Treatment of painful menstruation by obstetrician-gynecologist Irina Ivanovna Kulbach in Dnipro.

During painful menstruation, women often report severe cramps, disruption of their usual cycle rhythm, deterioration of overall well-being, and discomfort that interferes with daily life.

The physician conducts a thorough clinical assessment, reviews the complaints and medical history, and, if necessary, orders additional examinations to accurately determine the cause.

The patient receives a clear plan for further actions: recommendations for initial measures, necessary diagnostic steps, and monitoring of the condition's progress.

Special attention is given to differential diagnosis of the causes and ongoing management to timely adjust treatment and prevent exacerbations.

When to See a Doctor

Painful periods can manifest in different ways and be accompanied by various sensations. It is important to pay attention to changes in the nature of the pain and other symptoms, as well as how the condition affects your life. You should make an appointment with an obstetrician-gynecologist if during painful periods you notice:

• persistent or increasing cramps in the lower abdomen
• pain that interferes with daily activities or work
• prolonged feelings of discomfort and heaviness in the pelvic area
• irregularity or changes in the length of the menstrual cycle
• dizziness or weakness during your period
• worsening overall well-being during menstruation
• repeated episodes of severe pain over several cycles
• no relief from remedies you have tried to ease the pain
• worsening symptoms after stressful situations or painful experiences
• pain appearing for the first time or a significant change in its nature
• symptom aggravation affecting sleep and mood
• the need to adjust treatment if previous measures have not helped

Even if the pain seems familiar to you, it is better to get a professional evaluation to rule out possible causes and find the best ways to relieve the condition. It is important not to delay a visit if symptoms affect your quality of life or occur frequently. Our clinic offers support at every stage of examination and treatment.

Emergency Conditions or When to See a Doctor Immediately

• Sudden onset of very severe pain in the lower abdomen
• Progressive worsening of condition with intense weakness and dizziness
• Combination of pain with heavy bleeding or blood-stained discharge
• Sudden high fever with chills and general weakness

If you experience these symptoms, do not wait for a scheduled appointment, seek urgent medical care. Our clinic offers home visits by a doctor for prompt examination and support.

Causes and Risk Factors of Painful Menstruation

Painful menstruation can have various causes that affect the onset and intensity of symptoms. Knowing the possible factors helps to understand what should be checked during a doctor's visit.

Main Causes / Mechanisms (briefly)

• increased contractions of the uterine muscles causing spasms
• inflammatory processes in the pelvic organs
• hormonal changes affecting the cycle and tissue sensitivity
• presence of minor structural changes in the uterus or ovaries
• impaired blood circulation in the pelvic area

Risk Factors

• age during the reproductive period
• hereditary predisposition to pain during menstruation
• high levels of stress and emotional strain
• irregular or painful menstrual cycles since adolescence
• overweight or significant weight fluctuations
• chronic inflammatory diseases of the female reproductive system
• sedentary lifestyle
• harmful habits, including smoking

Reversible Causes That Should Be Excluded

• infectious diseases of the pelvic organs
• treatable inflammatory processes
• correctable hormonal imbalances
• side effects of certain medications

Painful menstruation requires careful evaluation by a specialist to determine the causes and choose the optimal ways to relieve symptoms.

Diagnosis

Diagnosis of painful menstruation is aimed at identifying possible causes of the symptoms and developing a plan for further action. The doctor conducts a step-by-step assessment to help understand the exact source of discomfort and how to manage it.

Diagnostic Approach

• Taking medical history with attention to complaint history and menstrual cycle
• Physical examination to assess general condition and identify possible signs of problems
• Ordering basic laboratory tests as indicated
• Performing ultrasound examination of the pelvic organs if necessary
• Additional tests based on individual indications
• Analyzing results and discussing further treatment strategy

Typical Tests as Indicated

• Ultrasound examination (USG) of the pelvic organs
• Complete blood count and biochemical blood analysis
• Hormonal tests to evaluate the cycle
• Tests for inflammatory processes
• Additional methods recommended by the doctor if needed

What to Bring to the Appointment

• Records of previous examinations and test results
• List of medications and supplements being taken
• Menstrual cycle and symptom diary (if kept)
• Questions and notes about concerning symptoms

Diagnosis of painful menstruation requires a comprehensive approach and individualized consideration of each case.

