Association of antimullerian hormone levels with menstrual cycle type and dysmenorrhea in young asymptomatic women

Capsule:
More-severe menstrual pain is associated with lower antimullerian hormone concentration among Japanese women age 20–22 years who had never used oral contraceptives; the effect persisted even after adjustment for menstrual-cycle regularity.

Authors:
Shoko Konishi, Ph.D., Yukiko Nishihama, M.S., Ayaka Iida, B.S., Jun Yoshinaga, Ph.D., Hideki Imai, Ph.D.

Volume 102, Issue 5, Pages 1439–1443

Abstract:

Objective:
To examine the association between antimüllerian hormone (AMH) levels and menstrual-cycle and lifestyle characteristics among young Japanese women.

Design:
Cross-sectional study.

Setting:
A university.

Patient(s):
Female students aged 20–22 years (n = 65) who had never used oral contraceptives.

Intervention(s):
Participants completed a questionnaire on reproductive and lifestyle characteristics, and kept a menstrual-cycle diary for 5 consecutive months. Serum AMH was measured once during the study period.

Main Outcome Measure(s):
Serum AMH concentration.

Result(s):
Compared with women with very mild menstrual pain, serum AMH concentration was 49.6% (95% CI 6.5%–72.8%) lower among women with severe menstrual pain. Higher AMH concentration was associated with irregular menstrual cycles. Even after adjusting for menstrual-cycle regularity and its interaction, more-severe menstrual pain was associated with significantly lower AMH concentration.

Conclusion(s):
Circulating AMH concentration was significantly lower among young Japanese women who had more-severe menstrual pain. Underlying physiological mechanisms need to be addressed in future studies.

  • Reshef Tal

    The authors describe an interesting association between dysmenorrhea
    and decreased AMH even after adjusting for menstrual-cycle irregularity. As
    they thoughtfully suggest in their discussion, endometriosis may be a potential
    explanation, since endometriosis has been previously shown to be associated
    with lower AMH. Since BMI has been shown in several studies to correlate
    negatively with AMH, and other studies suggest an association between BMI and
    dysmenorrhea, I wanted to ask the authors if they also controlled for BMI in their
    analysis?

    • Shoko Konishi

      Thank you very much for your comments. We have only checked the association between BMI and AMH using a bivariate regression analysis (Table 2) and found no significant association. Therefore, in the ANOVA, only cycle regularity and menstrual pain, but not BMI, were included to examine the association with AMH.

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