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Teen Girls' Health

Period Problems

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


It’s a rare woman who gets through her life without a cramp, pain, or other period problem. Cramps, aches, irregular bleeding, and other menstrual issues are the top reasons that new teenage patients come to see me.

Organic Tampons

One thing I’ve noticed about my teen patients: They’re very aware of environmental issues. Many of them care a lot about how we treat the earth and the quality of the food and drink that they put in their bodies.

I care, too. So I urge you to be equally careful about other things you put in your bodies—like tampons. I recommend organictampons and panty liners, which are manufactured without chlorine(a source of dioxin pollution, a serious environmental problem),made from organic cotton grown without pesticides, andwhich include no plastics or synthetic materials.

Good for your body and the planet? What’s not to like?

I tell them that most period problems start with hormones, which affect your whole body, not just your ovaries and uterus. They’re linked to everything from your skin to your appetite. They also seem to affect brain chemicals called neurotransmitters, which affect your moods. Since so many period problems are caused by hormones, many can be treated with hormones, too—specifically the birth control pill.

But there are lots of other ways to treat period problems, including heat therapy, healthy eating, meditation, and other methods.

Surprise! Expecting the Unexpected

“Um . . . does anyone have a tampon?”

My patient Jaida was running for sophomore class president. Twenty minutes before her big speech, she found herself in the girls’ room, begging anybody who came in for sanitary supplies. Although she’d had her period since age twelve, she still hadn’t settled into a predictable pattern and was always getting surprised. Fortunately, a girlfriend with a well-stocked purse rescued her in the nick of time. Jaida (who won the election) visited my office the following week.

I determined there wasn’t anything wrong with her physically and she didn’t really need treatment. But I encouraged her to start a “period diary,” something I think all my patients should do. She followed my directions below for several months and found that although her bleeding was still irregular, she could predict within a ten-day window when her period would come—and she made sure she always stocked her purse with tampons during that time.

Dear Diary . . .

You don’t need a lock and key for a period diary—just a regular wall calendar (which you don’t need to keep in the kitchen). I recommend doing this for at least six months, but many women always track their periods. On your calendar, note:

  1. The days your period starts and ends. Make an X on the first day of bleeding and keep making Xs every day until you stop bleeding.
  2. The severity of cramps or other symptoms. Use a scale of 0 to 5 (0 = no problems, 5 = your worst symptoms) to describe how intense the symptoms are on each day. For instance, your cramps might hit Level 4 on Day 1 of your period but subside to 2 or 3 on the next two days, and then go back to zero. After six months, look back over your calendar and see if you can find any patterns. Just knowing that your cramps will only last a day or two can make you feel better.
  3. How much you bleed. This one’s a little tricky. Most medical texts say the normal amount of bleeding is about five tablespoons and one teaspoon per period. But how in the world would you measure that? Walk around with a measuring spoon in your underwear? An easier way is to estimate how long it takes to completely soak a pad or tampon to the point there’s no white surface showing. If it takes less than one hour, that’s not normal, and you should see a doctor. Of course, my patients often change their pads or tampons before they’re completely soaked through, so I just tell them to note how often they change them and how soaked they are (is a pad 50 percent white? 75 percent white?). You don’t have to be super-precise about it: The point is to have an overall record, so you notice if there’s a month when you’re suddenly bleeding much more or less than usual.

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