<s>[INST] First, I should start off saying that I am 353lbs. About 2 weeks ago, I went in for my yearly physical (Pap, Pregnancy Test, etc). Before this last visit, it had been 2 years since having a physical done. While I did not have a physical for 2 years, I also was not on any type of birth control. My periods were very irregular, but I did not experience severe menstrual cramps. At my last physical I was put back on birth control (Ortho). I have not missed a day taking them, but a few days after starting the Green pills, I started to have very painful menstrual cramps. The severe pain started yesterday, and it is not constant. One minute the pain, on a scale of 1-10, is about a 2 or 3. The next minute, the pain is about an 8 or 9. Most of the pain is in my lower back, but whenever the 8-9 pain comes, it spreads to my thighs and lower front. I am trying to determine whether or not I need to go to the doctor, but I'm not sure when to know. Please help. Thanks. [/INST] HelloIn my opinion birth control pills are not responsible for menstrual cramps.you have stated that your periods are irregular, may I know the pattern of your periods?Do you have any urinary complains?Do you have fever? is there any foul smell from vagina?You can use hot water bag, if pain still persists take tab paracetamol .Dr.Mira Butani </s>