Primary dysmenorrhea is one of the most common gynecological complaints among adolescent girls and may interfere with daily and school activities. Exercise-based intervention, including aerobic exercise and core strengthening exercise, can reduce menstrual pain as non-pharmacological management. This study aimed to compare the effects of aerobic exercise and core strengthening exercise on primary dysmenorrhea among adolescent girls. A randomized pre-test and post-test-controlled trial was used. The research was conducted at SMP Muhammadiyah 2 Gamping, Sleman, Indonesia involving 34 adolescent girls aged 10-17 years with primary dysmenorrhea. Participants were randomly assigned using simple randomization into an aerobic exercise group (n=17) and a core strengthening exercise group (n=17). Pain intensity was measured using the Visual Analog Scale (VAS) before and after a three-week intervention performed three times weekly, with 30-minute sessions. The mean VAS score in the aerobic exercise group decreased from 6.00 ± 2.09 to 3.00 ± 1.86, while the core strengthening group decreased from 7.18 ± 1.94 to 4.53 ± 1.84. The reduction in pain intensity was greater in the aerobic group (3.00 points) than in the core strengthening group (3.00 points vs. 2.65 points; Mean difference −1.53; 95% CI −2.75 to −0.31; p=0.020). Both interventions significantly reduced primary dysmenorrhea pain intensity (p<0.001) with a significant difference between groups p=0.020. Aerobic exercise may provide greater benefits in school-based menstrual health programs for adolescent’s girls.
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