Menstrual Pain and Loneliness: The Mediating Role of Physical Functioning

It’s not just pain—reduced physical functioning drives loneliness in women.

Key Points

Highlights:

• Impaired physical functioning, rather than pain severity itself, is the main pathway linking menstrual pain to loneliness.
• Stability of physical functioning over time suggests it could serve as an early indicator for risk of social isolation in women with menstrual pain.

 Importance:

•  Interventions that focus on improving physical functioning may be more effective for preventing loneliness than targeting pain intensity alone.

What’s done here?

• A 3-year prospective cohort study was penned with 289 Australian women (ages 18–50) who had experienced at least mild menstrual pain in the past year.
• Online questionnaires assessed: menstrual pain (by Numeric Rating Scale), physical functioning (by WHOQOL-BREF physical domain), and loneliness (by UCLA-4).
• Data analyzed using a random-intercepts cross-panel longitudinal model (RI-CLPM), controlling for age, employment, marital status, and chronic illness.

Key results:

• Lower physical functioning predicted higher loneliness, even after adjustment.
• No direct association was found between pain severity and loneliness.
• Menstrual pain influenced physical functioning, which in turn drove loneliness → confirming an indirect pathway.
• Physical functioning remained relatively stable across timepoints, while pain severity fluctuated.

Strengths and Limitations:

• Strengths are , being the first longitudinal study to examine causal links between menstrual pain, functioning, and loneliness, and the use of sophisticated statistical modeling (RI-CLPM) strengthened causal inference.
• Limitations are measuring the loneliness only at the final time point, preventing assessment of bidirectionality; recruitment via online support groups that may have underestimated true loneliness levels, and exclusion of the transgender and gender-diverse populations limiting generalizability.

From the Editor-in-Chief – EndoNews

"This study breaks new ground by shifting our attention from menstrual pain itself to its consequences for daily life and social well-being. While pain severity is the most visible symptom, it is the functional impairment—the inability to work, study, or participate socially—that drives women into loneliness. This is a powerful reminder that endometriosis and dysmenorrhea are not just medical conditions, but lived experiences with profound psychosocial dimensions.

The findings carry important clinical and public health implications. Screening for physical functioning should become routine in the care of women with menstrual pain, not only to guide treatment but also to identify those at risk of isolation and its downstream consequences—such as depression, cardiovascular disease, and even premature mortality. For researchers, the study signals a new frontier: understanding how physical health, social connectedness, and psychological well-being interact in reproductive health.

Ultimately, this research reframes menstrual pain as more than an issue of symptom control—it is a determinant of quality of life and social health. By targeting functional health, clinicians may help women preserve not just mobility and productivity, but also dignity, relationships, and resilience."

Lay Summary

Menstrual pain is one of the most common health problems among menstruating individuals, with moderate-to-severe pain (dysmenorrhea) affecting up to 80%.

Beyond its physical and economic burden, the social consequences of menstrual pain are less well understood.

In a new longitudinal study published in the British Journal of Health Psychology, McCurry and colleagues investigated whether menstrual pain contributes to loneliness directly, or whether the impact is driven by the way pain impairs daily functioning.

The researchers followed nearly 300 Australian women for three years, collecting information on pain severity, physical functioning, and loneliness.

The findings were striking: menstrual pain alone did not directly predict loneliness. Instead, the loss of physical functioning—such as difficulty working, exercising, or attending social events—was the main pathway leading to increased feelings of loneliness. Women with poorer physical functioning were more likely to feel socially isolated, suggesting that functional health could serve as an early warning sign for loneliness in those with menstrual pain.

The authors recommend that health professionals screen for impairments in physical functioning when caring for women with menstrual pain. Doing so could help identify those at higher risk of loneliness and allow for more targeted support. They also emphasize the need for future research to explore the mechanisms linking physical functioning and social well-being.

Research Source: https://pubmed.ncbi.nlm.nih.gov/40415565/