Menstrual pain, or dysmenorrhea, can cause physical discomfort and mood swings, potentially impacting the attitudes of female nursing students toward marriage. Effective emotion regulation strategies are essential for managing stress and shaping their perspectives on marriage. This study sought to investigate the relationship between dysmenorrhea, emotional regulation skills, and attitudes toward marriage among female nursing students. A cross-sectional survey was conducted using a stratified sample of 504 female nursing students from four academic years. The study used a combination of the Working Ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD) Questionnaire, the Marital Attitude Scale, and the Emotion Regulation Questionnaire to assess various factors among the participants. The Pearson correlation coefficient was utilized to examine the relationships among the three primary variables. Additionally, linear regression analysis was employed to forecast attitudes toward marriage based on factors such as dysmenorrhea, residence, family type, regularity of the menstrual cycle, and age at menarche. The findings of the study are significant, revealing a negative correlation between dysmenorrhea and marital attitudes (r = -0.105, p = 0.019). Dysmenorrhea exhibited minimal and non-significant correlations with emotion regulation strategies, including cognitive reappraisal (r = -0.006, p = 0.898) and expressive suppression (r = 0.013, p = 0.774). In contrast, marital attitudes significantly influenced emotion regulation (β = -0.169, p < 0.001). Moderation analyses indicated significant effects of various factors on marital attitudes, including residence (β = -0.5136, p = 0.0478), family type (β = 5.9923, p = 0.0060), regularity of the menstrual cycle (β = 6.1262, p = 0.0014), and age at menarche (β = 1.5521, p = 0.0491). A significant negative correlation between dysmenorrhea and certain attitudes, specifically optimistic and realistic marital attitudes, was found. This indicates that higher levels of dysmenorrhea are associated with less favorable perspectives in these domains. Additionally, the study demonstrates that negative marital attitudes were linked to poorer emotional regulation. This suggests that individuals with more pessimistic views about marriage may face challenges in effectively managing their emotions. These results underscore the intricate connections between physical health, attitudes, and emotional well-being. They highlight the need to address dysmenorrhea within nursing education and practice, considering its broader psychological impact.