The pain begins prior to the onset of menstrual bleeding and is often the result of tissue congestion and tension. In some instances, it may be caused by pelvic conditions like salpingitis or a retroverted uterus. When the pain isn’t linked to a specific disease, management options include exercise, warm baths, laxatives, and over-the-counter pain relievers. Hormonal treatment in the week leading up to the menstrual cycle can also be effective for some individuals.