“Why are girls still missing so many days of school because of their menstrual cycles?” tweeted First Lady Michelle Obama in 2016. More than 90% of adolescents and 50% of menstruating women worldwide experience pain with menses, with 10% to 20% reporting severely painful cramps several days each month, affecting school and work. Primary dysmenorrhea (menstrual pain without an underlying medical condition) is also associated with enhanced pain sensitivity and temporal summation in adolescents and adult women, suggesting a central pain process. There are data that treating dysmenorrhea, as the first chronic pain disorder many women experience, may be the key to unlocking—and possibly preventing—chronic pain later in life. This session will focus on the evidence that dysmenorrhea is a primary risk factor for chronic pelvic pain and significantly and negatively impacts women across all ages. We will review early screening, keys to the clinical evaluation, and treatment modalities with an emphasis in adolescents.