essential to reduce this risk.