Your doctor will examine you and ask questions about your medical history and symptoms, such as:
- 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?
Tests and procedures that may be done include:
- Complete blood count (CBC)
- Cultures to rule out sexually transmitted infections
Treatment depends on what is causing your pain.
Your health care provider may prescribe birth control pills to relieve menstrual pain. If you don't need them for birth control, you can stop using the pills after 6 to 12 months. Many women continue to have symptom relief even after stopping the medication.
Your doctor may prescribe prescription pain medications. For pain caused by an IUD, your doctor may recommend:
- Waiting 1 year after it was placed. Painful periods go away in many women during this time.
- Removing the IUD and using other types of birth control.
- Changing to a different type of IUD that contains progesterone, which usually makes the periods lighter and less painful.
Surgery may be needed if other treatments do not relieve your pain. Surgery may be done to remove endometriosis, cysts, fibroids, scar tissue, or your uterus (hysterectomy).