AUTHOR=Orlandi Martina , Vannuccini Silvia , El Aoufy Khadija , Melis Maria Ramona , Lepri Gemma , Sambataro Gianluca , Bellando-Randone Silvia , Guiducci Serena , Cerinic Marco Matucci , Petraglia Felice 

TITLE=Menstruation-Related Disorders—Dysmenorrhea and Heavy Bleeding—as Significant Epiphenomena in Women With Rheumatic Diseases

JOURNAL=Frontiers in Pharmacology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.807880

DOI=10.3389/fphar.2022.807880

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Materials and methods:</bold> 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.</p><p><bold>Results:</bold> 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 (<italic>p</italic> &lt; .01). When compared to controls, women with RDs reported more frequent heavy menstrual bleeding (HMB) during adolescence (51.7 and 25.4%, respectively; <italic>p</italic> = .0001) and adult life (37.7 and 25.9%, respectively; <italic>p</italic> = .0065). Also, dysmenorrhea in adolescence was significantly more common among cases (55.6 and 45.4%, respectively; <italic>p</italic> = .0338). Gynecological pain (dysmenorrhea, non-menstrual pelvic pain, dyspareunia, dysuria, and dyschezia) in patients with RDs was more frequent than in controls (<italic>p</italic> = .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 (<italic>p</italic> = .0001; <italic>p</italic> = .0022; respectively). QoL scores were significantly reduced in women with RDs, either in physical (<italic>p</italic> = .0001) and mental domains (<italic>p</italic> = .0014) of short-form 12.</p><p><bold>Conclusion:</bold> 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.</p>