Effect of polycystic ovary syndrome on dysmenorrhea: a case-control study


  • Samaneh Behzadfar Department of Medicine, Ardabil Branch, Islamic Azad University, Ardabil, Iran
  • Faranak Jalilvand Department of Gynecology and Obstetrics, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
  • Narges Salehi Department of Medicine, Ardabil Branch, Islamic Azad University, Ardabil, Iran




Menstrual pain, PCOS, Menstruation


Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that has an important impact on women of reproductive age and is diagnosed with various hormonal disorders. Menstrual pain is a common and often problematic problem for women during their reproductive age. Although these two problems may appear to be presented separately, they often overlap and lead to complex and multiple challenges in health care for women. This study was conducted with the aim of the effect of PCOS on dysmenorrhea.

Methods: This case-control study was done on 92 women who visited Alavi hospital in Ardabil during 2022-2023. Data collected included age, body mass index, length of the menstrual cycle (in days), menstrual bleeding volume (number of pad changes during the menstrual cycle), duration of menstrual bleeding (in days), and the presence of menstrual pain. Additionally, the severity of menstrual pain was assessed using the visual analog scale (VAS). Data were analyzed using SPSS version 25.

Results: Mann-Whitney test showed a significant difference between subjects with PCOS and non-PCOS in terms of the frequency of pain scores (p=0.03). There was no significant difference between the two groups in the variable of pain intensity (p=0.70).

Conclusions: The results of this study showed that the frequency of dysmenorrhea increases in people with PCOS, but the intensity of menstrual pain does not increase.


McCartney CR, Marshall JC. Clinical practice. Polycystic Ovary Syndrome. N Eng J Med. 2016;375(1):54-64.

Suturina L, Belkova N, Igumnov I, Lazareva L, Danusevich I, Nadeliaeva I, et al. Polycystic Ovary Syndrome and Gut Microbiota: Phenotype Matters. Life (Basel, Switzerland). 2022;13(1).

Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis. Iran J Reproduct Med. 2015;13(10):591-604.

Daniilidis A, Dinas K. Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia. 2009;13(2):90-2.

Martin ML, Halling K, Eek D, Krohe M, Paty J. Understanding polycystic ovary syndrome from the patient perspective: a concept elicitation patient interview study. Heal Quali Life Outcomes. 2017;15(1):162.

Grandi G, Ferrari S, Xholli A, Cannoletta M, Palma F, Romani C, et al. Prevalence of menstrual pain in young women: what is dysmenorrhea? J Pain Res. 2012;5:169-74.

Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiologic Rev. 2014;36:104-13.

Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Dysmenorrhea and related disorders. F1000Research. 2017;6:1645.

Motavalli R, Shahbazzadegan S. Comparative study of the effects of fennel with Gelofen on the severity of primary dysmenorrhea: A randomized clinical trial. Iran J Obstetr Gynecol Infertil. 2018; 21(7):36-42.

Akiyama S, Tanaka E, Cristeau O, Onishi Y, Osuga Y. Evaluation of the treatment patterns and economic burden of dysmenorrhea in Japanese women, using a claims database. Clinico-Economics Outcomes Res. 2017;9:295-306.

Davoud Fazli SPM. Correlations Between Gonadotropin Hormones and the Manifestations of Polycystic Ovary Syndrome. Department of Biology, Payame Nour University (PNU), Tehran, Iran. 2022:5.

Demir M, Ince O, Ozkan B, Kelekci S, Sutcu R, Yilmaz B. Endometrial flushing α(V)β(3) integrin, glycodelin and PGF2α levels for evaluating endometrial receptivity in women with polycystic ovary syndrome, myoma uteri and endometrioma. Gynecological Endocrinol. 2017;33(9):716-20.

Kumari P, Bhanage A, Shinde E. Menstrual Irregularities among Adolescence Girls. Incidence Prevalence. 2020.

Superior ide. Prevalence of dysmenorrhea in undergraduate health courses at an institution of higher education. J Nurs UFPE Line. 2012;6(6):1386-94.

Bigambo FM, Wang D, Zhang Y, Mzava SM, Dai R, Wang X. Current situation of menstruation and gynecological diseases prevalence among Chinese women: a cross-sectional study. BMC Women's Health. 2022;22(1):270.

Suhaid DN, Widowati LP, Dewi NNSA. The Relationship Between Menstrual Length and Menstrual Cycle with Dysmenorrhea in High School Students. J Midwifery. 2023;8(1):36-42.

Care ACoAH. ACOG Committee Opinion No. 349, November 2006: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Obstetr Gynecol. 2006;108(5):1323-8.

Naz MSG, Dovom MR, Tehrani FR. The menstrual disturbances in endocrine disorders: a narrative review. Int J Endocrinol Metabol. 2020;18(4).

Fairley DH, Taylor A. Anovulation. BMJ. 2003;327(7414):546-9.

Stern K, McClintock MK. Regulation of ovulation by human pheromones. Nature. 1998;392(6672):177-9.

Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril. 2012;97(1):7-12.

Azevedo GD, Costa EC, Micussi MTABC, Sá JCFd. Modificações do estilo de vida na síndrome dos ovários policísticos: papel do exercício físico e importância da abordagem multidisciplinar. Revista Brasileira de Ginecolog Obstetrícia. 2008;30:261-7.

Corleta HvE, Chaves EBM, Krause MS, Capp E. Tratamento atual dos miomas. Revista Brasileira de Ginecolog Obstetríc. 2007;29:324-8.

Jeong JY, Kim MK, Lee I, Yun J, Won YB, Yun BH, et al. Polycystic ovarian morphology is associated with primary dysmenorrhea in young Korean women. OGS. 2019;62(5):329-34.

Creatsas G, Deligeoroglou E, Zachari A, Loutradis D, Papadimitriou T, Miras K, et al. Prostaglandins: PGF2α, PGE2, 6-keto-PGF1α and TXB2 serum levels in dysmenorrheic adolescents before, during and after treatment with oral contraceptives. Eur J Obstetr Gynecol Reproduct Biol. 1990;36(3):292-8.

Akdemir N, Cinemre H, Bilir C, Akin O, Akdemir R. Increased serum asymmetric dimethylarginine levels in primary dysmenorrhea. Gynecol Obstetr Investig. 2010;69(3):153-6.

Akdemir N, Cinemre FB, Bostancı MS, Cinemre H, Ünal O, Ozden S, et al. The correlation of serum asymmetric dimethylarginine and anti-Müllerian hormone in primary dysmenorrhea. Kaohsiung J Med Sci. 2016;32(8):414-9.

Villarroel C, Merino P, Lopez P, Eyzaguirre F, Van Velzen A, Iniguez G, et al. Polycystic ovarian morphology in adolescents with regular menstrual cycles is associated with elevated anti-Müllerian hormone. Human Reproduct. 2011;26(10):2861-8.

Sanchez-Garrido MA, Tena-Sempere M. Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Molecular Metabolism. 2020;35:100937.

Gordon CM. Menstrual disorders in adolescents: excess androgens and the polycystic ovary syndrome. Pediatr Clin N Am. 1999;46(3):519-43.






Original Research Articles