Objectives: This narrative review analyzes current knowledge on the pathophysiology of dysmenorrhea and the different therapeutic options currently available for adolescents and young women. Mechanism: Dysmenorrhea is the most common gynecological disorder among adolescents and young adult women. This condition can have a strong negative impact on the quality of life involving both physical and mental health. Although physiopathological mechanisms have been hypothesised there is still a poor understanding of this condition. Findings in Brief: The prevalence of dysmenorhea is quite variable depending on different studies but overall high. Nonsteroidal anti-inflammatory drugs are the preferred initial treatment; hormonal therapy, alone or in combination with non-hormonal treatments, is generally the next treatment option. There are evidences of the efficacy of non-pharmacological treatment, thus, these must be considered. Grading the intensity of pain would be of importance to address therapeutic choices and treatment options. Conclusions: To date there are yet many gaps in the understanding of dysmenorrhea that to do not allow any real personalized treatment. These gaps need to be filled in order to improve and target future treatment.