For women who still have dysmenorrhea after taking ibuprofen, special intramuscular atropine injections may often be considered for antispasmodic and pain relief, and special moxibustion for the lower abdomen or acupuncture for auricular acupuncture may also be considered to assist in the treatment. Some women with particularly severe dysmenorrhea may have secondary dysmenorrhea caused by ovarian chocolate cysts or adenomyosis, so taking ibuprofen alone may not provide complete pain relief, which is why they need a specific intramuscular injection of atropine to relieve spasm and pain. These women may need to be treated specifically for the primary condition, for example, women with adenomyosis may need to be treated with the placement of a Manned IUD in the uterine cavity.