title: Stress and dysmenorrhoea: a population based prospective study.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  This study shows a significant association between stress and the incidence of dysmenorrhoea, which is even stronger among women with a history of dysmenorrhoea.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.forename: A G
authors.initials: AG
authors.lastname: Ronnennberg
authors.forename: W
authors.initials: W
authors.lastname: Guang
authors.forename: A
authors.initials: A
authors.lastname: Huang
authors.forename: Z
authors.initials: Z
authors.lastname: Fang
authors.forename: T
authors.initials: T
authors.lastname: Zang
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: X
authors.initials: X
authors.lastname: Xu
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D004412:Dysmenorrhea / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008597:Menstrual Cycle; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*