[1] Symptoms often co-occurring with menstrual pain include nausea and vomiting, diarrhea, headache, dizziness, disorientation, fainting and fatigue.

[8][9] The use of certain types of birth control pills can prevent the symptoms of dysmenorrhea because they stop ovulation from occurring.

Rarely, birth defects, intrauterine devices, certain cancers, and pelvic infections cause secondary dysmenorrhea.

The underlying cause is unknown, though some evidence suggests it may be associated with ectopic pregnancy or the use of hormonal contraception.

[17] Other causes of secondary dysmenorrhea include leiomyoma,[18] adenomyosis,[19] ovarian cysts, pelvic congestion,[20] and cavitated and accessory uterine mass.

[23] Variant genotypes in the metabolic genes such as CYP2D6 and GSTM1 have been similarly been correlated with an increased risk of severe menstrual pain, but not with moderate or occasional phenotypes.

[26] The occurrence and frequency of secondary dysmenorrhea (SD) has been associated with different alleles and genotypes of those with underlying pathologies, which can affect the pelvic region or other areas of the body.

Individuals with disorders may have genetic mutations related to their diagnoses which produce dysmenorrhea as a symptom of their primary diagnosis.

When a cytosine 173 base pairs upstream of macrophage migration inhibitory factor (MIF) promoter was replaced by a guanine there was an associated increase in the likelihood of the individual experiencing PD.

[30] A second associated SNP was located 308 base pairs upstream from the start codon of the TNF-α gene, in which guanine was substituted for adenine.

These mutations may therefore affect pain responses during menstruation which lead to the differing phenotypes associated with dysmenorrhea.

[35] When the uterine muscles contract, they constrict the blood supply to the tissue of the endometrium, which, in turn, breaks down and dies.

These contractions, and the resulting temporary oxygen deprivation to nearby tissues, are thought to be responsible for the pain or cramps experienced during menstruation.

[36] The diagnosis of dysmenorrhea is usually made simply on a medical history of menstrual pain that interferes with daily activities.

Further work-up includes a specific medical history of symptoms and menstrual cycles and a pelvic examination.

[6] Based on results from these, additional exams and tests may be motivated, such as: Treatments that target the mechanism of pain include non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives.

[12][40] Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are effective in relieving the pain of primary dysmenorrhea.

[42][33] A 2009 systematic review (updated in 2023) found evidence that the low or medium doses of estrogen contained in the birth control pill reduces pain associated with dysmenorrhea.

[51] There is some evidence that exercises performed 3 times a week for about 45 to 60 minutes, without particular intensity, reduces menstrual pain.

[40] There is insufficient evidence to recommend the use of many herbal or dietary supplements for treating dysmenorrhea, including melatonin, vitamin E, fennel, dill, chamomile, cinnamon, damask rose, rhubarb, guava, and uzara.

[1][52] Further research is recommended to follow up on weak evidence of benefit for: fenugreek, ginger, valerian, zataria, zinc sulphate, fish oil, and vitamin B1.

[58] There were also concerns of bias in study design and in publication, insufficient reporting (few looked at adverse effects), and that they were inconsistent.

[58] There are conflicting reports in the literature, including one review which found that acupressure, topical heat, and behavioral interventions are likely effective.

[54] A 2007 systematic review found some scientific evidence that behavioral interventions may be effective, but that the results should be viewed with caution due to poor quality of the data.

[54] Although claims have been made for chiropractic care, under the theory that treating subluxations in the spine may decrease symptoms,[60] a 2006 systematic review found that overall no evidence suggests that spinal manipulation is effective for treatment of primary and secondary dysmenorrhea.

[10] A 2011 review stated that high-frequency transcutaneous electrical nerve stimulation may reduce pain compared with sham TENS, but seems to be less effective than ibuprofen.

One study indicated that in nulliparous individuals with primary dysmenorrhea, the severity of menstrual pain decreased significantly after age 40.

[67] A survey in Norway showed that 14 percent of females between the ages of 20 and 35 experience symptoms so severe that they stay home from school or work.

[69] A study from India conducted by Dr RimJhim Kumari found that painful menstruation affected 66.7% of the girls, out of which only 27% sought medical advice from a doctor.