The factors causing dysmenorrhea are complex and often include exposure to cold, mental stress, or conditions like endometriosis and adenomyosis, which can lead to elevated levels of prostaglandins. This increase in prostaglandins causes excessive contraction of the uterine smooth muscles during menstruation, leading to local ischemia and hypoxia, and resulting in pain. This pain is usually spasmodic and can cause nausea, vomiting, and other gastrointestinal symptoms. When these symptoms occur, pain relief should be the first priority. Additionally, it is important to avoid excessive tension, maintain mental relaxation, and avoid exposure to cold.