Rates of Anovulation in Adolescents and Young Adults with Moderate to Severe Primary Dysmenorrhea and Those without Primary Dysmenorrhea.
STUDY OBJECTIVE
To evaluate rates of presumptive anovulation in eumenorrheic adolescents and young adults with moderate to severe primary dysmenorrhea and those without primary dysmenorrhea.


DESIGN
Participants completed luteinizing hormone surge ovulation predictor test kits. Anovulatory cycles were defined by never receiving a positive result before the next menstrual period; participants were grouped as anovulatory if they experienced at least 1 anovulatory cycle during study participation. Participants rated daily level of menstrual pain on a 0-10 numeric rating scale.


SETTING
A university-based clinical research laboratory.


PARTICIPANTS
Thirty-nine adolescents and young adults (ages 16-24) with primary dysmenorrhea and 52 age-matched control girls.


INTERVENTIONS AND MAIN OUTCOME MEASURES
Rates of presumptive anovulation.


RESULTS
One hundred sixty-eight cycles were monitored, 29.8% (N = 50) of which were anovulatory (37.1% [39/105] vs 17.5% [11/63] of cycles in control and dysmenorrhea groups, respectively). During study participation, control girls were significantly more likely to have had at least 1 anovulatory cycle than were girls with primary dysmenorrhea (44.2% [23/52] vs 17.9% [7/39] of participants, respectively; P < .01). Cycle length and number of bleeding days between ovulatory and anovulatory cycles were similar. The primary dysmenorrhea group's maximum menstrual pain ratings did not differ between ovulatory and anovulatory cycles (4.77 and 4.36, respectively; P > .05).


CONCLUSION
Our data support previous findings of increased rates of ovulation in primary dysmenorrhea. However, menstruation after anovulatory cycles can be as painful as menstruation after ovulatory cycles. These data support the idea that regular menses do not necessarily indicate that a normal ovulatory cycle has occurred. Previous implications that ovulation is necessary for the development of substantial menstrual pain are incomplete.
['Seidman|Laura C|LC|', 'Brennan|Kathleen M|KM|', 'Rapkin|Andrea J|AJ|', 'Payne|Laura A|LA|']
D000293:Adolescent D000328:Adult D000858:Anovulation D004412:Dysmenorrhea D005260:Female D006801:Humans D008597:Menstrual Cycle D008598:Menstruation D010060:Ovulation D010061:Ovulation Detection D055815:Young Adult
Anovulation Adolescent Young adult Dysmenorrhea