Management of menstrual problems may involve treatment for Pre-menstrual syndrome (PMS), heavy or light periods, amenorrhea, or painful periods. Management first involves diagnosis of the problem, and evaluation of potential causes. Diagnosis will involve a discussion of the history of the problem, evaluation and potential causes. A pelvic exam, blood work, biopsies, and ultrasound may be suggested. There are many ways to manage menstrual problems, the options depend on the diagnosis, but may involve birth control pills, hormone replacement therapy, or other procedures/surgery.