The cramping associated with dysmenorrhea usually begins a few hours before the start of bleeding and may continue for a few days. The pain is usually described as being in the lower abdomen, possibly radiating to the thighs and lower back. Other symptoms associated with primary dysmenorrhea are nausea and vomiting, fatigue, diarrhoea, lower backache, and headache.

The symptoms of secondary dysmenorrhea vary with the underlying cause, but generally the pain associated with secondary dysmenorrhea is not limited to the time around menses as with primary dysmenorrhea. Also, secondary dysmenorrhea is less related to the onset of bleeding in menstruation, is seen in older women, and is associated with other symptoms like infertility.