INTRODUCTION Primary dysmenorrhea is defined as pain during the menstrual cycle, recurrent cramping type in the absence of an identifiable cause. It can negatively affect the quality of life of those who suffer from it. The objective is to determine the association between pain intensity in primary dysmenorrhea and the impact on quality of life related to menstrual health, presenteeism, and sexual function in adult Chilean women. METHODS Cross-sectional observational study. A sample of 392 women with painful menstruation in the last six months. A self-reported survey was distributed on social media between January and June 2024, consisting of sociodemographic questions, pain intensity and perception, the EQ5D-3L quality of life questionnaire, the Stanford Presenteeism Scale, and the Women's Sexual Function Questionnaire adapted to the study. RESULTS The mean age was 29.2 +/-8.2 years, and the mean pain intensity was 6.7 +/-2.04 points. High pain intensity was associated with greater impairment. Those with severe or extreme pain experienced a significant impact on their quality of life related to menstrual health. Among the compromised aspects, the most notable were the performance of usual activities (OR 9.99), lower work performance (lack of concentration), and decreased social activities. The most common mitigation measures used were local heat (96.7%), herbal teas (63.5%), and medication (90%). CONCLUSIONS Dysmenorrhea impacts different dimensions of quality of life. Despite its high prevalence, it is often underestimated, and women often normalize pain by employing various methods to mitigate it. The concept of menstrual health is a subjective and multidimensional experience. The results suggest the importance of comprehensively updating the management of dysmenorrhea and incorporating new studies on economic evaluation, prevalence, and self-image to delve deeper into the subject.