Painful periods in a teen girl
Dear Dr Mitchell,My 16-year-old daughter’s periods are unbearably painful. Her cramps leave her feeling incapacitated, and they are accompanied by fatigue and headaches. What can she do to alleviate the pain?Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.DISCLAIMER:The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
I am sorry to hear about the problem your daughter experiences with her monthly periods. Pain associated with the menstrual periods may be due to several factors, like endometriosis.
Endometriosis is a fairly common cause of period pain. It is a condition in which the tissues similar to that which line the inside of the uterus are present outside of the lining. These tissues may be present in the muscles of the uterus, ovaries, the Fallopian tubes, bowel and bladder. In rare cases this may be seen in the lungs.
The tissues shed and bleed in a monthly fashion similar to the lining of the uterus. This causes severe pelvic pain which usually starts before the onset of the period, continues throughout the menstrual flow, and persists sometimes for up to one week after the period has finished.
In severe cases it may present with cysts in the ovaries and severe adhesions in the pelvis causing the tubes, ovaries and bowel to be bound down. This cause chronic pelvic pain and infertility.
This can sometimes be detected on a pelvic ultrasound especially if there is ovarian involvement with cyst formation. The confirmation of endometriosis is usually via diagnostic laparoscopy. The condition can be treated by using medication to stop the menstrual flow, surgery to remove the deposits, and the use of pain medication.
The combined oral contraceptive pill can be used in your daughter’s case in a continuous manner to stop the period, thus giving her significant relief of her pain. Usually this is taken for six to nine months continuously to prevent the monthly menstrual period. Alternatively, the contraceptive injection Depo Provera can be given to stop the monthly period. This is usually given every three months and works well in reducing the pain significantly.
There are other drugs available on the market for short-term usage that will cause the deposits from endometriosis to shrink and reduce the pain.
Ovarian cysts can also cause pelvic pain with the menstrual period, as can uterine fibroids and pelvic infection. These can cause severe period pain and should be investigated for.
It is important to reduce the long-term usage of painkillers since these can cause severe stomach problems, including stomach ulcers.
There is also an intrauterine contraceptive device that is easy to insert called Jaydess or Skyla. This has in hormones that cause a significant reduction in the period pains and the menstrual flow. This will also be a good choice for long-term pain control and should be considered.
The subdermal implants are tiny rods that are put under the skin of the arm and this helps to reduce the menstrual flow and period pain in a similar manner to the contraceptive injection. These can be left in for up to five years.
Consult your doctor who will advise you further and do the appropriate investigations to determine the underlying cause of the severe period pains so the appropriate treatment can be undertaken.
Best regards.
