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ObjectiveThis study was aimed at identifying a correlation between polycystic ovarian morphology (PCOM) and the severity ofprimary dysmenorrhea in young Korean women. MethodsA total of 592 patients who visited a tertiary hospital from March 2008 to March 2015 for dysmenorrhea wereexamined. After excluding those with secondary causes of menstrual pain (for example, myoma, adenomyosis,endometriosis, and pelvic inflammatory disease), 361 women were recruited and retrospectively analyzed. Severedysmenorrhea was defined as a visual analog scale (VAS) score ≥6. ResultsThe mean patient age was 23.0±4.0 years, the average menstrual cycle length was 34.4±23.7 days, and the averagepain intensity was VAS 6.7±0.1 at baseline. PCOM was assessed by ultrasound in 54 women (15%). Patients with severemenstrual pain were more likely to have irregular menstrual cycles (P=0.03) and heavy menstrual flow (P=0.01) thanthose with mild menstrual pain. After adjusting for weight, height, menstrual cycle interval, and menstrual flow in thelogistic regression analysis, PCOM (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.05–4.97; P=0.04) and heavymenstrual flow (OR, 1.85; 95% CI, 1.05–3.28; P=0.04) were found to be significant independent factors influencingpain. ConclusionOur study shows that PCOM may have a correlation with the severity of primary dysmenorrhea. Since PCOM may playa role in the development of menstrual pain, patients with PCOM should be under active surveillance with resourcesfor prompt pain management readily available. It may also be necessary to further investigate the molecularmechanisms of pain development in primary dysmenorrhea.

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