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Updated: May 1, 2026

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Assessment of endothelial dysfunction in women with primary dysmenorrhea
Betül Sarıbıyık Çakmak1, Ahmet Can Çakmak2, Yusuf Can3
1Cardiology, Yenikent State Hospital, Türkiye.
Objectives:
Primary dysmenorrhea is a common condition characterized by cramp-like menstrual pain in young women. Recently, its effects on the cardiovascular system have garnered attention. Endothelial dysfunction is an early indicator of cardiovascular risk; however, its relationship with primary dysmenorrhea remains unclear. This study aims to evaluate endothelial function in individuals with primary dysmenorrhea using post-ischemic flow-mediated dilation (FMD) and volumetric flow (VolFlow) methods, and to compare the results with healthy controls.
Design:
This study included 31 women with a clinical diagnosis of primary dysmenorrhea and 31 healthy control women. Endothelial function was assessed using Flow-Mediated Dilation (FMD) and VolFlow methods. FMD measures the dilation of the brachial artery, while VolFlow evaluates arterial blood flow volume. Differences between the groups were analyzed using SPSS, and a p-value of < 0.05 was considered statistically significant. Normality was assessed using the Shapiro-Wilk test, and between-group comparisons were performed using appropriate parametric and non-parametric methods.
Findings:
The FMD values were significantly lower in the dysmenorrhea group (5.97 ± 5.29 vs. 10.95 ± 3.78, p < 0.001), and the proportion of individuals with endothelial dysfunction was higher (%51.6 vs. %6.45, p < 0.001). In the dysmenorrhea group, the baseline VolFlow value was 77.4 ± 24.1 ml/min, which increased to 81.4 ± 25.1 ml/min after cuff inflation (p < 0.001). In healthy controls, the VolFlow increased from 69.8 ± 15.3 ml/min to 92.0 ± 15.3 ml/min, but this change was not statistically significant (p = 0.08). The change in VolFlow (ΔVF) was significantly lower in the dysmenorrhea group (p < 0.001).
Results:
Our findings indicate a significant impairment of endothelial function in the primary dysmenorrhea group compared to the control group. Specifically, individuals with primary dysmenorrhea exhibited lower flow-mediated dilation (FMD) and Δ vascular function (ΔVF) values. To further investigate this relationship, large-scale studies are needed.
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