The evaluation of painful menstrual periods begins with a history and physical exam, including a pelvic exam.

Physical findings in a woman with painful menstrual periods may include:

• Abdominal tenderness
• Usually lower abdominal tenderness
• Tender uterus
• Tender ovaries
• Vaginal discharge

Tests that may be used to evaluate painful menstrual periods include:

• Complete blood count
• Pregnancy test
• PAP smear
• Thyroid profile
• Urinalysis
• Vaginal cultures
• Gonorrhea testing
• Chlamydia testing
• Pelvic ultrasound
• May be necessary if the diagnosis is not certain

Less commonly performed tests that may be used to evaluate painful menstrual periods include:

• Laparoscopy
• CT scan of the pelvis
• MRI scan of the pelvis