Most healthy women experience menstrual cramps during menstruation. However, if the menstrual cramps disrupt daily life for several days a month, or if a woman is older and suddenly starts experiencing painful menstruation, it is important that she see a physician, preferably a gynecologist.

A physician will compile a patient’s medical and menstrual history and perform a physical examination, including a pelvic exam. During the pelvic exam, a physician checks for any abnormalities in the reproductive organs and looks for signs of infection.

To rule out other conditions or identify the underlying cause for the painful menstruation (dysmenorrhea), a physician may recommend diagnostic tests that include:

• Blood tests. Laboratory analysis of blood to check for hormone levels or any condition that my affect normal body functions. In addition, if heavy menstrual periods are one of the symptoms, a physician may order a complete blood count (CBC) to determine if iron deficiency (anemia) is present.
  
  
• Tissue sampling. A physician may perform an endometrial biopsy by removing a sample of cells from the lining of a woman’s uterus for laboratory analysis.
  
  
• Imaging tests. Noninvasive tests that allow a physician to look for abnormalities inside a woman’s pelvic cavity, such as:
  
  
• • Ultrasounds. Tests that use sound waves to produce images of the shape and outline of various tissues and organs in the body. Ultrasounds can reveal ovarian cysts or abnormalities in a woman’s reproductive system. For a more thorough examination, a physician may order a transvaginal ultrasound.
    

• Hysteroscopy. During this procedure, a physician inserts a viewing instrument through the vagina and cervical canal to examine the cervix and the inside of the uterus.
  
  
• Hysterosalpingogram. During this procedure, a physician injects a contrast medium (special dye) through a woman’s cervix to highlight the uterine cavity and fallopian tubes for viewing on x-ray images.
  
  
• Laparoscopy. During this surgical procedure, a physician makes tiny incisions in a woman’s abdomen and inserts a fiber-optic tube with a small camera lens to view the pelvic cavity.

In most cases, menstrual cramps are the result of a normal menstrual cycle and do not require extensive treatment. However, if an underlying condition is diagnosed (e.g., pelvic inflammatory disease or endometriosis), treatment of the condition can often result in the alleviation of the menstrual cramps.