Association between adverse childhood experiences and menstruation-related symptoms among Japanese female workers: A cross-sectional study.

Backgrounds: Menstruation-related symptoms are a common and serious health problem even without a specific diagnosis such as premenstrual dysphoric mood disorder (PMDD) or dysmenorrhea. Various adverse childhood experiences (ACEs) might be associated with menstruation-related symptoms, not only traditional traumatic events such as abuse, but also expanded ACEs such as childhood poverty, school bullying, or natural disasters.

Objective: This study examined the association between expanded ACEs (ACEs for Japanese) and menstruation-related symptoms among Japanese working women.

Methods: Data came from an online survey conducted in October 2023 that included women aged 20-44 working full-time, who have never been pregnant and are not currently using contraception. Menstruation-related symptoms severity was evaluated using the Menstrual Distress Questionnaire (MDQ) and the Premenstrual Dysphoric Disorder (PMDD) scale. The MDQ score of the premenstrual and menstrual phases were classified into four categories as menstrual symptoms severity of each phase. Logistic regression assessed the association between ACEs and each outcome, adjusting for covariates.

Results: The analysis included 2000 women. Premenstrual and menstrual symptoms severity increased with two or more ACEs. In the fully adjusted model, women with four or more ACEs significantly showed severe premenstrual symptoms (adjusted odds ratio [aOR] = 2.81, 95%CI:2.12-3.72), and severe menstrual symptoms (aOR = 3.03, 95%CI: 2.29-4.02). Four or more ACEs were associated with PMDD (aOR = 5.61, 95%CI: 2.65-11.89). Childhood poverty and school bullying were also associated with menstruation-related symptoms severity, and natural disasters with PMDD.

Conclusions: Expanded ACEs were associated with menstruation-related symptoms. The results suggested the importance of trauma-informed care in gynecology, obstetrics, and occupational health practice.