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Menstrual Pain

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When to Seek Medical Care

Most women have significant improvement with home care. However, a woman should call her health care provider in these situations:

  • Menstrual cramps continue to be painful for longer than usual.
  • The pain is suddenly worse or different from what she may have experienced before.
  • Bleeding is excessive, requiring more than one pad or tampon per hour.
  • Signs of infection, such as fever, chills, and body aches, are present at the time of the period.
  • Menstrual cramps began in a woman older than 25 years.
  • The woman suspects she may be pregnant and any of these symptoms occur.

The woman's doctor can help her manage most symptoms. However, she should go to a hospital's emergency department if any of the following problems occur:

  • She faints.
  • She experiences repeated dizziness when standing up.
  • A sudden, intense pelvic pain causes her to double over.
  • Tissue is passed in the menstrual flow. Tissue often appears silvery or grayish.
  • She thinks she might be pregnant and has menstrual-type pain.

Exams and Tests

The doctor will ask for medical history details, as well as questions about the menstrual pain and symptoms. Be prepared to discuss these details:

  • The timing of the cramps in relation to the start of the period
  • Type of pain
  • Age when the cramps first started
  • Any recent change in the pain
  • Irregular periods
  • Vaginal discharge
  • Pain with intercourse
  • Infertility
  • History of pelvic infections
  • Age when first period occurred
  • Current medications
  • What things seem to improve or worsen the pain

The doctor will perform a pelvic exam to check for any problems. If there are concerns about a possible infection, cervical cultures and a blood test will confirm the diagnosis. Additional tests may be ordered.

  • The doctor may order a pregnancy test if the periods are irregular or the woman is not using birth control regularly.
  • An ultrasound exam is necessary if the doctor discovers any abnormal masses during the pelvic exam or there is a new onset of menstrual pain.
  • A doctor may recommend a laparoscopy, which is a minor surgical procedure allowing the doctor to look directly into the pelvic cavity with a fiber-optic scope. This is an outpatient procedure using very small incisions.
  • A hysteroscopy is another possible procedure. By inserting a hysteroscope (thin lighted tube) through the vagina, the doctor can see the cervix and the inside of the uterus without incisions. This can be done in a doctor's office or a hospital.
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