Аннотация
Dysmenorrhea is a prevalent gynecological conditionaffecting women of reproductive age. Primary dysmenorrhea (PD) typically begins during adolescence. PD is associated with varied intensities of discomfort, leading to both physical and emotional distress. Elevated cortisol secretion impacts the reproductive system and contributes to the occurrence of pain and autonomic symptoms during menstruation.Objective: To determine the impact of vitamin D supplementation on menstrual pain and its association with salivary cortisol in adolescents with PD.Methods: A total of 191 adolescent females with primary dysmenorrhea were randomized into two groups: thestudy group (n=96) received vitamin D (4000 IU), while the control group (n=95) received a placebo for three months. Before and after the intervention, salivary cortisol levels were measured four times: in the morning, afternoon, evening, and night. The Visual Analogue Scale was used to assess the level of pain. Results: Group baseline characteristics were similar. Compared totheplacebo, vitamin D led to a significant decrease in mean VAS from 6.0 ± 1.8 to2.49 ± 1.2 after 12 weeks (p<0.001). Both groups exhibited mild declines in cortisol levels, which were not statistically significant. Vitamin D arm revealed positive correlations between post-intervention pain and morning (r = 0.34), evening (r = 0.51), and night (r = 0.38) cortisol (all p ≤ 0.002), while placebo showed only a modest association (r = 0.25, p = 0.034). There were no major complications.Conclusion.Vitamin D markedly reduces menstrual pain in adolescents, while systemic cortisol changes are minimal. Nonetheless, residual pain remains linked to diurnal cortisol, suggesting that combining vitamin D with stress-modulating strategies may yield superior analgesia for PD.Keywords:vitamin D, cortisol, dysmenorrhea, adolescent girls, pain.