Nerve block or transection may be helpful when malignancies are inoperable but is of little use if they have metastasized. Nerve blocks can also be performed in some women with severe chronic pain syndromes of unknown etiology after workup. Cyclic pain may suggest a pelvic cause, but not all pain that occurs during the menstrual cycle has a pelvic cause. It may be due to disorders affecting other abdominal organs or psychosomatic or musculoskeletal disorders. The pain, although sometimes severe, resolves spontaneously.
Most women experience primary dysmenorrhea at some time during their life.
The pain is cramping or sharp and lasts the first few days of the menstrual period. It may radiate to the back, thighs, or deep pelvis. Occasionally, nausea or vomiting occurs. Adjunctive use of antidepressants relieves pain through peripheral neuroblockade and central stimulation. In its early stages, endometriosis causes cyclic pain, which starts several days before menses and continues through the first few days.