Dysmenorrhea refers to difficult or painful menstruations. They can be primary, meaning that it appears from the first menstruations of puberty, or secondary, occurring after several cycles without pain. They can occur before the onset of menstruation, along with the period, or a few hours or days later. The causes are many: abnormality of a genital organ, a tumor on one of these organs which is rare, or intrauterine contraception. Dysmenorrhea can be debilitating in daily life by the intensity or duration of the pain. If a cause is found, it should be treated. Otherwise, hormonal treatments are sometimes used.