OP07.06: Understanding dysmenorrhea in women with polycystic ovary morphology: a retrospective study

Polycystic ovary morphology (PCOM) is a diagnostic criterion for polycystic ovary syndrome (PCOS) that also exists as a separate entity. We aim to investigate prevalence of dysmenorrhea in the PCOM population, determine overall PCOM prevalence, and identify potential risk factors for dysmenorrhea. We retrospectively analysed data from patients aged 20 to 45 who underwent transvaginal scans between February and June 2023 at an ultrasound clinic specialised in gynecologic diseases. PCOM was diagnosed according to the latest PCOM ultrasound criteria. Patients without dysmenorrhea information were excluded. Prevalence of dysmenorrhea in PCOM patients was calculated, and baseline characteristics were compared between groups with mild (VAS < 6) and severe (VAS > 6) dysmenorrhea. Binary logistic regression analysis was run to identify potential risk factors for dysmenorrhea in PCOM patients. PCOM was found in 243/1321(18%) patients. After exclusion, 209 patients were analysed, with 39% experiencing mild and 61% severe dysmenorrhea. Mean age differed significantly between groups (p = 0.03). Severe dysmenorrhea was associated with heavy flow (p < 0.001) and dyspareunia (p = 0.01), while previous pregnancy correlated with milder dysmenorrhea (p = 0.007). Infertility was associated with more severe dysmenorrhea (p = 0.04). Adenomyosis was more common in PCOM patients with severe dysmenorrhea (p = 0.05). Heavy flow was identified as risk factor for dysmenorrhea (OR, 16.32; p < 0.001), while gravidity was protective (OR, 0.38; p = 0.016). Patients with PCOM referred for advanced endometriosis scan were more likely to have severe dysmenorrhea (OR, 4.34; P < 0.021). This study highlights severity of dysmenorrhea in individuals with PCOM and provides for the first time overall prevalence of PCOM, as a separate entity from PCOS. Further research is needed to understand the underlying pathophysiological mechanism of pain development in PCOM population, and exploring associations with other gynecological conditions is crucial for tailored treatment plan.