Most women experience some level of discomfort during their menstrual cycle — whether it’s cramps, mood swings, bloating, or fatigue. But have you ever noticed that your symptoms seem similar to your mother’s or sister’s? This raises an interesting question: are menstruation symptoms genetic? Research suggests that while environment and lifestyle play significant roles, genetics also influence how women experience their periods.

1. The Genetic Component of Menstrual Pain

Several studies indicate that genetics can influence menstrual pain, also known as dysmenorrhea. A landmark study by Treloar et al. (1999) using twins found that around 55% of the variation in menstrual pain severity could be attributed to genetic factors. In twin studies, if identical twins — who share nearly all their DNA — experience similar menstrual symptoms more often than fraternal twins, it suggests a strong genetic basis.

Specific genes related to inflammation and pain sensitivity may be involved. For example, variations in the OXTR gene (oxytocin receptor) and ESR1 gene (estrogen receptor alpha) have been associated with higher sensitivity to menstrual pain. Since estrogen levels fluctuate significantly during the menstrual cycle, genetic differences in how estrogen receptors function can affect how the body responds to hormonal changes.

2. Endometriosis and Family History

For women with severe menstrual pain, genetics play an even clearer role. Conditions such as endometriosis, which cause intense cramping and heavy bleeding, have a strong hereditary component. Studies show that first-degree relatives(mothers, sisters, or daughters) of women with endometriosis are six times more likely to develop the condition.

Endometriosis involves genetic factors affecting inflammation, immune response, and tissue growth — making it one of the clearest examples of a menstruation-related disorder with a genetic basis.

3. PMS and PMDD: Mood Symptoms and Hormone Sensitivity

Beyond physical pain, mood-related symptoms like irritability, depression, or anxiety before menstruation may also have genetic influences. Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are linked to how the brain responds to hormonal changes, particularly fluctuations in progesterone and serotonin.

Twin studies suggest that up to 40% of PMS symptom variance may be heritable. Moreover, women with certain variants of the serotonin transporter gene (5-HTTLPR) may be more sensitive to hormonal changes that affect mood.

4. The Role of Environment and Lifestyle

While genes lay the groundwork, environmental and lifestyle factors heavily influence how symptoms manifest. Diet, stress, exercise, sleep quality, and overall health can either amplify or reduce genetic predispositions. For instance, high-stress levels can increase prostaglandin production — the chemical that triggers uterine contractions and pain — even in women without a strong genetic predisposition.

Thus, menstruation symptoms often arise from an interaction between genes and lifestyle. Two sisters may share similar genes but experience different symptom severities based on stress, nutrition, or hormonal contraceptive use.

5. Conclusion

Menstrual symptoms are partially genetic, with strong evidence supporting hereditary links for dysmenorrhea, PMS, and endometriosis. However, lifestyle and environmental factors remain powerful modifiers. Understanding your family history can help you anticipate certain symptoms — but healthy habits, stress management, and medical guidance can significantly improve menstrual well-being, regardless of genetics.

References:

• Hirayama, F., Lee, A. H., Binns, C. W., & Zhao, Y. (2014). Genetic polymorphisms associated with menstrual pain. European Journal of Obstetrics & Gynecology and Reproductive Biology, 179, 163–167.

• Kendler, K. S., Karkowski, L. M., & Corey, L. A. (1992). Genetic influences on premenstrual symptoms: A twin study. Psychological Medicine, 22(2), 443–452.

• Sapkota, Y., et al. (2017). Genetic basis of endometriosis. Human Reproduction Update, 23(4), 513–532.

• Słopień, R., et al. (2018). Estrogen receptor alpha gene polymorphism and menstrual pain. Ginekologia Polska, 89(1), 27–32.

• Treloar, S. A., Bell, T. A., Nagle, C. M., & Martin, N. G. (1999). Genetic influences on dysmenorrhea and premenstrual symptoms: A twin study. American Journal of Obstetrics and Gynecology, 180(2), 277–283.

• Schmidt, P. J., et al. (2017). The role of sex hormones and serotonin in premenstrual dysphoric disorder. Biological Psychiatry, 82(9), 655–664.