Dysmenorrhea is a pain variant syndrome with wide range of manifestations and intensity even in the same person. Like other pain variants it seems to be very subjective and personality dependent.

Despite uniform molecular basis of dysmenorrhea further risk factors are needed to be clarified.

To find out which subgroup of patients express more severe symptoms and need stronger treatments.

Hundred and twenty consecutive patients (half reported dysmenorrhea of some concern while the other half of no or minor concern) were evaluated with the Millon's Clinical Multiaxial inventory MSMI-III. The former group used routinely drugs for dysmenorrhea in a PRN basis and some used medications as prophylaxis. The former group was free to use psychoactive medication but people using psychoactive medications were excluded from the latter group. Dysmenorrhea was not graded according to severity and stress was laid on personal view about the matter.

Patients with dysmenorrhea had higher scores in passive aggressive, borderline, avoidant, dependent, histrionic and obsessive personality scales (p< 0.04) while patients without dysmenorrhea showed higher scores in narcissistic, schizoid, schizotypal, paranoid personality scales (p< 0.07).

Dysmenorrhea patients show lower pain threshold, increased preoccupation about disease and higher rates of menstrual irregularity, are more regularly visited by their gynecologist, ask more questions about cancer and are more prone to adjustment disorder. We conclude that although the pathophysiological basis of dysmenorrhea can purely be attributed to organic and molecular landmarks the expression of pain and reaction to it is personality dependent.