Birth control pills may also decrease cramping with periods. Other conditions causing pain with periods are abnormal, and may require treatment. Submucous myomas are fibroid tumors on the inside of the uterus. They can act as a foreign body, cause the uterus to contract to try to expel them. They can often be removed without major surgery using an instrument called a resectoscope.
Adenomyosis is common cause of severe menstrual pain, and is often confused with fibroids.
An adhesion is where two organs stick together. Pelvic pain can occur when adhesions are stretched. For example, if an ovary is stuck to the intestine, ovulation may stretch these adhesions and cause pain. On the other hand, many adhesions cause no pain at all. Most adhesions can be freed during laparoscopy, but they can reform.