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Tests and diagnosis
By Mayo Clinic staffIf your doctor suspects that your menstrual cramps are being caused by an underlying disorder, he or she may order one or more of the following tests.
Ultrasound
This painless test uses sound waves to visualize internal organs. It is often used to check for abnormalities in the uterus, cervix and fallopian tubes. A wand, lubricated with jelly, is pressed against your lower abdomen and the resulting image shows up on a video screen. In some cases, the wand may be inserted into your vagina, to check your ovaries and the lining of your uterus.
Computerized tomography (CT)
A CT scan combines X-ray images taken from many angles to produce cross-sectional images of bones, organs and other soft tissues inside your body. This painless procedure can provide more detail than can regular X-rays. A technician positions you on a narrow table that slides into the machine. You must lie still during the test, or the images will be blurry. CT scans usually take about 30 minutes.
Magnetic resonance imaging (MRI)
MRIs use radio waves and a powerful magnetic field to produce detailed images of internal structures. This painless procedure may be used to check for tumors or signs of endometriosis. You lie on a narrow table that slides into a tunnel inside the MRI machine. You must lie very still during the scans to avoid blurring the images.
MRIs often take at least an hour to complete, but they are divided into individual scans that usually last only a few minutes. The machine is very noisy during the scans, so you may need earplugs to block the banging sounds. If you are claustrophobic, you should talk to your doctor about taking medicine to help you relax during the test.
Hysteroscopy
In this procedure, your doctor inserts a thin, lighted tube through your vagina and cervix into your uterus. The hysteroscope works like a tiny telescope, allowing your doctor to look through it to check for such things as fibroids or polyps. Afterward, you may experience some cramping and spotting.
Laparoscopy
In this outpatient surgical procedure, your doctor views your abdominal cavity by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens. Laparoscopy can check for:
- Endometriosis
- Adhesions
- Fibroids
- Ovarian cysts
- Ectopic pregnancy
- Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: Etiology, diagnosis and management. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/123257502-3/810739333/1524/245.html#4-u1.0-B978-0-323-02951-3..50039-X--cesec1_1158. Accessed March 2, 2009.
- Banikarim C. Primary dysmenorrhea in adolescents. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
- Dysmenorrhea. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp046.cfm. Accessed March 2, 2009.
- Smith RP, et al. Pathogenesis, clinical manifestations and diagnosis of primary dysmenorrhea in adult women. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
- Endometriosis and adenomyosis. In: Kumar V, et al. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, Pa.: Elsevier Saunders; 2005. http://www.mdconsult.com/das/book/body/123257502-5/810836639/1249/260.html#4-u1.0-B0-7216-0187-1..50026-2--cesec79_3198. Accessed March 2, 2009.
- Peipert JF, et al. Complications of pelvic inflammatory disease. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
- Ultrasound imaging of the pelvis. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=pelvus. Accessed March 3, 2009.
- CT: Abdomen and pelvis. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=abdominct. Accessed March 3, 2009.
- MRI of the body (chest, abdomen, pelvis). Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=bodymr. Accessed March 3, 2009.
- Hysteroscopy. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp084.cfm. Accessed March 3, 2009.
- Laparoscopy. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp061.cfm. Accessed March 3, 2009.
- Smith RP, et al. Treatment of primary dysmenorrhea in adult women. http://www.uptodate.com/home/index.html. Accessed March 3, 2009.
- Dysmenorrhea. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-2450-7..50117-1--cesec17&uniq=123506366&isbn=978-1-4160-2450-7&sid=811308126#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-2450-7..50117-1--cesec17%3Btype%3DbookPage%3Bisbn%3D978-1-4160-2450-7. Accessed March 3, 2009.
- Mind-body medicine: An overview. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/whatiscam/mind-body/mindbody.htm. Accessed March 3, 2009.
- An introduction to acupuncture. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/introduction.htm. Accessed March 3, 2009.
- Nasir LS. Dysmenorrhea. In: Rakel RE, et al. Conn's Current Therapy. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/123506366-5/811342293/1621/527.html#4-u1.0-B978-1-4160-4435-2..50267-3--cesec6_4271. Accessed March 3, 2009.
