Abstract
Background: In women with rheumatic diseases (RDs) menstruation-related disorders have never been investigated. The aim of this study was to evaluate gynecological symptoms/disorders in fertile age women with RDs. Materials and methods: All patients (n = 200) filled up a self-administered questionnaire on their gynecological history, menstrual cycle pattern, menstrual-related symptoms, and quality of life (QoL). The RD group was then compared to a control group of 305 age-matched fertile age women. Results: Among patients with RDs, 58% had arthritis, 40% connective tissue diseases (CTDs), and 1.5% systemic vasculitis. No differences were observed between CTDs and arthritis, except for a family history of HMB which was more common among women with CTDs (p < .01). When compared to controls, women with RDs reported more frequent heavy menstrual bleeding (HMB) during adolescence (51.7 and 25.4%, respectively; p = .0001) and adult life (37.7 and 25.9%, respectively; p = .0065). Also, dysmenorrhea in adolescence was significantly more common among cases (55.6 and 45.4%, respectively; p = .0338). Gynecological pain (dysmenorrhea, non-menstrual pelvic pain, dyspareunia, dysuria, and dyschezia) in patients with RDs was more frequent than in controls (p = .0001, .0001, .0001, .0001, .0002, respectively). Considering women who reported moderate and severe symptoms in RDs, dysmenorrhea and dyspareunia remain significantly more frequent in women with RDs than in controls (p = .0001; p = .0022; respectively). QoL scores were significantly reduced in women with RDs, either in physical (p = .0001) and mental domains (p = .0014) of short-form 12. Conclusion: Women affected by RDs frequently presented menstruation-related disorders; thus, female patients with RDs should be questioned about gynecological symptoms and referred to the gynecologist for an accurate evaluation.
Highlights
Rheumatic diseases (RDs) affect significantly more women than men, and for this reason, gynecological disorders may have an additional negative impact on women’s health (Krasselt and Baerwald, 2019).From menarche to menopause, gynecological and reproductive health is an essential part of well-being among women
The most common gynecological symptoms associated with menstruations are dysmenorrhea (Bernardi et al, 2017) and bleeding
Women with RDs reported more frequent HMB during adolescence and adult life than controls. These findings focus the attention on uterine fibroids and adenomyosis, uterine disorders characterized by HMB (Vannuccini et al, 2017), affecting both fertile age and perimenopausal women (Vannuccini and Petraglia, 2019)
Summary
Rheumatic diseases (RDs) affect significantly more women than men, and for this reason, gynecological disorders may have an additional negative impact on women’s health (Krasselt and Baerwald, 2019).From menarche to menopause, gynecological and reproductive health is an essential part of well-being among women. The most common gynecological symptoms associated with menstruations are dysmenorrhea (pain related to the uterine contractility) (Bernardi et al, 2017) and bleeding (shedding of endometrial cells and menstrual blood). These problems, according to their intensity and volume (severe dysmenorrhea and heavy menstrual bleeding (HMB)) (Critchley et al, 2020b), may cause a relevant impact on QoL. They may be early signs of menstruation-related disorders, such as uterine fibroids, endometriosis, and adenomyosis (Maybin and Critchley, 2015). The aim of this study was to evaluate gynecological symptoms/disorders in fertile age women with RDs
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