Primary dysmenorrhea is pain with your periods that is not caused by any other medical problem. Prostaglandins, chemicals produced by your body that cause your uterus to contract, are thought to cause this pain.

The best treatments for menstrual cramps are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) -- Such as ibuprofen or naproxen. These should be taken as soon as symptoms start, or even several days before your periods start, and continued for one to three days. An NSAID should be tried for a few cycles before deciding if it works for you or not.
• Birth control pills -- These can be used if you need birth control, or if the pain is severe and doesn't get better with NSAIDs. Birth control pills may take several months before they really work well for this purpose.

Don't forget to maintain a healthy lifestyle, which includes eating a balanced diet and getting enough exercise and sleep.

There are other over-the-counter medications for menstrual symptoms. Some include pain medication, such as acetaminophen, plus a mild diuretic for fluid retention or an antihistamine for tension and irritability. Ask your doctor if these are right for you.

Secondary dysmenorrhea is pain with your periods that is actually caused by a specific medical problem such as endometriosis, an ovarian cyst or pelvic inflammatory disease (a sexually transmitted disease). Your doctor will need to do a pelvic exam to check for these conditions.

Sometimes menstrual pain is severe and doesn't respond to any sort of treatment. In those cases your doctor may recommend a procedure called a diagnostic laparoscopy. In that procedure, small incisions are made in your abdominal wall while you are under anesthesia. Special miniature cameras are inserted into your abdomen so your doctor can look directly at your pelvic organs.