Dysmenorrhea refers to intense pain and cramping during menstruation. While dysmenorrhea does not affect fertility, it may be symptomatic of a fertility issue. Most women with dysmenorrhea have primary dysmenorrhea, which is caused by natural pelvic pain during menstruation. This type of dysmenorrhea is not associated with fertility. One in four women with dysmenorrhea, however, has secondary dysmenorrhea, which means the pain and cramping is due to an underlying gynecological cause. Some of these causes, such as pelvic inflammatory disease and ovarian cysts, may lead to infertility. If a few months have passed and over-the-counter medications and relaxation techniques have not resolved your symptoms, talk to your doctor to see if an underlying condition is responsible.