Dysmenorrhoea is a common symptom amoung premenopausal women.

Causes include idiopathic dysmenorrhoea, endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, and pelvic congestion. Idiopathathic dysmenorrhoea is thought to be due to spasm in uterine vessels and muscle as a result of excessive local amounts of a substance called prostaglandin. Sometimes, the irritable bowel syndrome can be exacerbated by menstruation. Classically, the dysmenorrhoea cause by endometriosis starts just before menstruation and is worse in the first few days of a period.

Standard investigations included an ultrasound scan and a laparoscopy.