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[/frame_right]Does your teenage daughter complain of painful menstruation every month? At times is she even missing school because of these painful periods? Did you know that this is the most common gynecologic complaint of adolescent females? Nausea, vomiting, diarrhea, headache, dizziness, and backache can even accompany the painful cramps that many young women have with their periods. These symptoms can be a large problem for young women, as many as 60-93% of them, and many of these symptoms result in limitations of daily activities. Unfortunately, only 15% of young women actually seek medical advice in regards to these symptoms. This is a tragedy given the treatment options that we have to significantly decrease if not eliminate the symptoms in these young women.
These symptoms are most often the result of excessive production of prostaglandins in the uterus which lead to increased uterine contractions during menses. This also affects the intestines, therefore leading to many of the other symptoms associated with the cramping. Very rarely are the symptoms related to other female gynecologic issues such as endometriosis, which gives symptoms of worsening pelvic pain over time with and without menses, or pelvic infections.
To determine if your daughter needs to be evaluated by a physician, you need to evaluate whether it is impacting her life. If she is missing school, sports events or other social activities due to the pain, it is time to see a physician. The physician will evaluate her medical history, especially how her cycles have progressed since she began menstruating. Honesty about sexual history is also very important, in order to rule in/out the possibility of pelvic infections.
Many young women are intimidated by going to the gynecologist, but most of the evaluation for painful periods in the adolescent woman involves discussion. An exam is very important, but does not always require a pelvic exam. The physician determines this after discussing the patient’s symptoms. A pelvic ultrasound may need to be performed for further evaluation, but many times this is not necessary either.
First line treatment for painful periods is Non-steroidal anti-inflammatory medications (NSAIDS) such as Motrin or Aleve. These tremendously reduce the prostaglandin levels that develop within the uterus, therefore decreasing the painful cramps. Ideally, the NSAIDS are started 1-2 days prior to the onset of menses and are continued for 3-4 days into the menses. If your daughter fails NSAID therapy after 2-3 months, the next step would be trying hormonal contraception such as birth control pills (OCPs). OCPs work by both suppressing ovulation which in turn decreases prostaglandin production in the uterus as well as by decreasing blood flow during menses.
Painful periods can really interrupt a young woman’s life and the treatment can be simple, with very little risk. If your daughter is experiencing these issues, please discuss this with your pediatrician or make an appointment for her to see a gynecologist. She will be happy you did.
Did not know that Dr. Robins had moved…will call