Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen or naproxen, usually relieve and/or reduce menstrual pain effectively. In addition, there are a number of OTC products specifically designed for menstrual cramps and discomfort. NSAIDs may be more effective if taken one or two days before a menstrual period begins and continued for a couple of days after it begins. In addition, soaking in a hot bath or using a heating pad on the abdomen can help ease menstrual cramps.

For severe cramps that cannot be relieved with use of NSAIDs or OTC medications, prescription anti-inflammatories (e.g., diclofenac, indomethacin) may alleviate pelvic pain. In addition, birth control pills that contain estrogen in a low dose plus progestin may be prescribed to suppress the release of eggs from the ovaries (ovulation). Currently, there are special (extended-cycle) birth control pills available that reduce the number of menstrual periods to only four a year.

In addition, the Food and Drug Administration (FDA) is currently reviewing another form of oral contraceptive pills that eliminate menstrual cycles altogether. Initial clinical trials have found the new pills to be as effective in preventing pregnancy as other forms of oral contraception as well as helping alleviate symptoms such as severe menstrual cramps, menorrhagia and menstrual migraines. The new extended birth control pills may be available by prescription soon. Patients interested in the new pill should consult with their gynecologist. If these treatments are ineffective for relieving pain, the menstrual symptoms may be caused by an underlying condition or abnormality.

If the pelvic pain is severe (dysmenorrhea) and is caused by an underlying condition, treatment will depend on the cause. For example, treatment could include antibiotics to combat infection for pelvic inflammatory disease or surgery to remove endometriosis lesions, fibroids or polyps. A narrow cervix (cervical stenosis) can be widened surgically if needed. However, this operation usually relieves the pain only temporarily.