Loneliness and analgesic overuse among low-dose estrogen-progestin users in Japan

Loneliness is related to menstrual disorders and medication use. Loneliness and pain are related and may be associated with analgesic use. The aim of this study was to investigate the prevalence of concomitant analgesic use and overuse, and to clarify factors associated with loneliness and analgesic overuse among women who are low-dose estrogen-progestin (LEP) users.

Women in their 20s and 30s were randomly selected from a research company's web panel (Macromill, Inc.) and LEP users were screened. The survey included analgesic concomitant use days per month and the Three-Item Loneliness Scale (TIL). Logistic regression analysis was performed with high TIL score (≥ 6) and analgesic use ≥ 10 days per month as the objective variables.

A total of 516 valid responses from LEP users were analyzed. Among them, 64.1% reported concomitant analgesic use on ≥ 1 day per month, 11.2% on ≥ 10 days per month, and 45.7% had high TIL score. High TIL score was significantly associated with concomitant analgesic use on ≥ 1 day per month (odds ratio [OR] 1.76, 95% confidence interval [95%CI] 1.18-2.63, p = 0.006). Concomitant analgesic use on ≥ 10 days per month was significantly associated with endometriosis (OR 5.25, 95%CI 2.15-12.81, p < 0.001) and concomitant analgesic use for low back pain (OR 4.67, 95%CI 1.65-13.18, p = 0.04).

To our knowledge, this is the first detailed study to investigate concomitant analgesic use and overuse among LEP users. Loneliness was found to be prevalent in this population and was associated with concomitant analgesic use, potentially reflecting underlying patterns of frequent or habitual analgesic intake. Furthermore, concomitant analgesic overuse was linked to conditions such as endometriosis and low back pain, underscoring the importance of medication monitoring that takes into account both loneliness and the self-recording of menstrual symptoms. Greater attention by healthcare professionals to the psychosocial context of concomitant analgesic overuse and loneliness may facilitate more meaningful patient dialogue and contribute to improved quality of life.