As children and young people return to school this week, the findings offer a timely reminder of the urgent need to take adolescent menstrual pain seriously and improve the support available to young people.
Published in The Lancet Child & Adolescent Health, the study is the first large-scale investigation into how painful periods (dysmenorrhoea) in adolescence are linked to pain in young adulthood.
Researchers analysed data from over 1,100 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC), also known as Children of the 90s, finding that those with severe period pain at age 15 had a 76% higher risk of chronic pain by age 26, relative to those who reported no period pain. For moderate pain, the relative risk was increased by 65%.
Among teenagers who reported no period pain, 17% developed later chronic pain. After adjustment for various factors that could explain the association, the risk difference was +4.8 percentage points for mild, +12.7 for moderate, and +16.2 for severe period pain (see graphs under Notes to editors).
A clear pattern of increasing risk with increased period pain severity was found for overall chronic pain and across body sites; including headache, back, abdominal, and joint pain.
Professor Katy Vincent, gynaecologist and senior author of the study from Oxford's Nuffield Department of Women's & Reproductive Health, said: 'We’ve known for a long time that period pain can really disrupt young people’s lives, impacting their social development, education and mental health. However, we know that most young people don’t seek help for period pain and those who do may be dismissed, belittled or told it is normal. This study shows that teenage period pain may also shape future physical health. Once established, chronic pain can be difficult to manage and has wide-reaching consequences for the individual, society and the healthcare system. The link between adolescent period pain and chronic pain in adulthood is therefore a wake-up call. We need to improve menstrual education, reduce stigma, and ensure young people have access to effective support and treatment early on. It would be fantastic if 2025/2026 was the year that we really started to take period pain seriously rather than telling teenagers they ‘just need to learn to live with it’!'
While earlier studies have hinted at a link between menstrual pain and later chronic pain, most have been small, short-term, or based on clinical samples that don’t reflect the wider population. This research is the first to use data from ALSPAC, one of the UK’s most comprehensive birth cohort studies, designed to be broadly representative of the UK population.
In addition, while previous studies have focused on pelvic pain, this study is the first to reveal a link between adolescent period pain and chronic pain in other parts of the body.
The researchers believe the link between adolescent period pain and later chronic pain may be partly explained by changes in the nervous system.
Professor Vincent explained: 'Adolescence is a time of heightened ‘neuroplasticity’, when the brain and wider nervous system are more adaptable and thus potentially more sensitive to repeated pain signals. Persistent menstrual pain during this critical period may cause long-term changes in how the body processes pain, increasing the risk of developing chronic pain conditions in the future.'
The study also explored the role of mental health, finding that anxiety and depression that began in the two years following menstrual pain explained only a small part of the link - suggesting that both biological and psychological mechanisms may be involved. Further work by the research team is currently trying to better understand what processes underlie these observations.
Dr Rachel Reid-McCann, the lead researcher from of Oxford's Nuffield Department of Women's & Reproductive Health, said: 'I’m so proud to have contributed to this important research, which highlights just how common period pain is among teenagers in the UK. And crucially, that it may have lasting health consequences. These findings show that menstrual pain should not be dismissed or trivialised. It deserves serious attention.'
The project has been developed and supported by an advisory panel of young people, two of whom have provided comments on these findings. Ela, 17 years old, said: 'I was so passionate about being involved with RoADPain to honour the millions of women and girls who have been dismissed and told ‘it's just period pain’ by society. I feel like I've been part of something game-changing."
Wiktoria, another young person involved with the study, said: 'This research is really important due to how normalised period pain has become while it should never be a reason for someone to have to miss school, work or everyday activities. Having shown that teenagers with menstrual pain are more likely to experience chronic pain in adulthood we want teenagers to know that there is no normal period pain and if they are ever concerned they should feel free and confident, not scared, to go and speak to a healthcare professional. Equally, healthcare professionals should take the matter seriously rather than dismiss these concerns. Young people should feel heard, supported and treated well rather than be told that they just need to learn to tolerate the pain.'
Dr Angela Hind, CEO of the Medical Research Foundation, said: 'As children and young people return to school this week, these findings couldn’t be more timely. Pain research, especially into period pain, is woefully underfunded and at the Medical Research Foundation we’re working to fill that gap. This study shows how important medical research is for improving health, particularly for young people. The researchers have shown that period pain can have a profound impact not just during adolescence, but well into adulthood - affecting areas far beyond the pelvis and impacting many aspects of life. We hope it will pave the way for a deeper understanding of how to better manage menstrual pain and its long-term effects.'
This research was fully funded by the Medical Research Foundation, as part of the Advanced Pain Discovery Platform (APDP). The APDP is an innovative collaboration between charities, government agencies and a pharmaceutical company and is funded by the Medical Research Foundation, UK Research and Innovation, Versus Arthritis, and Eli Lilly.
The paper, 'Longitudinal association between dysmenorrhoea in adolescence and chronic pain in adulthood: a UK population-based study', is published in The Lancet Child & Adolescent Health.