Depression increases chances of experiencing menstrual pain

A new study identifies a link between depression and dysmenorrhea, with sleeplessness as a potential mediator. 

In a recent study published in Briefings in Bioinformatics, scientists investigate the genetic relationship between depression and dysmenorrhea using Mendelian randomization, genome-wide association studies (GWAS), and protein-protein interaction analyses.

Depression and dysmenorrhea

Depression, particularly in women, often co-occurs with reproductive health conditions like dysmenorrhea or painful menstrual periods. GWASs have identified several genetic markers shared between the two conditions, thus suggesting overlapping biological pathways.

Although previous studies have identified significant correlations between these conditions, the biological basis of this association remains poorly understood. Furthermore, establishing the causality has proven challenging due to confounding factors in observational studies.

Mendelian randomization, which is a method that uses genetic variants to infer causality, has been widely used to explore associations between psychiatric and reproductive disorders. Despite extensive research in this field, no Mendelian randomization study has comprehensively examined the causal relationship between depression and dysmenorrhea.

About the study

In the present study, researchers integrate genomic data with expression and protein interaction analyses to elucidate the shared mechanisms between depression and dysmenorrhea and highlight potential intervention targets.

A bidirectional Mendelian randomization framework was used to investigate the causal relationship between depression and dysmenorrhea. GWAS datasets were used to obtain information on genetic variants associated with each condition while ensuring no overlap in sample populations.

Two-sample Mendelian randomization analyses were used to determine causality, whereas the multivariable Mendelian randomization analysis addressed potential mediators like sleeplessness and body mass index (BMI). Genetic variants that met statistical thresholds were then filtered to ensure reliability and avoid linkage disequilibrium and confounding.

Expression quantitative trait locus data from the Genotype-Tissue Expression (GTEx) database were also analyzed to identify genes associated with the genetic variants and their expression in tissues relevant to depression and dysmenorrhea. A protein-protein interaction network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database to map interactions among proteins encoded by these genes.

Sensitivity analyses, including heterogeneity and pleiotropy checks, were performed to determine the validity of the genetic tools used in the study. Furthermore, Bayesian colocalization analysis was used to identify shared genetic variants that may be involved in both conditions.

Potential mediators between depression and dysmenorrhea, such as sleeplessness, were also examined using a two-step Mendelian randomization analysis. This method assessed the genetic role of depression on the mediators and their subsequent impact on dysmenorrhea.

Transcriptional regulatory networks were incorporated into the dataset to explore gene expression control mechanisms and further validate the identified causal pathways. By integrating genomic, transcriptomic, and proteomic data, any findings on the genetic link between depression and dysmenorrhea would be strengthened.

Study findings

Genetic variants associated with depression increased the risk of dysmenorrhea by approximately 1.5 times, with consistent findings observed across European and Asian populations. Additionally, multivariable Mendelian randomization analyses revealed sleeplessness as a significant mediator, thus suggesting that disturbed sleep may partially explain this association. Other mediators, such as BMI and ibuprofen use, did not significantly impact this association.

Colocalization analysis identified shared genetic variants, with the rs34341246 of ribonucleic acid (RNA) binding motif single-stranded interacting protein 3 (RMBS3) gene emerging as a common factor influencing both conditions.

The protein-protein interaction analysis also highlighted the involvement of key genes such as G protein-coupled receptor kinase 4 (GRK4) and ring finger protein 123 (RNF123), thereby indicating overlapping biological pathways involving signal transduction and cellular regulation. The expression data also linked depression-associated variants to altered gene activity in tissues related to the nervous and reproductive systems.

Reverse Mendelian randomization analyses did not identify any evidence that dysmenorrhea increases the risk of depression, thus suggesting a unidirectional relationship. The genetic findings remained robust across sensitivity tests, with minimal pleiotropy and heterogeneity detected.

Additionally, the integration of transcriptomic and proteomic data revealed regulatory networks involving transcription factors like signal transducer and activator of transcription 3 (STAT3), which may influence both conditions.

Conclusions

Depression appears to be a causal factor for dysmenorrhea through shared genetic mechanisms and mediated pathways, especially those involving sleep disturbances. The study findings also emphasize the importance of integrating mental and reproductive health management with implications for targeted screening and intervention strategies.

By identifying key genes and regulatory networks, the current study provides the foundation for exploring novel therapeutic approaches while also revealing the interconnected nature of psychological and reproductive health.