Most girls feel uncomfortable during their periods, when they may have cramps in the 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, and 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.
Heating pads or bottles. One study found that while only a third of girls surveyed used a hot water bottle or pad, this was 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 (NSAIDs) pain-relievers. 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. The key is to take it the day before menstruation starts and prostaglandin activity kicks in, if your daughter’s period is regular. If it comes unpredictably, she should take medication at the first sign of bleeding or discomfort.
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? The evidence that exercise helps painful periods is promising, though not conclusive. The goal is a regular exercise routine, not necessarily to push herself when she has cramps. When the pain hits, orgasms may distract her and release happy brain chemicals.
Birth control pills. These prevent the production of prostaglandins and can also reduce headaches, PMS, cysts, and endometriosis. Parents sometimes worry that the pill could increase their daughter’s chances of developing cancer or infertility, but “all evidence indicates that this is not the case,” says Lauren Streicher, associate clinical professor of obstetrics and gynecology at Northwestern University. “And 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 likely to graduate from high school, and 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.
Schedule a doctor’s visit if your daughter’s periods are very painful and OTC remedies don’t help. Other symptoms worth investigation: if her period lasts more than seven days, she’s bleeding between periods, or needs to replace a pad or tampon more often than every two hours, if her periods were previously regular but become irregular, or if 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 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 10 to 15 percent of women of reproductive age and may require surgery. The problem most often begins in adolescence, but at this early stage 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, and fever. 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.
June 18, 2015
Janet O’Dell, RN