Treatment

Treatment of painful menstruation is aimed at reducing discomfort and improving quality of life. The therapy plan is tailored individually, taking into account the characteristics of each patient and examination data.

Therapy Goals

• reduce the intensity of pain and cramps during menstruation
• correct possible causes affecting symptoms
• improve overall condition and the ability to perform daily tasks
• prevent complications and exacerbations

Main Treatment Approaches

• may include medication methods to relieve symptoms
• use of non-medication methods such as physiotherapy and supportive procedures
• therapy is individualized and built according to indications, considering the specifics of the body
• interventions may be applied if medically indicated
• emphasis on a comprehensive approach to improve condition and maintain health

What the Doctor Does

• selects and adjusts therapy depending on the patient's response
• takes into account concomitant diseases and possible risk factors
• monitors for side effects and adjusts treatment if necessary
• explains to the patient the criteria for evaluating therapy effectiveness
• coordinates interaction with other specialists if needed

What to Expect: Plan and Monitoring

• therapeutic effect is evaluated approximately after several cycles
• if no improvement is observed, the doctor adjusts the treatment plan
• follow-up visits are scheduled as indicated for control and therapy adaptation
• it is important to follow recommendations and regularly inform the doctor about the condition

To arrange an individual treatment plan, please schedule a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention of painful menstruation helps reduce the severity of symptoms and improve overall well-being. An individualized prevention plan is discussed with your doctor, taking into account your personal characteristics.

Main Primary Prevention Measures

• maintaining an active lifestyle with regular physical activity
• quitting smoking and reducing exposure to other harmful habits
• managing chronic diseases that may affect women's health
• reducing stress levels using available relaxation methods
• following a consistent sleep and rest schedule

Screening and Secondary Prevention / Regular Monitoring

• regular examinations by an obstetrician-gynecologist as indicated
• monitoring the menstrual cycle and any changes that occur
• undergoing tests recommended by your doctor to assess hormonal balance
• observing for possible inflammatory processes in the pelvic area

Practical Advice

• keep a diary of your menstrual cycle and symptoms to discuss with your doctor
• avoid exposure to cold and sudden temperature changes
• discuss stress triggers and methods to reduce stress with your doctor
• maintain a healthy diet with an adequate amount of nutrients
• seek medical attention promptly if new or worsening symptoms appear

Preventive measures for painful menstruation help support health and reduce discomfort, but require regular monitoring and an individualized approach.

Important to Know

Painful menstruation is a common issue that can significantly reduce quality of life. When discomfort arises, it is important not just to try to relieve the pain but to understand its cause. Early assessment helps choose the right approach and reduce potential risks. Managing the problem over time allows timely adjustments to treatment and takes overall health changes into account. Factors such as stress levels, physical activity, sleep quality, and accompanying illnesses can influence the severity of symptoms.

• It is important to identify the cause of the pain, not just relieve the symptoms
• Early consultation helps prevent complications and disease progression
• Ongoing monitoring allows treatment to be adapted according to condition
• Stress, physical load, and sleep disturbances can worsen pain manifestations
• Self-treatment can obscure the clinical picture and delay diagnosis
• Condition management is comprehensive, considering all health aspects
• A doctor’s experience enables support throughout all stages of treatment and observation

If you have questions or need help with painful menstruation, we recommend reviewing the general information or scheduling a consultation for a more detailed discussion.

Self-care before the appointment: what you can and cannot do

Before the appointment for painful menstruation, you can take several safe steps to relieve your condition and gather information for the doctor. If symptoms worsen, urgently seek help from Dr. Irina Ivanovna Kulbach.

