Pain, Psychological Distress and Social Functioning in Dysmenorrhea: A Prospective Comparison in People With and Without a Diagnosis of Endometriosis

Objective Assess longitudinal biopsychosocial wellbeing in people with dysmenorrhea alone compared to people with dysmenorrhea and diagnosed endometriosis Design Longitudinal survey Setting Online Population or Sample The sample comprised of 405 women with dysmenorrhea alone and 276 with dysmenorrhea and diagnosed endometriosis (dysmenorrhea+). Methods Participants completed online surveys 12 and 24 months after the initial baseline survey was completed in 2019. Two cross-lagged panel models were used, one for each group. Main Outcome Measures Pain, psychological distress, and social functioning. Results The dysmenorrhea+ group presented significantly higher pain at all times points and higher psychological distress, and lower social functioning at Times 1 and 2, compared to the dysmenorrhea group. In the dysmenorrhea model, pain at Time 2 was significantly positively associated with psychological distress at Time 3 ( B = .168, p = .001) and negatively associated with social functioning at Time 3 ( B = -.188, p = .001), whilst social functioning was negatively associated with psychological distress at Time 3 ( B = -.144, p = .011). In the dysmenorrhea+ group model, only psychological distress was associated with social functioning at Time 2 ( B = -.133, p = .048). Conclusions Although participants with dysmenorrhea+ presented overall poorer functioning, pain in the dysmenorrhea group was predictive of future psychosocial distress. This suggests that people with dysmenorrhea need adequate pain treatment and validation, as well as interdisciplinary care, to reduce future psychosocial difficulties.