Menorrhagia is a common symptom and is often associated with dysmenorrhea. The effect of transcervical resection of the endometrium (TCRE) on dysmenorrhea associated with menorrhagia was investigated in a prospective study. Ninety consecutive women were monitored before surgery and for a period of up to 12 months after resection. The amount of pelvic pain experienced was scored daily on a scale of 0-3, and was timed in relation to menstruation. There was a significant decrease in the level of pain experienced during menstruation and overall during the menstrual cycle (p < 0.001), but not in the premenstruum. The effect on pain was immediate and was maintained throughout the follow-up period of the study. The presence of adenomyosis or leiomyomata in the surgical specimen did not influence the beneficial effect on pain. Based on these findings, dysmenorrhea during menstruation should not be a contraindication to transcervical endometrial resection in women with menorrhagia.