The discomfort is associated with menstrual bleeding and is commonly observed in teenagers. Diagnostic tests typically show no abnormalities in the pelvic region, and the condition often improves after childbirth. Pain relief usually involves over-the-counter painkillers. If those are ineffective, dilation of the cervix can be considered, as the pain is believed to result from uterine muscle cramping. In extreme cases, a surgical procedure called presacral neurectomy may be performed to sever the nerves to the uterus.