Menstruation - Painful

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What to Expect at your Health Care Provider's Office

Your health care provider will obtain your medical history and perform a physical examination, paying close attention to your pelvis and abdomen.

Your doctor will ask questions about your symptoms, such as the following:

• How old were you when your periods started?
• Have they always been painful? If not, when did the pain begin?
• When in your menstrual cycle do you experience the pain?
• Is the pain sharp, dull, intermittent, constant, aching, or cramping?
• Are you sexually active?
• Do you use birth control? What type?
• When was your last menstrual period?
• Was the flow of your last menstrual period a normal amount for you?
• Do your periods tend to be heavy or prolonged (lasting longer than 5 days)?
• Have you passed blood clots?
• Are your periods generally regular and predictable?
• Do you use tampons with menstruation?
• What have you done to try to relieve the discomfort? How effective was it?
• Does anything make the pain worse?
• Do you have any other symptoms?

Diagnostic tests that may be performed include:

• Blood tests including CBC
• Ultrasound
• Dilation of the cervix
• Laparoscopy
• Cultures (may be taken to rule out sexually transmitted diseases such as gonorrhea, primary syphilis, or chlamydia infections)

Birth control pills may be prescribed to alleviate menstrual pain. If not needed for birth control, they may be discontinued after 6 to 12 months. Many women note continued freedom from symptoms despite stopping the medication.

Surgery may be necessary for women who are unable to obtain adequate pain relief or pain control. Procedures may range from removal of cysts, polyps, adhesions, or fibroids to complete hysterectomy in cases of extreme endometriosis.

Prescription medications may be used for endometriosis. For pain caused by an IUD, removal of the IUD and alternative birth control methods may be needed.

Antibiotics are necessary for pelvic inflammatory disease.