Hello dear, Understand your concern. Following are the causes of painful heavy menstruation. It mainly due to hormonal imbalance. Other cause may be Depression, Excessive weight gain and weight loss, excessive alcohol/tea /coffee consumption, PCOS, endometriosis and adenomyosis Dysfunctional uterine bleeding, pre cancerous condition of cervix Take: tablet meftal spas three times a day 3-4 days before period 1.Limit caffeine, salt and nicotine from a few days before your period until two weeks after it 2. Healthy lifestyle 3 Stretching and regular exercise routines will reduce cramping and menstrual pain. 4. Yoga can be extremely helpful to reduce both the physical and mental symptoms 5. Massage can also help both physical and emotional symptoms. also relieve depression, anxiety and panic attacks. 6. Hot baths help with cramping, back pain and relaxation. 7. Sleep of atleast 8 hours 8. Maintain hygiene in pelvic area,wear loose pure cotton underwear. If not resolves, you can consult the gynecologist Go the following test 1. Pelvic examination 2. USG 3. ELISA and Nucleic acid amplification test to diagnose STD infection 4. Hormone profile: LH,FSH, Estrogen, Progesterone, thyroid profile, prolactin 5. PAP smear Hope this may help you Best regards Dr. Sagar