Menstrual-cramp guide
Short-course prescription anti-inflammatory treatment for a familiar, cyclic primary-cramp pattern after pregnancy, secondary causes, and medication risks are screened out.
Start online
Primary dysmenorrhea typically starts just before or with a period and improves over the first few days. New, worsening, non-cyclic, or otherwise atypical pelvic pain may reflect endometriosis, fibroids, adenomyosis, infection, or pregnancy and needs an in-person evaluation instead.
If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.
Quick facts
Common symptoms
May fit online care
Look for another care setting
What to have ready
What happens next
Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.
Your physician
Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.
Anti-inflammatory treatment works best when started just before or at the first sign of predictable cramps and taken on schedule during the painful days. Waiting until pain is severe can make it harder to control.
The usual lower-cost choice is naproxen 500 mg every 12 hours with food during the painful days. Mefenamic acid is another choice. Neither is taken with ibuprofen or another NSAID (a nonsteroidal anti-inflammatory medicine), and mefenamic acid is limited to 5 days per cycle.
Seek gynecology care for a new or worsening pattern, pain between periods, pain during sex, abnormal bleeding, infertility concerns, infection symptoms, or failure of both a proper scheduled NSAID trial and hormonal treatment. Severe one-sided pain with possible pregnancy, dizziness, fainting, shoulder-tip pain, or heavy bleeding is an emergency.
Hormonal birth control can make periods lighter or stop them for some people. That is handled in our separate birth control visit, which checks blood pressure, clot risk, migraine history, smoking, pregnancy, and medicine interactions.
Read the birth-control guideNot quite what you have? Here are other conditions we treat.
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