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.