Menstrual Pain and Substance Use in Women Receiving Inpatient Treatment for Substance Use Disorders.

Objectives: Pain is a risk factor for substance use and can negatively affect outcomes of substance use disorder (SUD) treatment. Menstrual pain is common among menstruating women yet has received little attention in the substance use literature. This study aimed to characterize menstrual pain and explore the association between menstrual pain and substance use in women receiving SUD treatment.

Methods: Participants in SUD inpatient treatment were recruited for a cross-sectional self-report survey study. The current analyses focused on participants who reported a menstrual cycle in the past 6 months (N=56) and completed a questionnaire to assess menstrual cycle characteristics, menstrual pain severity, and menstrual pain interference. Substance use (eg, alcohol, cocaine) and misuse of medications to relieve menstrual pain (ie, used without a prescription or in any way other than prescribed) was also assessed.

Results: Half of the participants (n=28) reported using substances for menstrual pain; the most commonly used substances were cannabis, alcohol, and nicotine/tobacco. Menstrual pain severity was associated with substance use to manage menstrual pain (B=0.34, SEB=0.11, P<0.01); higher pain interference was associated with higher odds of using substances to manage menstrual pain (B=0.55, SEB=0.16, P<0.001).

Conclusions: These results indicate that menstrual pain is highly prevalent in this population and may be a risk factor for substance use among women in SUD treatment. Conducting menstrual history assessments with patients seeking SUD treatment might be clinically helpful. It may also be helpful for clinicians to closely monitor the impact of menstrual pain on substance use and treatment outcomes.