Dysmenorrhea is generally caused by endometriosis in the majority of cases. If the endometrium is misplaced in the ovaries, it can form ovarian chocolate cysts; if misplaced into the myometrium, it can lead to adenomyosis, which generally presents with dysmenorrhea that tends to worsen over time. In most cases, this condition is considered to be caused by endometriosis. Additionally, the occurrence of dysmenorrhea should not exclude the possibility of being caused by a cold uterus. Patients with a cold uterus might experience lower abdominal pain and a cold lower abdomen during menstruation; in such cases, treatment can involve warming the meridians to dispel cold and using warming and pain-relieving medicines for symptomatic treatment. Moreover, if dysmenorrhea is caused by Qi stagnation and blood stasis, there might be a large volume of menstrual blood accompanied by large blood clots during the bleeding process. Treatment in this scenario would involve using medicines that invigorate the blood, break up stasis, soften hardness, and disperse conglomeration for symptomatic management.