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
- 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.