Most women who have period pain find it's mild enough to treat at home. However, if your periods are causing you severe pain, contact your GP for advice.

Also contact your GP if you have:

• a fever
• sudden and severe pain in your abdomen
• a large amount of blood clots in your period
• thick or foul-smelling vaginal discharge

When you visit your GP they will look at your medical history and ask you to describe your symptoms. They may also ask about your menstrual cycle and sexual activity.

Try not to feel embarrassed or awkward when talking to your GP about this. They need to know this information to help determine the cause of your period pain. It will allow them to provide the most appropriate treatment for your pain.

Pelvic examination

Although most cases of period pain are not caused by an underlying condition, your GP may feel it necessary to carry out a physical examination so any other conditions can be detected or ruled out. Usually, the physical examination will involve your GP examining your pelvic area.

During a pelvic examination for period pain, your GP will need to examine you internally. This will involve your GP inserting gloved, lubricated fingers into your vagina to feel for any abnormalities in your womb or ovaries.

A pelvic examination will only be carried out by a qualified health professional, such as a GP or a gynaecologist (a specialist in the female reproductive system).

This type of examination will not be carried out without your consent. You'll also be asked if you'd like to have a friend or relative present, or another health professional, such as the practice nurse, to act as a chaperone.

Referral

If your period pain does not respond to treatment, or your GP suspects an underlying condition, you may be referred to a specialist. In most cases, you will be referred to a gynaecologist.

To determine what might be causing your period pain, your gynaecologist may have to carry out a series of tests and procedures. Some of these are included below.

• a urine or blood test
• pelvic ultrasound – an ultrasound scan uses high-frequency sound waves to produce an image of the inside of your body; it is a painless procedure, and will allow your specialist to detect any abnormalities in your reproductive organs
• laparoscopy – under general anaesthetic, a small cut is made in your abdomen through which a fibro-optic telescope (laparoscope) is inserted; it can be used to look at your internal organs, as well as take samples of tissue (a biopsy)
• hysteroscopy – this test allows your specialist to look inside your womb using a fibro-optic telescope, which is carefully passed through your vagina and into the womb to look for any abnormalities