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Background: Menstrual discomfort is common among women of reproductive age and can be debilitating. The accuracy of self-report of menstrual discomfort is unknown., Methods: At enrollment into the DES Reproductive Health Study in 1990, premenopausal women classified their frequency of any menstrual discomfort as "always," "often," "sometimes," and "never." Subsequently, women provided daily diary information for up to 6 months regarding any menstrual discomfort and medication used for menstrual pain., Results: A total of 324 women contributed data on 4 or more menstrual cycles in the prospective study. At enrollment, 10% had reported never having menstrual discomfort. Of these, 65% recorded at least 1 day of menstrual discomfort during follow-up. For the 27% who had reported always having discomfort, 88% recorded discomfort in all cycles. The enrollment statement of discomfort was more strongly correlated with the percentage of cycles in which women took medication for menstrual pain; respondents who said they never had menstrual discomfort reported use of pain medication in 3% of cycles; sometimes, 36%; often, 67%; and always, 92%. The average number of days per cycle with prospectively recorded menstrual discomfort was also correlated with the enrollment response., Conclusions: A single question regarding frequency of menstrual discomfort was positively correlated with prospectively recorded menstrual discomfort and especially with pain requiring medication.

We sought to determine the effects of cigarette smoking on menstrual function using prospectively recorded menstrual data in a cohort study of women ages 37-39 years. Eighty-three current smokers and 275 nonsmokers provided menstrual data for analysis. Smoking was associated with decreased duration of bleeding, increased daily amount of bleeding (subjectively scored), and increased duration of dysmenorrhea. These effects were most pronounced in the heaviest smokers. Smoking was not associated with cycle length, but we found some evidence for increased variability of cycle length among heavier smokers. We conclude that cigarette smoking affects menstrual function, most importantly by increasing the duration of dysmenorrhea.