A survey of our case records reveals a number of significant features. For example, dysmenorrhoea is not, as is so often thought, restricted even in large part to single women and marriage of itself is rarely a cure for it. When marriage per se does appear to result in relief, it can probably be said to be due to relaxation from the mental and physical tension of unsatisfactory single life. It is hard to understand how marriage can alter any endocrine factors that might be responsible for the distress. It will be noted that a few women, indeed, have increased pain with post-marital menstruation, and this, too, is not to be rashly ascribed to adnexal infection. It is more likely an evidence of new mental strain. The mechanism of psychic control of menstruation and its disturbances is no less puzzling now than a century ago.
From Shute EV. Dysmenorrhoea. CMAJ 1940;42(2):149.