S1119 Gastrointestinal Dysfunction and Irregular Bowel Patterns During Menstrual Cycle of Patients With Dysmenorrhea: A Systematic Review and Meta-Analysis of Population-Based Studies

Introduction: Dysmenorrhea, defined as painful menstruation, affects up to 90% of menstruating women and often presents with concurrent gastrointestinal (GI) symptoms such as bloating, constipation, diarrhea, nausea, vomiting, and abdominal cramping. While these symptoms are frequently self-reported, the overlap between dysmenorrhea and bowel irregularities remains underexplored. Fluctuations in progesterone, estrogen, and elevated prostaglandin levels during menstruation may contribute to altered GI motility. This systematic review and meta-analysis aims to assess the prevalence and types of GI dysfunction among patients with dysmenorrhea and evaluate the strength of this association using population data. Methods: A systematic literature search was conducted in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library through from 2010 to 2025, following PRISMA guidelines. Eligible studies included cross-sectional, cohort, or case-control designs that evaluated GI symptoms or bowel pattern changes during menstruation in individuals with dysmenorrhea. A total of 6 studies comprising 450 participants were included. A large majority of the studies conducted screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Results: The pooled analysis showed a significantly higher prevalence of diarrhea, and constipation in women with dysmenorrhea compared to those without. The subgroup analyses suggested a stronger association among women less than 30 years of age and in those not using hormonal contraceptives. Across all of the studies the average odds ratio was between 1 and 4 indicating that the risk factor for GI dysfunction is higher in women with dysmenorrhea and those who are not on oral contraceptives. Conclusion: GI dysfunction is significantly more prevalent in individuals with dysmenorrhea, supporting the hypothesis of a shared pathophysiological mechanism that involves fluctuations in progesterone, estrogen, and prostaglandin-mediated smooth muscle activity. Recognition of these comorbid symptoms can guide comprehensive clinical management and improve quality of life. Future research should focus on mechanistic and longitudinal studies to delineate causality and therapeutic targets.