News release

From: The Lancet

Painful periods during adolescence linked to symptoms that began years earlier, with Black and Hispanic girls more likely to be affected, US study suggests

More than half of girls participating in the long-term US Adolescent Brain Cognitive Development (ABCD) study [1] developed painful periods (dysmenorrhoea) by the age of 12 or 13, with Black and Hispanic girls most likely to be affected, according to new research published in The Lancet Child & Adolescent Health journal. Girls who went on to have painful periods were more likely to have had other physical symptoms or signs of more advanced puberty when assessed at ages 9 to 10.

Researchers followed 2,254 girls aged 9 to 10 who joined the ABCD study between 2016 and 2018, and had not had their first period. Participants were reassessed at ages 12 to 13, when they rated their own period pain on a scale of 0 to 10. By then, nearly 58% had developed dysmenorrhoea, and around 20% of those reported severe dysmenorrhoea.

At ages 9 to 10 years, girls with non-painful physical symptoms, such as nausea and dizziness, were more likely to go on to develop period pain three years later. Girls already showing signs of early physical development at that age, such as breast development, body hair, or a growth spurt, were also considerably more likely to develop dysmenorrhoea [2]. Sleep problems at that age were not linked to whether girls developed period pain. But among girls who did develop dysmenorrhoea, earlier sleep problems were linked to greater disruption to daily activities once their periods began [3].

Black adolescents were 38% more likely to develop painful periods than White adolescents, and Hispanic adolescents were 34% more likely than non-Hispanic adolescents. These disparities may reflect wider social and cultural factors, including unequal access to health care and stigma around menstruation, as well as earlier physical development among Black and Hispanic girls, which is itself linked to social and cultural stressors.

The authors say the findings suggest that girls likely to develop dysmenorrhoea could be identified before their periods begin, opening earlier opportunities for clinical support, particularly for those facing the greatest health inequalities.

[1] The Adolescent Brain Cognitive Development (ABCD) study is a long-term, population-based cohort study that enrolled 11,868 children aged 9 to 10 years at 21 sites across the United States between 2016 and 2018 and has reassessed them at regular intervals since.

[2] Physical development was assessed by parents or guardians using the Pubertal Development Scale, which rates signs such as breast development, body hair, skin changes, and growth spurts from no development to fully developed; girls with higher average scores were considered more physically developed for their age.

[3] Sleep problems at ages 9 to 10 years were also reported by parents or guardians, using the 26-item Sleep Disturbance Scale for Children. This gives a single overall score covering a wide range of difficulties, such as trouble falling or staying asleep, disturbed breathing during sleep, and excessive daytime sleepiness.