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.
Medications for Menstrual Pain
The best way to relieve painful menstrual cramps is to take an anti-inflammatory medication. Ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and ketoprofen (Orudis) are available without a prescription and are effective at blocking the effects of prostaglandins.
- These drugs work better if taken before the start of menstruation and can be continued as long as needed. If one type does not relieve the pain, try another, because these medications do not work the same in everyone.
- Anti-inflammatory drugs like this can be harsh on the stomach. If there is a history of kidney problems or stomach problems (such as ulcers or reflux), consult with your health care provider before starting this type of medication. Taking the pills with meals may help prevent upset stomach.
- Starting some form of hormonal birth control is another option to control or stop menstrual cramps. This can be a pill, an injection, a transdermal patch, or a hormone-containing IUD. These methods can reduce or eliminate the menstrual flow leading to less pain.
Menstrual Pain Home Remedies
If anti-inflammatory medicine is not an option or if additional relief is needed, the following strategies may help relieve menstrual cramps:
- A heating pad to the pelvic area
- Massage to the back and lower abdomen
- Exercise, especially prior to the start of a period
- Thiamine (100 mg daily)
- Low-fat vegetarian diet
- Calcium (1,200 mg daily)