In a cross-sectional population-based study the association between the menstrual pattern in ninth grade schoolgirls and calendar age, gynaecological age, body mass index (BMI) and historical parameters was investigated. The survey was held in a combined urban and rural region, south of Amsterdam. A total of 2480 adolescents, mean age 15.3 +/- 0.6 (SD) years, answered a questionnaire: response 92%. The menstrual cycle patterns were categorized to regular menstrual cycles (RMC), irregular menstrual cycles (IMC), oligomenorrhoea, polymenorrhoea, pre-menarche, <6 months after menarche, and oral contraceptive use. Gynaecological age was strongly associated with the prevalence of IMC but only weakly with the prevalence of oligomenorrhoea. In a logistic regression analysis gynaecological age, subjective acne and intellectual performance were independently associated with oligomenorrhoea. Gynaecological age, low BMI, chronic non-specific lung disease (CNSLD) or allergic disease, stress and strain, weight loss of >5 kg were independently associated with IMC. More than 8 h sports per week was associated with not having experienced menarche in the ninth grade but not with menstrual cycle disturbances. The association between CNSLD or allergic disease and IMC has not previously been described. The associations between weight loss, low body weight, stress, physical exercise or signs of hyperandrogenism and menstrual cycle patterns in adolescents are weak when studied on a population basis. The value of these parameters to explain abnormal menstrual cycle patterns is limited.