What you can do before the appointment

• Note the time of onset and nature of the pain, as well as situations that worsen it
• Keep a symptom diary: pain intensity, accompanying sensations
• Bring a list of medications you are taking, including dosages if known
• Measure your temperature, blood pressure, and pulse rate if possible
• Reduce physical activity and ensure rest until you see the doctor
• Drink sufficient water to avoid dehydration
• Use gentle pain relief methods if they are usually safe and there are no contraindications
• Avoid stressful situations and try to get adequate sleep

What you should not do before the appointment

• Do not stop or change previously prescribed medications without consulting a doctor
• Do not start taking new medications or remedies without recommendations
• Do not use unverified folk remedies or treatment methods
• Do not try to interpret the results of examinations and tests on your own
• Do not ignore increasing pain and accompanying alarming symptoms
• Do not exceed the dosages of any painkillers without doctor’s approval
• Do not delay seeking medical help if your condition worsens or new symptoms appear

If signs of an emergency condition appear, immediately seek help from Dr. Irina Ivanovna Kulbach.

How I Can Help as a Doctor with Painful Menstruation

When addressing complaints of painful menstruation, it is important to obtain a comprehensive and thorough assessment of the condition. During the consultation, I help to identify the causes of the symptoms, develop a clear action plan, and monitor the effectiveness of the treatment. All factors affecting the condition are taken into account — from medical history to lifestyle.

In a consultation for painful menstruation, I can assist you with the following:

• Review symptoms and history to identify possible causes of pain
• Assess the severity of symptoms and associated risks
• Analyze current medications and their tolerability
• Develop a plan for examination, treatment, and monitoring as indicated
• Consider concomitant diseases and medications when selecting therapy
• Provide lifestyle and regimen recommendations tailored to your condition
• Discuss criteria for progress and timing of follow-up visits
• Conduct initial diagnostics and differential diagnosis
• Adjust treatment if effectiveness is insufficient or side effects occur

This comprehensive approach ensures individualized support at all stages — from initial evaluation to monitoring outcomes and preventing potential complications. Your condition will be regularly reassessed considering any changes and the need for adjustments.

Questions to Ask the Doctor About Painful Periods

During a consultation regarding painful periods, you can discuss the following points with Irina Ivanovna Kulbach:

• severe or frequent cramps and pain before or during your period
• irregularity or changes in the nature of your menstrual cycle
• weakness, dizziness, and feeling unwell during your period
• recurring or worsening pain that interferes with work and rest
• lack of improvement after previous treatment or self-care attempts
• issues related to accompanying inflammations or other gynecological conditions
• the need for a second opinion or review of previously conducted examinations

If you experience sudden severe pain, heavy bleeding, or a sharp worsening of your condition, do not wait for a scheduled appointment—urgent medical care is needed.

Questions You Can Discuss During the Consultation

• What is happening to me and what could it be?
• Why is the pain getting worse or why did it start now?
• How can I tell if this is related to my period or another condition?
• What examinations are necessary in my particular case?
• Which tests or investigations are truly essential?
• How should I prepare for the examinations and the appointment?
• What treatment options are available and how do they differ?
• Can this condition be completely cured or is it chronic?
• What should I do if the prescribed treatment doesn’t help?
• Is it possible to avoid procedures or surgery?
• How long might the treatment last and how often will check-ups be needed?
• What signs indicate that the condition is improving or worsening?
• What should I do if symptoms suddenly worsen or flare up?

During the appointment, the doctor will thoroughly discuss your complaints and help determine the next steps. In complex or urgent cases, you may be referred to other specialists or advised to undergo additional examinations.

How the Consultation Proceeds

A consultation for painful menstruation includes discussing complaints, assessing the condition, and developing a plan for further actions. The scope and types of examinations are determined individually, based on your symptoms and indications. During a single appointment, the doctor does not make a final diagnosis but forms a preliminary picture and directions for the next stage.

