If your cramps disrupt your life for several days a month or suddenly change in location or severity from your normal monthly experience, schedule an appointment with your gynecologist. If your doctor thinks it is necessary, you will receive a pelvic exam (with a pap smear) to check for abnormal reproductive organs and infections.

If you are suffering from secondary dysmenorrhea, the underlying cause of your cramping must be treated. This may include antibiotics to treat infections or surgery to remove offending tissues. Some of the conditions that cause secondary dysmenorrhea are:

• Pelvic inflammatory disease (PID): An infection found in female reproductive organs that is usually attributed to sexually transmitted bacteria.
• Adhesions: Abnormal fibrous attachments between organs.
• Andenomyosis: The cells of the inner uterine lining invade its muscular wall (a benign condition).
• Endometriosis: A painful condition in which cells from the lining of the uterus become implanted outside of it, usually on the ovaries, fallopian tubes, or pelvis lining.
• Using an intrauterine device (IUD): A small, plastic, T-shaped birth control device that is inserted into the uterus.
• Uterine fibroids and uterine polyps: Benign (noncancerous) tumors and growths protruding from the uterus lining.

Other tests may be performed to identify the cause of secondary dysmenorrhea, such as a hysteroscopy, laparoscopy, or some sort of imaging test.

• In a hysteroscopy, a special instrument is inserted through your vagina to examine your uterus and cervical canal.
• In a laparoscopy, your doctor makes small incisions in your abdomen and inserts an instrument with a small camera lens to get a close up look at your pelvic cavity.
• Imaging tests are non-invasive ways of looking inside your body. Computerized tomography, also known as a CAT or CT scan is a highly advanced descendant of the X-ray. Magnetic resonance imaging (MRI) uses radio waves, magnetism, and a computer to get internal images.