Dysmenorrhea refers to painful menstrual cramps that typically occur before or during menstruation. Primary dysmenorrhea has no underlying pathology and is caused by prostaglandin-induced uterine contractions. Secondary dysmenorrhea results from conditions like endometriosis, fibroids, or pelvic inflammatory disease. Symptoms may include cramping, lower back pain, nausea, and fatigue. Management can include NSAIDs, hormonal contraceptives, dietary changes, and, in some cases, evaluation for underlying conditions through imaging or laparoscopy.