1. Clarifying complaints and the purpose of the visit: what exactly is bothering you, when symptoms appeared, what worsens or relieves the pain, and the patient’s expectations
2. Collecting medical history and risk factors related to the menstrual cycle and women’s health
3. Discussing any previous treatments and examinations, if applicable, and recommendations to bring their results to the appointment
4. General examination with an assessment of the condition of the pelvic organs and other systems as indicated
5. Preliminary analysis of possible causes and exclusion of the most concerning conditions without making a final diagnosis
6. Planning examinations, which may include ultrasound, blood tests, hormonal tests, and other procedures as indicated
7. Developing a treatment and management plan taking into account your individual characteristics and examination results
8. Discussing timing for follow-up visits, criteria for evaluating progress, and recommendations for timely medical attention if your condition changes

If this is your first consultation, the focus will be on clarifying symptoms and searching for possible causes. If previous treatment has been ineffective, special attention is given to analyzing the reasons and adjusting the approach to improve your condition.

Preparation for the Appointment

To ensure your consultation with the obstetrician-gynecologist regarding painful menstruation is as effective as possible, it is important to prepare properly. This will help the doctor assess your condition more quickly and develop a plan for further actions.

• Bring a list of all current medications with their names and dosages, if known
• Bring the results of previous examinations, tests, and imaging, including ultrasound scans and hormone tests
• Note when and how the symptoms start, and what worsens or alleviates them
• Do not stop taking prescribed medications without consulting your doctor
• If fasting is required, do not eat or drink for 8–12 hours beforehand (unless otherwise advised; confirm when making the appointment)
• Avoid using cosmetics, creams, and other products before the appointment if this was specified when booking
• Come with any questions and notes you want to discuss with the doctor
• Clarify preparation details in advance when making the appointment, especially if additional examinations are planned

If you have any doubts about how to prepare, it’s better to confirm details by phone and do not change your medication regimen without consulting your doctor.

About the Doctor

Irina Ivanovna Kulbach is a top-category obstetrician-gynecologist with over 40 years of experience. She regularly works with patients experiencing painful menstruation, including initial consultations, recurring symptoms, and cases where previous treatment has not yielded the desired results.

The doctor pays special attention to the differential diagnosis of causes and ongoing management, taking into account comorbidities and individual patient characteristics. During the consultation, you will receive a clear analysis of the situation and a plan of further steps aimed at relieving symptoms and improving quality of life.

Why Patients Choose Dr. Irina Ivanovna Kulbach

When choosing a specialist for painful menstrual periods, many people pay attention to a systematic and comprehensive approach to diagnosis and treatment. Irina Ivanovna works with her patients step by step, taking into account all accompanying issues and ensuring transparency in therapy. She carefully reviews previous prescriptions and test results, which helps avoid unnecessary procedures and select the most suitable treatment strategy. This approach is especially important in chronic and complex cases, where constant monitoring and timely adjustment of treatment are required.

• A clear action plan with defined steps from diagnosis to outcome monitoring
• Tests only when indicated, without excessive examinations or wasting time
• Review of already performed tests and analyses to create the most accurate picture
• Consideration of comorbidities and medications for safe treatment
• Monitoring of condition dynamics and therapy adjustments if there is no effect
• Explanation of goals, possible risks, and alternatives in simple and understandable language
• Emphasis on prevention of exacerbations for long-term improvement
• Experience in managing complex and recurrent cases of painful periods and related issues

Irina Ivanovna helps to understand the causes of pain and develop a plan tailored to the individual features of the body and the patient’s goals. This approach ensures more informed and controlled treatment at every stage.

Clinical Cases

Initial Consultation for Severe Menstrual Pain

A middle-aged patient presented with complaints of intense painful menstruation significantly impairing her quality of life. It was important to exclude serious gynecological pathologies and identify possible contributing factors. The physician conducted a detailed medical history and examination, recommending necessary investigations, including ultrasound and laboratory tests. During follow-up, a gradual reduction in pain and stabilization of the condition were observed. The patient continued with scheduled monitoring and therapeutic support according to an individualized plan.

