Girls who are ignorant of their body and normal reproductive processes may assume that menstruation is evidence of a disease or even a punishment for misbehavior. Girls who are not taught to think of menstruation as a normal body function may experience considerable shame and a feeling of being unclean during their first menstruation. Even when menstruation is finally recognized as a normal process, feelings of uncleanliness may linger well into adulthood. In recent years, however, better education about anatomy and physiology has led to acceptance of menstruation. In fact, many women have come to view menstruation with pride as a distinctly female process.
Some families even have a private celebration to honor the maturation of the young woman.
Nonetheless, many women experience physical discomfort several days before their menstrual period. About half of all women suffer from dysmenorrhea, which is a painful menstruation. This is especially common during the early adult years. Some women experience quite intense discomfort, including cramps caused by contractions of the smooth muscles of the uterus, headaches, Mittelschmertz or pain in the midsection, nervousness, fatigue, stuffy nose, and crying spells. In its most severe form, often involving depression and anger, this condition is known as premenstrual syndrome or PMS, and may require medical attention.