P080 DYSMENORRHEA IN WOMEN WITH ULCERATIVE COLITIS

Abstract

Dysmenorrhea and ulcerative colitis (UC) are conditions that commonly affect women of reproductive age. Despite their similar symptoms, the relationship between the two is poorly understood. The aims of this study were to explore the relationships between dysmenorrhea, UC disease activity, and health-related quality of life (HRQoL) as well as determine the impact of dysmenorrhea on pain severity and pain medication use in women with UC. This was a case-control study comparing menstruating women with UC (cases) to healthy, age-matched controls. All subjects completed a series of questionnaires to assess the prevalence of dysmenorrhea, menstrual cycle characteristics, and the experience of menstrual distress as measured by the Moos Menstrual Distress Questionnaire (MDQ). In addition, menstrual pain severity, pain medication use, UC disease activity, and HRQoL were analyzed and compared among cases and controls with dysmenorrhea and between cases with and without dysmenorrhea. Logistic regression models were performed to assess relationships Fifty women with UC and 65 healthy controls were studied, and the prevalence of dysmenorrhea was somewhat higher in women with UC compared to controls (62%, 46% respectively, p=0.091). We found no difference in MDQ scores during the premenstrual or menstrual phases between cases and controls with dysmenorrhea. However, cases with dysmenorrhea had lower menstrual distress scores during the intermenstrual phase compared to controls with dysmenorrhea (p=0.042). Cases with dysmenorrhea had lower HRQoL compared to controls with dysmenorrhea according to some measures. No differences were found in HRQoL or UC disease activity scores between cases with and without dysmenorrhea. No significant difference was found between menstrual pain scores in cases and controls with dysmenorrhea; however, pain medication use significantly differed with controls reporting higher levels of non-steroidal anti-inflammatory drug (NSAID) use (p<0.0001). Cases with dysmenorrhea reported higher pain scores compared to cases without (p<0.0001). Dysmenorrhea is common among women with and without UC resulting in higher pain scores in comparison to individuals without dysmenorrhea. When comparing cases and controls with dysmenorrhea, no difference in menstrual distress was found during the premenstrual and menstrual phases of the menstrual cycle suggesting that women with dysmenorrhea experience menstrual distress similarly regardless of UC status. Despite women with UC and dysmenorrhea having similar pain scores to their healthy counterparts with dysmenorrhea, pain medication use was lower among cases. This suggests that women with UC may be undertreating their menstrual pain by avoiding use of NSAIDs due to the conventional advice to avoid these agents in the setting of IBD.