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Stress and dysmenorrhoea: a population based prospective study
  1. L Wang1,
  2. X Wang2,
  3. W Wang1,
  4. C Chen1,
  5. A G Ronnennberg1,
  6. W Guang3,
  7. A Huang3,
  8. Z Fang3,
  9. T Zang3,
  10. L Wang4,
  11. X Xu1
  1. 1Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
  2. 2The Mary Ann and J. Milburn Smith Child Health Research Program, Children’s Memorial Hospital, Chicago, IL, USA
  3. 3Institute for Biomedicine, Anhui Medical University, Anhui, China
  4. 4Department of Environmental Health, School of Public Health, Peking University, Beijing, China
  1. Correspondence to:
 Dr X Wang
 The Mary Ann and J. Milburn Smith Child Health Research Program, Children’s Memorial Hospital, 2300 Children’s Plaza, Box 157, Chicago, IL 60614-3394, USA;


Background: Dysmenorrhoea is the most common gynaecological disorder in women of reproductive age. Despite the association between stress and pregnancy outcomes, few studies have examined the possible link between stress and dysmenorrhoea.

Aims and Methods: Using a population based cohort of Chinese women, the independent effect of women’s perceived stress in the preceding menstrual cycle on the incidence of dysmenorrhoea in the subsequent cycle was investigated prospectively. The analysis included 1160 prospectively observed menstrual cycles from 388 healthy, nulliparous, newly married women who intended to conceive. The perception of stress and the occurrence of dysmenorrhoea in each menstrual cycle were determined from daily diaries recorded by the women.

Results: After adjustment for important covariates, the risk of dysmenorrhoea was more than twice as great among women with high stress compared to those with low stress in the preceding cycle (OR = 2.4; 95% CI 1.4 to 4.3). The risk of dysmenorrhoea was greatest among women with both high stress and a history of dysmenorrhoea compared to women with low stress and no history of dysmenorrhoea (OR = 10.4, 95% CI 4.9 to 22.3). Stress in the follicular phase of the preceding cycles had a stronger association with dysmenorrhoea than stress in the luteal phase of the preceding cycles.

Conclusion: This study shows a significant association between stress and the incidence of dysmenorrhoea, which is even stronger among women with a history of dysmenorrhoea.

  • OR, odds ratio
  • CI, confidence interval
  • SD, standard deviation
  • BMI, body mass index
  • dysmenorrhoea
  • painful menses
  • prospective study
  • stress

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  • This study is supported in part by grants 1R01 HD32505 from the National Institute of Child Health and Human Development; 1R01 ES08337, ES-00002, P01 ES06198, and 1R01 ES11682 from the National Institute of Environmental Health Science; and 20-FY98-0701 and 20-FY02-56 from the March of Dimes Birth Defects Foundation, USA

  • Please address requests for reprints to: Dr X Xu, Department of Environmental Health, FXB101, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA;