This prospective cohort study examined premenarche risk factors (ages 9–10) for dysmenorrhoea presence and severity at ages 12–13 in 2,254 female adolescents from the US population-based ABCD Study, following up at 3 years after baseline.
57.6% (n=1,299) developed dysmenorrhoea by age 12–13, with 19.0% of those reporting severe symptoms. Non-painful somatic symptoms predicted future dysmenorrhoea (OR 1.17, 95% CI 1.04–1.32). Advanced pubertal status at ages 9–10 was the strongest predictor (OR 1.79, 95% CI 1.47–2.17). Black and Hispanic adolescents had ~34–38% higher odds of dysmenorrhoea vs. White and non-Hispanic peers, respectively. Sleep disturbances predicted menstrual pain interference (β 0.16, 95% CI 0.01–0.31), but not dysmenorrhoea status itself.
- Dysmenorrhoea was assessed only at a single follow-up (age 12–13), limiting longitudinal tracking of severity changes. - Self- and parent-reported measures introduce potential recall and reporting bias. - Study was conducted in the USA only, limiting global generalizability.
Screen girls aged 9–10 for early pubertal development, non-painful somatic symptoms, sleep problems, and social risk factors (lower income, Black or Hispanic race/ethnicity) as early markers of dysmenorrhoea risk. Proactive identification before menarche may allow earlier intervention before pain becomes chronic.
