Department of Pain, Sydney Children's Hospital, Randwick, New South Wales, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2022 Oct;62(5):725-731. doi: 10.1111/ajo.13560. Epub 2022 Jun 27.
The extent to which maternal transmission of primary dysmenorrhoea is genetically determined in adolescents and young women has yet to be determined. We aimed to assess heritability and associations relevant to primary pain syndromes using a twin family study.
Participants were young menstruating female twins, and their oldest sisters and mothers, whose families were registered with Twins Research Australia and previously participated in a twin family study of primary paediatric pain disorders. Questionnaire packs were mailed, assessing current maximum and average menstrual pain intensity, current pain interference with activities and retrospective dysmenorrhea secondary symptoms.
The sample comprised 206 twin individuals (57 monozygous (MZ) and 46 dizygous (DZ) pairs) aged 10-22 years, eldest siblings (n = 38) aged 13-28 years and mothers (n = 101) aged 32-61 years. The estimated regression coefficient of the relationship between mother-daughter and twin-sibling dyads indicated significant associations for the measures of dysmenorrhea and supported heritability. Adjusted for age, the within twin-pair correlation for MZ twins was generally more than twice that of DZ twins. Heritability estimates were maximal pain intensity 0.67 (P = 3.8 × 10 ), average pain intensity 0.63 (P = 3.7 × 10 ), pain interference 0.57 (P = 1.8 × 10 ) and retrospective symptoms 0.57 (P = 1.8 × 10 ). Twin individuals with a lifetime (three-month) history of iron deficiency and those with painless restless legs syndrome (RLS) were significantly more likely to have more intense pain associated with menstruation.
Primary dysmenorrhea in adolescents and young women was shown to be relatively strongly genetically influenced and associated especially with a history of iron deficiency and painless RLS which have potential therapeutic implications.
原发性痛经在青少年和年轻女性中的遗传程度尚未确定。我们旨在使用双胞胎家族研究评估原发性疼痛综合征的遗传性和相关性。
参与者为年轻的经期女性双胞胎及其年龄最大的姐妹和母亲，这些家庭已在澳大利亚双胞胎研究中心注册，并以前曾参加过原发性儿科疼痛障碍的双胞胎家族研究。通过邮寄问卷包，评估当前最大和平均月经疼痛强度、当前疼痛对活动的干扰以及回溯性痛经的次要症状。
该样本包括 206 名双胞胎个体（57 对同卵（MZ）和 46 对异卵（DZ）），年龄在 10-22 岁，年龄最大的姐妹（n=38），年龄在 13-28 岁，母亲（n=101），年龄在 32-61 岁。母女和双胞胎兄弟姐妹对子之间关系的回归系数估计表明，痛经的指标存在显著关联，并支持遗传性。调整年龄后，MZ 双胞胎的双胞胎内相关性通常是 DZ 双胞胎的两倍以上。最大疼痛强度的遗传率为 0.67（P=3.8×10-8），平均疼痛强度为 0.63（P=3.7×10-8），疼痛干扰为 0.57（P=1.8×10-8），回溯性症状为 0.57（P=1.8×10-8）。有终身（三个月）缺铁史和无痛不宁腿综合征（RLS）的双胞胎个体更有可能与月经相关的疼痛更强烈。
青少年和年轻女性的原发性痛经被证明具有相对较强的遗传影响，尤其是与缺铁史和无痛 RLS 相关，这具有潜在的治疗意义。
