Increased risk is associated with younger age, IUD use, multiple sexual partners, and past medical history of any of the conditions associated with secondary dysmenorrhea. If the pain is severe. The medical history will be obtained and a physical examination performed. The physical examination will probably include a pelvic examination. If not needed for contraception, they may be discontinued after 6 to 12 months.
Many women note continued freedom from symptoms despite stopping the medication.
Surgery may be indicated for those women unable to obtain adequate pain relief or control. Procedures may range from removal of cysts , polyps, adhesions , or fibroids to complete hysterectomy in cases of extreme endometriosis . Prescription medications may be used for endometriosis. For pain caused by IUD, removal of the IUD and alternative birth control methods may be needed. Antibiotics may be indicated for pelvic inflammatory disease .