Background <p>Menstrual distress affects a substantial proportion of individuals of reproductive age and is associated with impaired quality of life and psychological comorbidities, yet validated German-language instruments for its assessment are lacking. The present study examined the reliability and validity of the German version of the Menstrual Distress Questionnaire (MEDI-Q), a 25-item self-report instrument previously validated in Italian, English, and Indonesian.</p> Methods <p>A community sample of <i>N</i> = 1,035 German-speaking women completed the MEDI-Q alongside the DASS-21, the PAF10, and a global rating of menstrual symptom severity. Internal consistency, test-retest reliability, convergent validity, and structural validity via confirmatory factor analysis (CFA) were examined.</p> Results <p>Internal consistency was high (α = 0.839, ω = 0.844) and test-retest reliability acceptable over a naturalistic long-term interval (ICC = 0.823). MEDI-Q Total Score, MS, and MSD correlated negatively with age and positively with psychological distress, premenstrual symptoms, and global symptom severity, while the Menstrual Specificity Index (MESI) showed a significantly weaker and statistically distinct association with the global rating. Among three competing factor models, the theoretically proposed 5-factor structure showed the best relative fit, though none of the models reached conventional fit thresholds (CFI/TLI ≥ 0.90), and structural validity warrants further investigation. Applying the proposed cut-off of ≥ 20, 36.4% of the community sample exceeded this threshold.</p> Conclusions <p>The German MEDI-Q represents a psychometrically adequate instrument for standardised assessment of menstrual distress in German-speaking contexts, facilitating cross-cultural comparisons across four language versions, while structural validity remains unestablished and the instrument should be interpreted as a total score measure pending further investigation.</p>