The Truth About What Really Causes Period Pain Is Far From Sraightforward

by Lauren Sharkey
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Period pain comes in two forms: pain that is caused by an underlying health condition like endometriosis or pain that isn't caused by any medical issues. The latter form, known as primary dysmenorrhoea, is likely to be what you experience every month but scientists are baffled as to what exactly causes it. One theory, however, is that it could be down to family history. So is period pain genetic?

A 2016 study carried out by scientists at Pfizer Inc. and genetics company 23andMe concluded that it is indeed a possibility. Describing their research as the "first genome-wide association study of this form of chronic pain," researchers surveyed 11,800 people who have periods and asked them about the severity of their menstrual cramps.

After gene analysis, the team found a genetic variant associated with individuals of European ancestry that reported severe period pain. This variant was in the gene encoding nerve growth factor (NGF) which sits in a part of the genome responsible for regulating ovarian tissues. Interestingly, a link between NGF and chronic pain mediation has already been revealed.

“To date, the genetic basis of pain severity for dysmenorrhea remains largely unknown,” 23andMe's senior scientist, Nick Furlotte, said in a statement. “Our findings could provide deeper insight into potential treatments for what is a chronic and debilitating condition.”

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In the two years since those results were published, few advances have been made in determining whether genes really are responsible for period pain. However, the personal experiences of many sufferers has led doctors to believe that menstrual cramps "run in the family." The only problem is that medical experts have long been unsure "whether that is a genetic trait [or] whether it's related to a condition like endometriosis[..]" Dr. Paul R Weber told SheKnows.

Dr. Heather Currie, spokesperson for the Royal College of Obstetricians and Gynaecologists, told me that she isn't aware of any research into the link between period pain and genetics. But she makes an interesting point in that there could be a psychological element to period pain, although she stresses that she's not saying "it's all in your head" because "people genuinely do suffer from the bleeding and the pain."

She went on to explain that perception and anticipation are associated with any kind of pain, adding: "So a part of [period pain] could be that if we see our mums suffering in this way, is that what we're expecting? It doesn't mean we're not having the pain but how we react to it may be influenced by how we saw our mothers dealing with it."

Currie's main point, however, is that "The pain is something that's unnecessary. Whether it's genetic or not, what there is is a lack of proactiveness in managing it." It's important to let those who suffer with period pain know "about the options like the use of [certain] contraceptive pills, for example."

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As Bupa states, what is common knowledge among the medical community is that prostaglandins — chemicals that cause the tightening of the uterine muscles thereby temporarily stopping blood supply to the womb — cause period pain. And studies, some dating as far back as the '80s, have found a link between increased prostaglandin levels and more severe menstrual pain.

It's clear that some people suffer more than others during their time of the month, but more research will need to be carried out before a genetic link can be determined to be the reason why. Unfortunately, as Currie mentions, research into period pain and its treatment is scant. One doctor, Richard Legro, has even found it hard to get his research funded, telling Quartz: “I think the bottom line is that nobody thinks menstrual cramps is an important public health issue.”

John Gillebaud, a professor of reproductive health at University College London, echoed Legro's sentiment to the publication, adding that "it hasn’t been given the centrality it should have. I do believe it’s something that should be taken care of, like anything else in medicine."

Only time will tell if that really does happen.