Most girls feel uncomfortable during their periods. If your daughter’s pain persists, rule out serious problems like endometriosis and teach her about what helps period cramps.
Most girls feel uncomfortable during their periods, when they may have cramps in their lower abdomen and even vomit, get diarrhea, and feel dizzy or faint. The girls who feel the worst have higher levels of hormone-like chemicals known as prostaglandins, which make the smooth muscles in the uterus contract.
Try out these strategies. If your daughter’s problems continue, don’t let her suffer unnecessarily month after month: Rule out other issues such as uterine fibroids, pelvic inflammatory disease, or endometriosis.
Teach her what helps period cramps
- Heating pads or bottles. One study found that, while only a third of girls surveyed used a hot water bottle or pad, heating pads or bottles were the most successful treatment. You can buy pads that fit under clothes and emit heat continuously for hours.
- Over-the-counter (OTC) nonsteroidal anti-inflammatory pain-relievers (NSAIDs). Ibuprofen (Advil, Motrin) and naproxen (Aleve) are more effective than aspirin or acetaminophen (Tylenol). But teenagers often take too little or take the medication too late. If your daughter’s period is regular, teach her to take NSAIDs the day before menstruation starts and prostaglandin activity kicks in. She can mark the day on her calendar, a good practice in staying organized. If her period comes unpredictably, she should take medication at the first sign of bleeding or discomfort.
- Supplements. A review of existing research concluded that taking 100 mg of vitamin B1 daily can help, as can magnesium, although the correct dose is unclear.
- Exercise. It’s good for everyone to exercise, so if your daughter tends to sit and lounge rather than run, why not urge her to get moving? A 2019 review of the evidence at that time concluded that 45 to 60 minutes of exercise of any intensity, at least three times a week, could cut pain intensity. The goal is a regular exercise routine, not necessarily to push herself when she has cramps.
- Other alternative remedies. There’s no strong evidence for chiropractic treatment of menstrual cramps or for a variety of herbs you’ll hear about, but some research supports acupuncture.
- Birth control pills. These prevent the production of prostaglandins and can also reduce headaches, PMS, cysts, and endometriosis. The longer she uses oral contraceptives, the greater her risk of cervical and breast cancer. But the risk of endometrial, ovarian, and colorectal (colon) cancers are cut, according to the National Cancer Institute.
Evaluate your own cost-benefit tradeoff. Lauren Streicher, MD, clinical professor of obstetrics and gynecology at Northwestern University, is a fan of reducing PMS. “Any mother of an adolescent girl during a pre-menstrual meltdown can attest that the reduction in PMS alone makes it worthwhile.”
A treatment to avoid: medical marijuana. In states where medical marijuana is legal, it’s often used to manage pain. If your daughter comes home saying her girlfriends are using it, here are the arguments why that may be a very bad idea.
- Kids who start using pot before the age of 15 are less likelly to graduate from high school.
- Marijuana can trigger anxiety, depression, or psychosis in children who are vulnerable, though the science focuses on kids who smoke heavily and at least weekly.
- You also probably don’t want to put your daughter in a position where other kids will ask her to share.
When to see a doctor
Schedule a doctor’s visit if your daughter’s periods are very painful and OTC remedies don’t help. Other symptoms worth investigation include:
- Her period lasts longer than seven days.
- She’s bleeding between periods.
- She needs to replace a pad or tampon more often than every two hours.
- Her periods were previously regular but become irregular.
- She gets a fever and feels sick after using a tampon.
It’s also worth a visit if she hasn’t started menstruating within three years of the first sign of developing breasts.
To investigate underlying medical issues, you might save time and go straight to a gynecologist unless your daughter is more likely to open up with your family doctor.
Endometriosis afflicts about 11 of U.S. women ages 15 to 44 and may require surgery. The problem most often begins in adolescence, but at this early stage it is easy to miss since the symptoms are vaguer.
A common misdiagnosis is irritable bowel syndrome, which is common among women with painful periods. In one study, teenagers had to wait almost two years from the onset of symptoms before they had a diagnosis of endometriosis.
Some of the symptoms of pelvic inflammatory disease are:
- Bleeding between periods
- An unusual discharge
- Pain or bleeding during sex
- A burning sensation when urinating
If your daughter does turn out to have this condition, she can prevent the worst complications — which include infertility — with an early course of antibiotics.
Pelvic inflammatory disease isn’t always caused by chlamydia or gonorrhea — however, it’s obviously time for a talk about her sexual activities. She needs to tell her partners to get checked out and treated.
Also be sure she knows that, even after a course of antibiotics, she could get re-infected.
August 30, 2022
Janet O’Dell, RN