Helping with your teen’s period woes

Dear doctor,
My daughter, who is 16 years old now, started having periods 3 years ago. She is experiencing heavy periods and pelvic pain, and I am not sure what to do?

Thank you for your query. Periods in teenagers are very variable in terms of the amount of bleeding and pain. Luckily, most teenagers experiencing heavy and painful periods will only have such symptoms for only a short period of their reproductive life. The symptoms tend to settle down spontaneously in most cases, without any specific intervention.

But in some cases the symptoms will persist, like in your daughter’s case, requiring specific interventions. I would urge you to take your daughter along for a gynecology consultation. An assessment will be done, enabling a diagnosis to be made, which might mandate some specific treatment.

So what kind of assessment will my daughter go through to make a diagnosis?

The gynecologist will ask for a chronology of events, and try to grade the amount of bleeding and pain your daughter is experiencing. Young girls are usually spared the agony of a gynecology examination, which might be traumatizing at such an early age. Information about their reproductive organs can usually be deduced from imaging studies. If any doubt arises, the other way out is to examine them under anesthesia.

In the majority of cases, no specific diagnosis will be made. Most of the symptoms will be related to a maturing reproductive system. This means some imbalance of hormones, and pain which may not necessarily be evidenced by physical disease. Rarely, some girls will have a specific disease. You might have heard of diseases like endometriosis which are not unheard of in young girls, and can cause dreadful symptoms.

Will my daughter be offered specific treatment to control her symptoms?

Yes, there are many options to control your daughter’s symptoms. Waiting it out is an initial option, as the symptoms are likely to resolve spontaneously. There are some medications that can be used to control pain and bleeding, requiring to be used only at the time when symptoms appear. Longer term control of symptoms can be achieved with the use of hormones, the simplest being use of the freely available contraceptive pill. You may be concerned initially that your teen is taking the pill, but this usually tends to give optimal control of symptoms.

In rare cases, symptoms may be so severe that control with simple measures may be unachievable. Your daughter may thus require further evaluation and treatment with surgical approaches. Any surgery at your daughter’s age would be very conservative, balancing the relief of symptoms with preservation of future fertility.

I anticipate your daughter will pull through this difficult phase of her reproductive life. But seek gynecological help in good time to save her the agony of dreadfully painful and heavy periods.