Treatment Adjustment Due to Lack of Effect from Previous Therapy

A young woman experiencing recurrent severe menstrual pain reported that prior recommendations did not lead to relief. A crucial step was to thoroughly clarify her treatment history and comorbid conditions that could affect the therapy’s effectiveness. The physician reviewed previous examinations and adjusted the management strategy based on new data and individual characteristics. At follow-up visits, a decrease in the frequency and intensity of pain episodes was noted despite the chronic nature of her complaints.

Chronic Course of Painful Menstruation against the Background of Comorbidities

A patient with a longstanding history of painful menstruation along with additional gynecological and general diagnoses sought comprehensive management. It was important to consider possible interactions with current medications and assess associated risks. The physician developed a treatment plan with stepwise monitoring of the condition, including regular examinations as indicated. Over time, stabilization and improvement in overall well-being were observed, allowing a reduction in discomfort during critical periods. The patient continued with observation focused on preventing exacerbations.

Symptom Exacerbation and Control Plan After Condition Worsening

A young woman presented with increased pain and deterioration of well-being during menstruation. The physician prioritized urgent exclusion of complications and swiftly organized the necessary investigations. After preliminary stabilization, an individualized control plan was established with regular visits and therapy adjustments based on dynamic monitoring results. Over several weeks, gradual improvement, symptom control, and adaptation of recommendations to the patient’s current needs were noted.

Second Opinion and Review of Previously Conducted Examinations

A middle-aged patient came for an additional opinion after multiple prior consultations and investigations without a clear diagnosis. The physician thoroughly analyzed the provided materials, identified gaps, and proposed a plan for further diagnostic steps. This comprehensive review allowed determination of directions for subsequent treatment and monitoring. Following changes in therapeutic tactics, improvement in clinical parameters and symptom reduction were observed, contributing to enhanced quality of life.

How long does the consultation last?

The consultation typically takes 30–60 minutes; please confirm the duration when booking.

How to prepare for the appointment?

It is recommended to write down your main complaints, avoid changing medications without consultation, and prepare questions for the doctor.

What should I bring to the appointment?

Bring the results of previous examinations, tests, medical records, and a list of medications you are taking.

Do I need to come on an empty stomach?

Usually no, unless otherwise specified when booking.

How many visits are usually required?

It depends on the situation; typically several visits are needed for examination and treatment monitoring.

When can I expect the first treatment results?

This is individual and depends on the chosen treatment plan and your body's specifics.

What should I do if my condition worsens before the appointment?

If your condition worsens or you experience alarming symptoms, seek urgent medical help.

Can treatment be combined with my current medications?

Discuss all medications with your doctor; do not change or add any drugs on your own.

Is it possible to get an online consultation?

Yes, online consultations are available by prior appointment and depending on technical feasibility.

Can I come with already completed examinations?

Yes, bring all available documents for a more comprehensive analysis of your situation.

Is it necessary to come for follow-up visits, and how often?

Follow-up visits are scheduled as needed to monitor effectiveness and adjust treatment.

Can I get a second opinion about my case?

Yes, the doctor reviews all requests and, if necessary, examines previous data.

What should I do if symptoms return after improvement?

It is recommended to book a follow-up consultation to assess your condition and possibly adjust treatment.

What examinations are usually needed for painful periods?

The approach depends on the cause and symptoms; the doctor will order tests as indicated.

How to recognize if my condition requires urgent care?

Seek immediate help if you experience severe pain, heavy bleeding, or sudden deterioration.

Can I evaluate the treatment results myself?

It is important to discuss any changes with your doctor and avoid self-interpretation.

Should I stop taking medications before the appointment?

Do not stop prescribed medications without consulting your doctor.

How soon after booking can I get an appointment?

The wait time depends on clinic workload; please confirm when booking. Home visits may be available.