A:   Dysmenorrhea is the term that describes painful menstruation (periods). There are many causes of dysmenorrhea, and it should not always be dismissed as “normal”, especially if your period is so painful that it is disruptive to your activities of daily living. One possible cause of dysmenorrhea is endometriosis. Endometriosis is a condition in which uterine tissue grows outside of the uterus. This can cause cramping, pelvic pain, heavy bleeding, and painful intercourse, along with many other symptoms. The only definitive way to diagnose endometriosis is by performing surgery and taking a biopsy of this tissue, but many providers will diagnose endometriosis based off patient history and report of symptoms. The first-line treatment for endometriosis is hormonal therapy, most commonly with a hormonal form of birth control.