Copyright © 1991 by Andover Medical Publishers, Inc. Women with spinal cord injury (SCI) may have unique complications that have not yet been well described because their presence in the SCI population is so low compared with that of males. In particular, reproductive health complications unique to women with SCI are poorly understood. In this case report, an apparent relationship between autonomic dysreflexia and the menstrual cycle of a 38-year-old woman with paraplegia is described. The autonomic dysreflexia disappeared after total hysterectomy. Possible mechanisms for these relationships are discussed. The case illustrates the need for more quantitative investigation of the similarities and differences between the reproductive health cycle of women with SCI and their able-bodied counterparts, so that more effective care can be provided.