Do Combined Oral Contraceptives Relieve Dysmenorrhea?

Oral contraceptives have long been considered an option for relieving symptoms of dysmenorrhea, but a 2009 Cochrane review cast doubt on that claim. Now, a new study out of Sweden offers contradictory evidence.

Dr. Ingela Lindh, from the department of obstetrics and gynecology, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden, and colleagues conducted a longitudinal case-control study looking at three groups of women who turned 19 in different decades (ie, in 1962 [N= 656), in 1972 [N= 780], and in 1982 [N=666]). Lindh et al. sent questionnaires to randomly selected women to ascertain weight/height, contraception, pregnancy history and other reproductive health factors. They used a verbal multidimensional scoring system (VMS) and a visual analogue scale (VAS) to measure baseline severity of dysmenorrhea, and then again five years later (age=24).  Dysmenorrhea severity among women who used combined oral contraceptives was compared with those who women did not use oral contraceptives.

Lindh et al. found reduction in dysmenorrhea severity was associated with combined oral contraceptive use as well as increasing age, independently; they noted that contraception use had a greater impact. The researchers also found that childbirth was associated with a reduction in severity. Interestingly, the researchers noted that women from the youngest cohort (i.e., the 1982 group) reported a greater severity of dysmenorrhea as compared to their counterparts in the 1972 and 1962 groups; the increased severity was present both at age 19 and 24. However, the researchers were unsure why this may be.

“We found that combined oral contraceptive use reduced dysmenorrhea by 0.3 units, which means that every third woman went one step down on the VMS scale, for instance from severe pain to moderate pain, and which meant that they suffered less pain, improved their working ability and there was a decrease in the need for analgesics,” Lindh explained in a statement to the press. “On the VAS scale there was a reduction in pain of nine millimeters.”

Ultimately, Lindh and colleagues believe their results contradict the results of the Cochrane review. “In this longitudinal case–control study, COC [combined oral contraceptive] use and increasing age, independent of each other, reduced the severity of dysmenorrhea,” they concluded.

References:

Reference:
Lindh I, Ellström AA, Milsom I. The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. Hum Reprod. 2012; Jan 17 [Epub].