Painful menstrual periods Health Article

Call your health care provider if

Call your doctor right away if:

• Vaginal discharge is increased in amount or is foul-smelling.
• You have a fever.
• Your pain is significant, your period is more than one week late, and you have been sexually active.

Also call your doctor if:

• Self-care measures don't relieve your pain after 3 months.
• You have an IUD that was placed more than 3 months ago.
• You pass blood clots or have other symptoms with the pain.
• Your pain is severe or sudden.
• Your pain occurs at times other than menstruation, begins more than 5 days before your period, or continues after your period is over.

What to expect at your health care provider's office

Your doctor will examine you, paying close attention to your pelvis and abdomen, and ask questions about your medical history and current 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?

Diagnostic tests that may be performed include:

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

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.

Surgery may be necessary for women who are unable to get enough pain relief or pain control. Procedures may range from removal of cysts, polyps, adhesions, endometriosis, or fibroids to a complete hysterectomy.

Prescription medications may be used for endometriosis.

For pain caused by an IUD, your doctor may recommend:

• Waiting until the end of the first year of use. Painful periods go away in many women during this time.
• Have the IUD removed and use alternative birth control methods.
• Change to an IUD that contains progesterone, which usually makes the periods lighter and less painful.