Huang Qiuyuan, Huang Xizhen, Huang Liyuan, Wang Yanglin, Li Suyu, Zheng Xiangqin
Department of Radiation Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
Department of Radiation Oncology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
Pain Res Manag. 2025 Jul 23;2025:4194108. doi: 10.1155/prm/4194108. eCollection 2025.
Dysmenorrhea is a common gynecological symptom among reproductive-aged women, associated with substantial pain and decreased quality of life. Previous studies have suggested that inflammatory and hormonal fluctuations linked to dysmenorrhea may influence endometrial cancer (EC) risk though causality remains uncertain. This study aimed to investigate potential causal relationships between dysmenorrhea (including pain severity, analgesic use, endometriosis, and related pelvic pain) and EC risk using a Mendelian randomization (MR) approach. A two-sample MR analysis was conducted using genome-wide association study (GWAS) data, selecting single nucleotide polymorphisms (SNPs) significantly associated with dysmenorrhea to assess EC risk. Primary analysis was performed with the inverse-variance weighted (IVW) method, while weighted median and MR-Egger analyses were conducted to enhance robustness. The IVW analysis showed a significant inverse association between dysmenorrhea and EC risk (OR = 0.883; 95% CI: 0.794-0.983; and =0.023), which remained significant after adjusting for confounders (OR = 0.868; 95% CI: 0.775-0.971; and =0.0136). Sensitivity analyses supported this protective association. Other factors, including pain severity, analgesic use, endometriosis, and related pelvic pain, showed no significant association with EC. This study indicates a potential inverse relationship between dysmenorrhea and EC risk. These findings provide novel causal evidence for understanding complex associations in female reproductive health, underscoring the need for further research on dysmenorrhea in EC prevention.
痛经是育龄期女性常见的妇科症状，会带来剧痛并降低生活质量。既往研究表明，与痛经相关的炎症和激素波动可能会影响子宫内膜癌（EC）风险，但其因果关系仍不确定。本研究旨在采用孟德尔随机化（MR）方法，探讨痛经（包括疼痛严重程度、止痛药物使用、子宫内膜异位症及相关盆腔疼痛）与EC风险之间的潜在因果关系。使用全基因组关联研究（GWAS）数据进行两样本MR分析，选择与痛经显著相关的单核苷酸多态性（SNP）来评估EC风险。主要分析采用逆方差加权（IVW）方法，同时进行加权中位数分析和MR-Egger分析以增强稳健性。IVW分析显示痛经与EC风险之间存在显著的负相关（OR = 0.883；95% CI：0.794 - 0.983；P = 0.023），在调整混杂因素后仍具有显著性（OR = 0.868；95% CI：0.775 - 0.971；P = 0.0136）。敏感性分析支持这种保护关联。其他因素，包括疼痛严重程度、止痛药物使用、子宫内膜异位症及相关盆腔疼痛，与EC无显著关联。本研究表明痛经与EC风险之间可能存在负相关关系。这些发现为理解女性生殖健康中的复杂关联提供了新的因果证据，强调了在EC预防中对痛经进行进一步研究的必要性。
