When Period Pains Cramp Your Daughters Style


by Lauren Streicher, MD

While it may seem like your menstruating teen is being a drama queen, menstrual cramps can be really painful. Roughly 50% of teens suffer from menstrual cramps and in 15% the pain is severe enough to interfere with normal activities. Since the average girl today starts menstruating at age 10, an adolescent with difficult periods can expect a minimum of 240 days, or over 8 months, of pain before she even leaves her teens

While endometriosis or another gynecologic issue is possible, most teen cramps are not an indication of a serious problem. The culprit is usually increased production of prostaglandins, a hormone-like substance that can cause intense uterine contractions. Some teens also experience monthly diarrhea, nausea and vomiting.

While crawling into bed, lying in the fetal position and wishing for a hysterectomy is one strategy, there are other solutions. The heating pad, an old standby, is actually a good idea. A study released in 2004 confirmed that continuous low level heat on the lower abdomen combined with ibuprofen dramatically reduced, or even eliminated, menstrual pain. Thermacare Menstrual Patches or any disposable heatingpad thatadheres to the lower abdomen, can be worn discreetly under clothes, and emit continuous heat for 8 hours. Over the counter NSAIDS (non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen dramatically reduce the formation of prostaglandins and decrease cramping and bleeding. The key is to take them the day before menstruation starts and prostaglandin activity kicks in. That’s no problem if your daughter has regular periods, but if her cycles are unpredictable, the medication should be taken at the first sign of bleeding or discomfort.  Once the period is fully flowing and the cramps excruciating, it’s too late to get the maximum benefit.

Of course, there is no better way to eliminate menstrual cramps than by eliminating menstruation. Using hormonal contraception like birth control pills to eliminate or drastically shorten bleeding (even when contraception is not needed) can change the life of a teen who has a major meltdown every time she realizes her period is going to interfere with an important social or sporting event. Many parents are concerned that giving hormonal contraception to teens will negatively affect future fertility or increase the chance of developing cancer down the road.  Fortunately, all evidence indicates that this is not the case. As an extra bonus, eliminating menses not only gets rid of cramps, but also reduces hormonal headaches, anemia, ovarian cysts, PMS and endometriosis. And any mother of an adolescent girl during a pre-menstrual meltdown can attest that the reduction in PMS alone makes it worthwhile. Not to mention the hundreds of dollars you will save every year by not buying pads, tampons and pain medication. And being the parent of a cramp-free teen ... priceless.

10/27/2010 doctoroz.com

When No Period Is No Problem


By Lauren Streicher, MD


When the pill was first released for use as a contraceptive in 1960, it was prescribed to include a hormone-free week in order to ensure a normal menstrual period. The scientists that invented the pill felt that in spite of the nuisance factor, maintaining a normal menstrual cycle would make women comfortable taking this new form of contraception. The truth is, there is no medical benefit to that week off, and there are a number of advantages (beyond wearing white pants without fear) to skipping the pill-free days and instead take an active pill up to 365 days a year.

The obvious benefit is that no period means no cramps, no menstrual headaches,  and no making a midnight run to buy tampons! Women who are anemic from heavy periods may particularly benefit. Eliminating the hormone-free week also dramatically decreases the chance of an inadvertent pregnancy that can occur if a new pack of pills is started late. The idea of eliminating periods by taking pills continuously is not a new concept. For over 20 years gynecologists have recommended continuous rather than cyclic use of birth control pills to eliminate painful menses in women with endometriosis. What’s new is the notion that menstrual suppression is an option driven by patient preference and convenience rather than medical indication.

Many women, when asked, think it is unnatural and unsafe to not bleed monthly, which is why the majority of women who use hormonal contraception take three weeks of hormones followed by four to seven hormone free days to bring on a menstrual period. While a monthly period may seem “natural,” what nature really intended was for women to be pregnant or nursing as much as possible and have relatively few periods. Consider that prehistoric women experienced only 50 menstrual cycles in a lifetime (due to shorter lifetime and increased rate of pregnancy) as opposed to the approximately 450 menstrual periods experienced by most women today.

With the average woman spending over 2,000 days of her life bleeding, it’s no surprise that according to a Harris poll, a majority of women would eliminate or decrease the number of their menstrual periods if safe to do so.

Currently, many new forms of hormonal contraception are packaged this way, and the expectation is that this trend will continue. I predict our granddaughters will want to hear about the “olden days” when women who were not trying to get pregnant still got a period.

So if you take birth control pills, try skipping the hormone-free days. People who use a NuvaRing may also be able to skip the ring-free week and replace one ring with another after 3-4 weeks.

Buying those extra couple of packs every year can be expensive, but you can more than make up for it in the money saved in pads, tampons and pain medication!

Origianlly published Jan, 2014 DoctorOz.com