Soft drinks worsen menstrual pain, study shows

New research reveals that carbonated soft drinks may increase the severity of menstrual pain, while moderate coffee consumption offers a surprising protective effect against severe dysmenorrhea.

Study: Associations between soft drinks intake and primary dysmenorrhea among Chinese undergraduate female students. Image Credit: Kmpzzz / Shutterstock.com

A recent study published in Scientific Reports investigates the potential role of soft drink intake on the development of primary dysmenorrhea (PD) in Chinese women.

What is PD?

PD, which is one of the most common painful conditions affecting women throughout the world, causes affected individuals to experience pain during menstruation without pelvic disease. Current estimates indicate that 45-95% of female undergraduate students suffer from PD throughout the world, including 40% of young Chinese undergraduates.

The cramping lower abdominal pains associated with PD can negatively affect an individual’s quality of life, cause loss of working hours, and increase healthcare costs. In the United States, PD is responsible for the loss of 600 million work hours at an economic cost of two billion U.S. dollars (USD). Similarly, total healthcare costs for patients with PD in Japan can reach up to 2.2 times higher than costs incurred by women without PD.

Previous research suggests that PD rates are up to seven times higher among women who drink one or more soft drink servings every day as compared to non-consumers. Soft drinks are carbonated drinks that contain an average of 100 grams of sugar per liter. The intake of soft drinks has continued to rise over the past few decades, especially among children and adolescents.

Both soda and coffee, traditionally Western beverages, have become increasingly popular in China, whose population historically consumed green tea. Coffee's caffeine content has stimulant effects on the human nervous system, which can impact physical stamina, cognitive function, and mental health conditions like anxiety.

PD incidence among soft drink and coffee drinkers

The current cross-sectional study was conducted between September 29, 2020, and October 22, 2020. The study cohort comprised 1,809 female undergraduates with an average age of 19.7 years, 906 of whom resided in rural areas.

A total of 852 participants were diagnosed with PD, 25.9% of whom reported severe PD. Mild and moderate PD was reported by 24.4% and 49.6%, respectively. PD incidence was also related to menstrual flow and cycle.

About 51% of study participants with PD reported soft drink intake as compared to 48.8% of those without PD. Comparatively, 44.8% and 55% of PD and non-PD study participants consumed coffee, respectively.

The likelihood of PD was 24% higher among soft drink consumers. In fact, the relationship between soft drink consumption and PD severity was dose-dependent, with mild PD associated with weekly or less frequent soft drink consumption. In contrast, increasing pain severity was associated with a higher frequency of consumption.

Among rural participants with PD, the likelihood of soft drink intake was 40% higher than that of those who consumed other beverages. Overall, carbonated soft drink intake was associated with more severe PD.

Moderate to severe PD was 55% less likely among those who drank coffee; however, this association was not dose-dependent. More research is needed to explore potential mechanisms involved in the relationship between coffee intake and PD.

How do soft drinks contribute to PD?

The high sugar content of soft drinks may lead to nutritional disturbances due to reduced vitamin/mineral absorption and processing, which may negatively impact muscle function and ultimately lead to painful spasms associated with PD.

Higher prostaglandins (PGs) in the endometrium of women with PD may also contribute to the relationship between soft drink consumption and PD incidence, as PG levels are up to twice as high as those found in women without PD.

PGs may be synthesized from metabolic substrates derived from dietary sugar. These compounds trigger uterine contractions, which constrict blood vessels and release pain-causing anaerobic metabolites.

High sugar intake can also increase cortisol levels. Cortisol is a stress hormone; therefore, high cortisol levels may reflect dysregulated stress responses that lead to PD among sugar-sweetened soft drink consumers. Despite these hypotheses, more research is needed to elucidate the exact mechanisms involved in this association.

Conclusions

Carbonated soft drink consumption appears to be a risk factor for PD, particularly among rural women, whereas coffee intake was protective against severe PD. Thus, educating young women about the adverse effects of excessive soft drink consumption is crucial, while moderate coffee drinking could reduce PD severity.

Journal reference:
  • Wang, L., Wen, S., Maxwell, A., et al. (2024). Associations between soft drinks intake and primary dysmenorrhea among Chinese undergraduate female students. Scientific Reports. doi:10.1038/s41598-024-71802-8.
Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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