Menstruation in adolescents with familial Mediterranean fever: attack trigger or dysmenorrhoea? A prospective cross-sectional study
Authors' conclusion
Our findings raise the possibility that menstruation does not uniformly act as a trigger for FMF attacks and that a subset of symptoms reported during the menstrual period may reflect premenstrual discomfort or PMS/PMDD-like features rather than true FMF attacks.
Study context
- Population
- Adolescents with familial Mediterranean fever (FMF), ≥1 year post-menarche, without comorbidities or secondary dysmenorrhoea
- Participants
- 42 adolescents
- Exposure
- Adolescents with FMF reporting menstruation-triggered attacks vs those not reporting them
- Menstruation-triggered attacksn = 16
- Outcome
- Self-reported menstruation-triggered FMF attacks
Main finding
As reported in the abstract
Menstruation-triggered attacks
38%
16
Observational data: associations, not effects.
Further findings
Mood disturbances, self-reported menstruation-triggered FMF attacks vs others
- Mood disturbances significantly more frequent in patients reporting menstruation-triggered attacks
- 81.3% vs 26.9%, P = 0.002
Clinical FMF attacks by Eurofever/PRINTO criteria and M694V homozygosity
- Classified as clinical FMF attacks (Eurofever/PRINTO)
- 64.2%
- Higher M694V homozygosity in clinical FMF attacks
- 55.6% vs 20%, P = 0.049
High-CRP group (>7.67 mg/l) vs ≤7.67 mg/l
- Chest pain more common in high-CRP group
- 36.4% vs 6.5%, P = 0.032
- M694V homozygosity more common in high-CRP group
- 72.7% vs 32.3%, P = 0.033
CRP during menstruation
- CRP during menstruation increased slightly but remained lower than during typical FMF attacks
Primary dysmenorrhoea
- Primary dysmenorrhoea (PD) reported
- 88.1%
Premenstrual syndrome (PMS) or PMDD
- Approximately two-thirds met PMS or PMDD criteria, without differences in genotype or inflammatory activity among PMS categories
Original publication
Menstruation in adolescents with familial Mediterranean fever: attack trigger or dysmenorrhoea? A prospective cross-sectional study. Rheumatology (Oxford). Published 3 April 2026. doi:10.
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