Variation of symptoms during the menstrual cycle in female patients with gastroparesis

Abstract

Background: Gastroparesis, a chronic gastric motility disorder with symptoms of nausea, vomiting, early satiety, postprandial fullness and bloating, predominantly affects women. Some studies suggest that gastric emptying may be slower in females especially during the luteal phase of the menstrual cycle when estrogen and progesterone levels are elevated. In females with irritable bowel syndrome, symptoms may worsen during the luteal phase. The aim of this study was to determine if symptoms of gastroparesis vary along the menstrual cycle and to determine the effect of oral contraceptive agents (OCPs) on symptoms.

Methods: Thirty-nine premenopausal women were studied (10 gastroparesis patients not on OCPs, 10 gastroparesis on OCPs, nine healthy women not on OCPs and 10 healthy women on OCPs). The Gastroparesis Cardinal Symptom Index Daily Diary was used to assess daily symptoms (0=none and 5=very severe).

Key results: Gastroparesis patients not on OCPs had significantly worse symptoms during the luteal phase compared to the follicular phase for nausea (2.25±0.68 vs 1.58±1.06; P<0.001) and early satiety (2.80±0.50 vs 1.70±1.50; P<0.001), but not for vomiting, bloating, abdominal pain, fullness, or loss of appetite. Gastroparesis patients on OCPs showed little day-to-day variation of symptoms. Vomiting was more severe in patients off OCPs (2.00±0.80 vs 1.20±0.83; P=0.040). Healthy women exhibited little to no symptoms regardless of OCP use.

Conclusions & inferences: Increased symptoms, particularly nausea and early satiety, occurred in the luteal phase of the menstrual cycle in female patients with gastroparesis. A variation in symptoms was not seen in gastroparesis female patients on hormonal contraception.