Factors Associated with Severe Primary Dysmenorrhea in Adolescent Girls: A Retrospective Single-Center Study

Objective: To identify the risk factors for severe primary dysmenorrhea in adolescent girls and provide evidence for clinical prevention and intervention. Methods: This retrospective study enrolled adolescent girls with primary dysmenorrhea from Jingzhou Central Hospital between January 2022 and December 2023. Participants were divided into severe group and mild-to-moderate group grouped by VAS score (VAS 0-10, 0=no pain, 1-3=mild, 4-6=moderate, 7-10=severe). Demographic, lifestyle, menstrual and laboratory parameters were collected via questionnaires and medical records. Bivariate analysis and multivariate Logistic regression were used to screen independent risk factors, and ROC curve was applied to assess model performance. Results: 426 participants were included (158 in severe group, 268 in mild-to-moderate group). Early menarche (≤12 years old), frequent cold food intake (≥3 times/week), high serum PGF2α level and low physical activity level were independent risk factors (all P<0.05). The predictive model yielded an AUC of 0.826 (95% CI: 0.783-0.869), showing good predictive efficiency. Conclusion: Early menarche, frequent cold food intake, high serum PGF2α and low physical activity are independent risk factors for severe primary dysmenorrhea in adolescent girls. Targeted interventions on these factors can help reduce the occurrence of severe dysmenorrhea.