Effects of epidural steroid injections on menstrual cycle in women: An observational study

Savaş Şencan1, Serhad Bilim2, Merve Demirci3, Osman Hakan Gündüz1

1Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye
2Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Medipol University Faculty of Medicine, İstanbul, Türkiye
3Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye

Keywords: Epidural injections, hypothalamo pituitary adrenal axis, menstrual disturbance, spinal injections, steroid.

Abstract

Objectives: The aim of this study was to investigate the effect of epidural steroid injections on the menstrual cycle of women and to identify risk factors in those with changes.
Methods: A total of 78 women who had epidural steroid injections between the ages of 18 and 55 years were retrospectively analyzed. The patients were called by phone and asked whether there was any change in their menstrual cycles after the epidural injections. Data including demographic and clinical characteristics, body height and weight, education status, alcohol and smoking habits, comorbidities, number of children, birth control method, history of cesarean section, miscarriage, and abortion were recorded.
Results: Changes in the menstrual cycle were seen in five of 12 patients who underwent cervical interlaminar epidural steroid injection, in 27 of 56 patients who underwent lumbar transforaminal epidural steroid injection, in one of two patients who underwent lumbar interlaminar epidural steroid injection, and in three of eight patients who underwent caudal epidural steroid injection. The number of patients with obesity was higher in the patients with changes than those without, indicating a statistically significant difference (41.7% vs. 14.3%, respectively; p=0.007).
Conclusion: Our study suggests that epidural steroid injections are associated with changes in the menstrual cycle. Obesity is a risk factor for menstrual cycle changes after epidural steroid injections.