Longitudinal genetic analysis of menstrual flow, pain, and limitation in a sample of Australian twins

Genetically informative longitudinal data about menstrual disorders allow us to address the extent to which the same genetic risk mechanisms are operating throughout the reproductive life cycle. We investigate the relative contributions of genes and environment to individual differences in menstrual symptomatology reported at two waves, 8 years apart, of a longitudinal Australian twin study. Twins were questioned in 1980-1982 and 1988-1990 about levels of menstrual pain, flow, and perceived limitation by menses. Longitudinal genetic analysis was based on 728 pairs (466 MZ and 262 DZ) who were regularly menstruating at both survey waves. A bivariate Cholesky model was fitted to the two-wave data separately for flow, pain, and limitation variables. The baseline model comprised common genetic and environmental factors influencing responses at both waves and specific effects influencing only the second-wave response. We also included age as a covariate in the model. Proportions of the longitudinally stable variance in menstrual flow, pain, and limitation attributable to genetic and individual environmental effects were calculated for the best-fitting models. Genetic factors accounted for 39% of the longitudinally stable variation in menstrual flow, 55% for pain, and 77% for limitation. The remaining stable variance was due to individual environmental factors (61, 45, and 23%, respectively). Therefore the stable variance over the 8-year interval was largely environmentally influenced for menstrual flow, was approximately equally determined by genetic and by nonshared environmental influences in the case of pain, and was due almost entirely to genetic influences for limitation by periods. We demonstrate for the first time that the same genetic influences are operative throughout the reproductive life span.