Primary Dysmenorrhea (Menstrual Cramps)
These symptoms include:
Menstrual cramps are generally diagnosed via a focused medical history and a routine pelvic exam that shows a lack of abnormal findings.  Secondary causes, such as endometriosis, can be evaluated with ultrasound but sometimes require further testing or evaluation by a specialist. Visit the American College of Obstetricians and Gynecologists to learn more about diagnosing primary dysmenorrhea and reducing menstrual pain.
Over-the-counter Nonsteroidal anti-inflammatory drugs (NSAIDs) are the go-to treatment for menstrual cramps as they lower prostaglandin production and thus reduce cramping. Check with your healthcare provider before taking NSAIDs.
For patients with significant primary dysmenorrhea (cramps not caused by another disease process), occasionally oral contraceptive pills may be recommended by a doctor as they may reduce episodes of cramping as well.
Seek medical help if menstrual pain is not relieved by NSAIDs or other self-care practices, cramps happen when you are or may be pregnant, cramps suddenly become worse, you are over 25 years of age and get severe cramps for the first time, cramps are accompanied by a fever, or you experience pain not around the time of menstruation.
Dieting to lose weight, skipping meals, and a low intake of antioxidants have been associated with a greater risk of menstrual cramps. Higher intakes of fiber, fruits, and vegetables, and dairy products have been associated with reduced risk. It should be noted, though, that studies vary in the way they assess dietary habits and in their methods for measuring menstrual pain, so more evidence is needed to support specific diets and foods for dysmenorrhea.
Elevated prostaglandin concentrations triggered by the drop in progesterone before menstruation are thought to be the main cause of menstrual cramps. There is some less certain evidence that elevated vasopressin concentrations may also play a role in this condition.