Premenstrual syndrome (PMS) profoundly affects a woman’s quality of life, causing physical and emotional distress. This study aimed to describe premenstrual pains in reproductive-age women (18–45 years). The main group included 136 women with moderate and severe PMS; the control group consisted of 136 healthy females with only sporadic premenstrual symptoms. We encouraged the participants to rate their symptoms using the menstrual distress questionnaire by Rudolf H. Moos and to keep a symptom diary over the course of 3 menstrual cycles. We also used the visual analogue scale, which allows estimating pain intensity. In the main groups the participants scored an average of 47.14 ± 3.67 total points on the distress questionnaire (moderate PMS), whereas the controls scored 10.28 ± 1.94 points (mild PMS) (p < 0.05). Among the most typical premenstrual symptoms observed in the main group and the controls were: headaches (66.17 % vs. 22.79 %, respectively; p < 0.001); breast tenderness/pain (83.08 % vs. 49.26 %, respectively; p < 0.001); pelvic pain (70.58 % vs. 35.29 %, respectively; p < 0.001); bloatedness/stomach ache (64.7 % vs. 25.73 %, respectively; p < 0.001), and muscle/joint pain (51.47 % vs. 21.32 %, respectively; p < 0.001). The average number of premenstrual symptoms observed in the main group was 5.62 ± 0.92, of which 2.47 ± 0.68 represented intense pains determining PMS severity. The results of our study suggest that premenstrual symptoms should be monitored prospectively over at least 2 consecutive menstrual cycles using a diary, because retrospective data are unreliable.