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So I think patients with very painful cramping related to their menstrual cycle a lot of times we can improve that by just starting a hormonal birth control option a lot of times it lessens bleeding and lessens cramps and we tend to see a lot of improvement with just starting there. Another thing is patients will tell me that pain medication doesnamp;#39;t help you know when the pain gets really bad Iamp;#39;ll try taking certain medications and get no relief but I think itamp;#39;s important to teach them that taking those medications kind of throughout the menstrual cycle can help overall alleviate their painful symptoms and if those things donamp;#39;t improve you know there might be something else going on that we can investigate things like ovarian cysts or endometriosis or just different things that you know could be kind of the root of whatamp;#39;s going on with their pain. I think a lot of times and encouraging people to use NSAIDs like ibuprofen or Aleve kind of leading
