Early pubertal timing is a risk factor for adolescent dysmenorrhea

Abstract

Females who experience menarche early have elevated risk for dysmenorrhea; yet, other puberty features precede menarche. Using data from the Adolescent Brain Cognitive Development Study®, pubertal timing was estimated via random effects linear growth curves of pubertal status indicators excluding menarche for postmenarcheal females with no (n = 1083), mild (n = 1239), or severe (n = 266) dysmenorrhea. Early pubertal timing increased odds for dysmenorrhea by 22-31%, making it a novel marker for dysmenorrhea risk.

Keywords: Endocrine reproductive disorders.

Fig. 1. Estimated probabilities of developing dysmenorrhea by the 3-year follow-up (planned assessment at ages 12–13 years) in the ABCD Study® based on pubertal timing.

As pubertal timing (age at mid-puberty according to indicators other than menarche) occurs later in chronological development, the likelihood of developing mild (red line) or severe (purple line) dysmenorrhea decreases, and the likelihood of not experiencing pain during menstruation (yellow line) increases. The y-axis reflects the probability of reporting dysmenorrhea, and the x-axis reflects the observed minimum and maximum ages in the sample from baseline (youngest: 8.9 years) through the 3-year follow-up (oldest: 14.5 years).

Fig. 2. CONSORT diagram showing participant inclusion criteria and demographic characteristics.

Significant differences were observed in age at year-3 follow-up, age at mid-puberty, SES, and race/ethnicity for adolescent females with no, mild, and severe dysmenorrhea (ps < 0.001). Note. Socioeconomic status was indexed by income-to-needs ratio, which was missing for 5.2% of the sample. ABCD Adolescent Brain Cognitive Development. PDS Pubertal Development Scale, M mean, SD standard deviation, SES socioeconomic status.