Primary dysmenorrhea is painful menstrual period without any underlying pathological cause. It is a common problem among adolescents. Despite the high prevalence, primary dysmenorrhea is often poorly treated, disregarded by health professionals, pain researchers, and the adolescents themselves. They may accept it as a normal part of the menstrual cycle. Increased levels of prostaglandins E2 and F2α cause dysrhythmic myometrial contraction, hypercontractility, increased muscle tone leads to ischaemia and pain. It affects the quality of life and performance. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first line of treatment. Progesterone significantly relieves the pain in subsequent cycles. Combined oral contraceptives (COC) are invaluable in the management of dysmenorrhoea.