When pelvic pain is caused solely by a menstrual cycle, it's called primary dysmenorrhea (painful menstruation). When pelvic pain has another underlying cause, like endometriosis or uterine fibroids, it's called secondary dysmenorrhea.
• Pain cycles may begin 6 to 12 months after getting your first menstrual period
• Pain may start 2 to 3 days before you get your period or when you start bleeding
• Pain may last 8 to 72 hours
• Pain may decrease as you get older
• Pain may be unusually severe and worse with time
• Pain may last longer than 2 to 3 days
• Pain may start later in life (like after age 25)
Clinicians usually recommend seeing a healthcare provider in person, likely for a pelvic exam, if you haven't experienced period pain relief after 3 to 6 months of NSAID or hormonal contraceptive treatment. They also recommend seeing a doctor if you have other symptoms of secondary dysmenorrhea, like pain during sex, pelvic pain that isn't related to your menstrual cycle, or abnormal bleeding.