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Teen Girls' Health

Painful Periods

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By Jennifer Ashton, M.D., Ob-Gyn with Christine Larson
WebMD Feature by “The Body Scoop for Girls”


Not a day goes by when a patient doesn’t come in for help with cramps, aches, and other period-related pain. That’s not surprising. Studies show that 60 to 92 percent of teenage girls have painful periods. So if you’re dealing with pain, know you’re not alone. About 15 percent of girls have pain that interferes with their daily lives, sometimes to the point of missing school or activities. Another 15 percent of teens have pain that’s not bad enough to send them to the doctor—but does send them to the pharmacy, looking for over-the-counter solutions. Only fourteen out of one hundred teens with painful periods ever seek help for their problem. And one out of three parents whose daughters had painful periods was unaware that their daughters were suffering. (As a mom, this last part really breaks my heart!)

Dr. Ashton’s Period Playlist

  • You don’t have to live with terrible cramps. This is the twenty-first century: We believe in treating pain.
  • No “specially formulated for PMS or periods” remedy sold over the counter actually works. Don’t buy them.
  • Oral hormones—aka “the pill”—are a very common treatment for period pain. Most concerns about the pill are based on myths. For the most part the pill can be a safe and effective therapy for many period-related problems, including cramps.


True or False? Everyone Gets PMS

Everyone Gets PMS

FALSE. Technically, premenstrual syndrome only affects about 40 percent of women. If that sounds low, it’s because PMS is technically defined as a “diagnosable” medical condition with symptoms that are so severe they interfere with your life—keeping you home from school or away from activities, say, and in serious discomfort. Some women also suffer from premenstrual dysphoric disorder (PMDD), which brings severe depression or mood disorders with it.

But even though most women don’t officially have PMS, teens may be more likely to have it than adult women, with an estimated 14 to 88 percent of teens having moderate to severe symptoms, like cramps, irritability, headaches, food cravings, bloating, depression, or anger.

Quiz: Normal / Not Normal

Which of these period symptoms are normal?

  • Mild cramps that ease up when you take two Advil or Motrin
  • Cramps that not only don’t respond to Advil but actually make you cry
  • Moodiness or irritability
  • Food cravings
  • Weight gain of one to two pounds
  • Mild headaches
  • Severe headaches or headaches that interfere with your vision
  • Tiredness
  • Lack of concentration
  • Mild sadness or lack of interest in your favorite activities
  • Depression: Unstoppable crying jags or persistent dark thoughts
  • You miss school or skip activities for a day or more every

Painful periods (which doctors call dysmenorrhea) usually result from one of two problems:

  1. “The Bullhorn Problem.” These are pains and other symptoms caused by normal physical and hormonal processes in your body (that’s what was happening with Lori). Your body’s sending the right signals but sending them a little too loudly—and causing side effects like cramps, headaches, moodiness, or other symptoms. It’s like your body’s using an electric bullhorn instead of a cell phone to talk to your ovaries.
  2. “The Plumbing Problem.” Less often period pain can be caused by a physical problem with the pelvis, like an injury, infection, or abnormal growth in the uterus. In other words, it’s a problem with the physical “plumbing.” For example, I treated one thirteen- year-old patient in the emergency room for pain so severe she was throwing up. The ER doctors thought she had appendicitis, but CT scans showed a rare physical condition. She essentially had two cervixes, with a wall dividing one side of her uterus and vagina from the other! One of her cervixes was blocked, which caused a buildup of blood that didn’t flow out with the rest of her period. Two simple operations cured the problem. Her condition was rare, but other, more common physical problems can also create this kind of problem (which doctors call secondary dysmenorrhea).

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