Is dysmenorrhea really hereditary?

Dysmenorrhea is a common problem experienced by many women during menstruation. In severe cases, it can even affect their normal life. There have been some studies in the scientific community on whether dysmenorrhea is hereditary, but the answer is not simple. This article will analyze the relationship between dysmenorrhea and heredity from multiple perspectives, including genetic factors, physiological mechanisms, and lifestyle.

1. Two types of dysmenorrhea

Dysmenorrhea is divided into primary dysmenorrhea and secondary dysmenorrhea, and the causes of the two are different:

1. Primary dysmenorrhea: It accounts for more than 90% of dysmenorrhea, has no clear organic lesions, and is mainly related to excessive secretion of prostaglandins (PG) in the endometrium during menstruation. Prostaglandins can cause strong contractions of the uterus, leading to ischemia and pain.

2. Secondary dysmenorrhea: caused by diseases such as endometriosis, adenomyosis, pelvic inflammatory disease, etc., and requires treatment targeting the cause.

2. Possible influence of genetic factors

Recent studies have found that dysmenorrhea may indeed have a certain genetic tendency, but it is not directly determined by a single gene:

1. Family aggregation phenomenon:

Several studies have shown that if a mother or sister has severe dysmenorrhea, a woman’s own risk of developing the disease may increase by 2-3 times. For example:

A study of twins found that the heritability of dysmenorrhea was about 55%, suggesting that genes and the environment play a role.

Endometriosis (a common cause of secondary dysmenorrhea) is also thought to be genetically linked, with first-degree relatives of patients having a 7- to 10-fold increased risk.

2. Related gene research:

Scientists have found that certain genes may affect the risk of dysmenorrhea through the following pathways:

Prostaglandin metabolism-related genes (such as COX-1, COX-2): regulate inflammatory response and uterine contraction intensity.

Hormone receptor genes (such as estrogen receptor genes): affect the sensitivity of the uterus to hormones.

Pain perception genes: Genes related to neurotransmitters (such as the COMT gene) may affect an individual's tolerance to pain.

3. Other factors that cannot be ignored

Although genetics may increase the risk of dysmenorrhea, the following factors are also important:

1. Lifestyle:

Long periods of sitting, lack of exercise, and a high-sugar diet may exacerbate inflammatory responses.

Smoking or exposure to secondhand smoke increases prostaglandin levels in the body.

2. Psychological pressure:

Chronic stress may aggravate dysmenorrhea through the neuroendocrine system.

3. Reproductive health issues:

Early age of menarche, short menstrual cycle, heavy menstrual flow, etc. may increase the probability of dysmenorrhea.

4. Environmental factors:

Endocrine disruptors, such as plasticizers, may interfere with hormone balance.

4. How to deal with dysmenorrhea?

1. Tips for family history:

If there is a family history of severe dysmenorrhea or endometriosis, regular gynecological examinations are recommended to detect secondary causes early.

2. Scientific relief methods:

Hot compress: promotes pelvic blood circulation and relieves uterine spasms.

Drugs: Nonsteroidal anti-inflammatory drugs (such as ibuprofen) can inhibit prostaglandin synthesis; short-acting contraceptives are effective for some patients.

Exercise: Regular aerobic exercise (such as yoga, jogging) can relieve pain.

Diet: Increase intake of Omega-3 fatty acids (such as deep-sea fish) and magnesium (such as nuts), and reduce caffeine and alcohol.

3. Seek medical attention promptly:

If dysmenorrhea is accompanied by abnormal bleeding, painful intercourse, or infertility, diseases such as endometriosis should be ruled out.

V. Conclusion

The onset of dysmenorrhea is the result of multiple factors, including genetics, hormones, and the environment. Although genetics may increase susceptibility, most dysmenorrhea can be effectively controlled through a healthy lifestyle, scientific management, and timely treatment. Women do not need to worry too much about the "family curse", but should take positive actions and pay attention to their own health.

References:

1. Obstetrics and Gynecology (9th edition), People's Medical Publishing House

2. Nature Reviews Genetics, 2018 (Progress in research on genetics of dysmenorrhea)

3. American College of Obstetricians and Gynecologists (ACOG) Guidelines