If your daughter complains of having cramps during her period, you can tell her that she isn’t alone. An estimated 90 percent of adolescent girls report experiencing painful periods or dysmenorrhea. Menstrual pain usually isn’t caused by anything abnormal, and there are plenty of pain management options available:
Lifestyle and behavior modifications. A healthy lifestyle including a nutritious diet, exercise, adequate sleep and stress reduction can help reduce painful periods.
Over-the-counter (OTC) therapies. OTC pain medications such as ibuprofen and naproxen can be taken right before or at the beginning of the period to help reduce cramping. Heating pads combined with OTC pain medicines seem to provide significant relief for many girls.
Hormonal therapy. Various types of birth control pills or devices such as IUDs can help reduce or prevent painful periods. Hormonal therapy is usually prescribed only after lifestyle modifications and OTC therapies aren’t successful.
However, if your daughter has heavy bleeding, pain that continues to worsen or that impacts her ability to participate in normal activities, then it’s time to take her to a pediatric or adolescent gynecologist. By finding out the source of the discomfort, the quicker your daughter can get the right therapy, feel better and reduce her chances of having any long term reproductive impacts. Here’s what you can expect during the appointment.
Health history. The doctor will ask your daughter questions about health conditions, sexual activity, amount of bleeding, when she had her first period, what the pain is like and if she has tried any therapies to control the discomfort.
Physical exam. This includes measuring height, weight and blood pressure along with an abdominal and pelvic exam. If your daughter’s period is very heavy, the doctor may want to draw blood to make sure she is not anemic (a shortage of red blood cells) or look for other clues that could offer more information about what could be causing the pain.
Imaging. If past treatments have not been successful, the physician may order an ultrasound. The ultrasound is simple and painless and can help identify conditions that could be causing problems.
If the physician suspects that the pain is being caused by a specific condition, and hormonal therapies have not worked, they may suggest laparoscopic surgery. Laparoscopic surgery is performed through a few tiny incisions and can also be used as a diagnostic tool to help identify or rule out conditions such as endometriosis (when uterine tissue grows outside the uterus) or fibroids. In cases where endometriosis has been confirmed through laparoscopy, physicians may prescribe a type of hormonal therapy that stops ovulation and menstruation completely.
Ultimately, whatever the cause, painful periods shouldn’t be ignored or endured. The American Congress of Obstetricians and Gynecologists recommends an initial gynecologic visit between the ages of 13 and 15 years. It’s important for young women to make gynecological care part of their health care routine and to develop a relationship with their gynecologist and parents where they can discuss healthy behaviors while dispelling myths and fears. If your daughter needs a gynecologist, she can see a specialist at Nationwide Children’s by calling: (614) 722-6200 or (877) 722-6220. No referral is necessary.
Kate McCracken, MD is a distinguished member of Nationwide Children’s Pediatric and Adolescent Gynecology team.
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