This study sought to describe and compare adherence to the Mediterranean diet and consumption of local foods from the Huelva region among Spanish university women in relation to menstrual pain and other menstrual characteristics. This cross-sectional study included 311 health science students. The study variables were sociodemographic and gynecologic characteristics, adherence to the Mediterranean diet using the KIDMED questionnaire, alcohol consumption (SDU) and consumption of local food. A descriptive bivariate analysis and multiple binary regression were performed for menstrual pain. Up to 55.3% of participants had moderate adherence to the Mediterranean diet and only 29.6% had high adherence. Women with low adherence had longer menstrual cycles ( < 0.01). Eating less than two pieces of fruit per day (OR = 3.574; 95%CI = 1.474-8.665; < 0.05) and eating pulses more than one day a week (OR = 2.320; 95%CI = 1.006-5.348) raised the probability of suffering menstrual pain. A positive correlation between SDU and cycle length was identified ( = 0.119, = 0.038), and menstrual bleeding was lower in women who consumed olive oil daily ( = 0.044). In conclusion, the Mediterranean diet, alcohol consumption and consuming typical foods from southern Spain appear to influence cycle length, menstrual flow and menstrual pain. Further research is necessary to confirm and expand these findings.