Red flags & when to go in person for Menstrual Cramps (Dysmenorrhea)

Audience: adult

Menstrual cramps, or dysmenorrhea, are common and usually cause mild to moderate pain during periods. Many people manage cramps at home or through telemedicine by discussing symptoms and treatments with a healthcare provider online. However, some signs mean you should see a healthcare professional in person. Severe pain that suddenly worsens, heavy bleeding soaking through pads or tampons quickly, or pain accompanied by fever or unusual symptoms may need urgent evaluation. Telemedicine can help assess typical cramps, suggest pain relief methods, and guide self-care. It cannot replace physical exams or tests needed for serious conditions. Knowing when to seek in-person care helps keep you safe while managing menstrual cramps effectively.

Red flags — go in person / ER

• Sudden severe lower abdominal pain that does not improve with usual pain relief — seek immediate in-person care.
• Heavy menstrual bleeding soaking through one or more pads or tampons every hour for several hours — go to emergency or urgent care.
• Fever above 38°C (100.4°F) with cramps, or foul-smelling vaginal discharge — see a healthcare provider promptly.

What telemedicine can do

• Assessment of typical menstrual cramps and mild to moderate pain.
• Guidance on over-the-counter pain relief and self-care strategies.
• Advice on when to seek in-person care or urgent evaluation.

What telemedicine cannot do

• Physical pelvic examination or ultrasound imaging.
• Laboratory tests to diagnose infections or other conditions.
• Management of severe pain, heavy bleeding, or signs of infection requiring urgent care.

What Are Menstrual Cramps?

Menstrual cramps are pains in the lower belly that happen before or during your period. They come from your uterus contracting to shed its lining. These cramps often feel like dull, throbbing, or sharp pains and usually start a day or two before your period and last a few days.

When Are Menstrual Cramps a Concern?

Most cramps are mild and get better with rest or over-the-counter pain medicine. But sometimes cramps can be a sign of other health issues, especially if the pain is very strong, lasts longer than usual, or comes with other symptoms like heavy bleeding or fever.

Red Flags: When to Get In-Person Care

Seek urgent medical care if you experience:

These signs may require physical exams, tests, or treatments that cannot be done through telemedicine.

How Telemedicine Can Help

Through telemedicine, healthcare providers can:

Telemedicine is a good first step for typical menstrual cramps but has limits.

Limitations of Telemedicine for Menstrual Cramps

Telemedicine cannot perform physical exams, pelvic ultrasounds, or lab tests needed to diagnose conditions like infections, fibroids, or endometriosis. If your symptoms suggest these or other serious issues, an in-person visit is necessary.

How to prepare for your tele-visit

• Note the start date, duration, and severity of your menstrual cramps.
• Record any other symptoms like bleeding amount, fever, or unusual discharge.
• List any medications or treatments you have tried and their effects.
• Prepare to describe your general health and any other medical conditions.
• Have a quiet, private space and a device with internet or phone access for your tele-visit.

After your tele-visit

• Follow the treatment or self-care advice given by your healthcare provider.
• Monitor your symptoms and note any changes or worsening.
• Schedule an in-person visit if recommended or if red-flag symptoms develop.
• Use pain relief methods as advised, such as heat pads or medication.
• Keep track of your menstrual cycles and symptoms for future visits.

FAQs

What causes menstrual cramps?

Menstrual cramps are caused by the uterus contracting to shed its lining during your period. These contractions reduce blood flow and cause pain.

When should I worry about my menstrual cramps?

You should seek medical care if your cramps are very severe, suddenly get worse, last much longer than usual, or come with heavy bleeding, fever, or unusual discharge.

Can telemedicine help with menstrual cramps?

Yes, telemedicine can help assess your symptoms, suggest pain relief, and advise when to get in-person care. However, it cannot replace physical exams or tests.

What treatments can help menstrual cramps?

Common treatments include over-the-counter pain relievers like ibuprofen, applying heat to the lower belly, rest, and gentle exercise. Your healthcare provider can guide you on safe options.

When do I need to see a doctor in person?

See a doctor in person if you have severe pain not relieved by medication, heavy bleeding, fever, or other concerning symptoms that need physical examination or tests.

Sources

1. Menstrual Cramps (Dysmenorrhea) — MedlinePlus, U.S. National Library of Medicine.
2. Dysmenorrhea — Mayo Clinic.
3. Menstrual Problems — Centers for Disease Control and Prevention (CDC).
4. Dysmenorrhea: Painful Periods — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you have severe symptoms or concerns, please seek prompt evaluation by a healthcare professional in person.