Dr Phil: What can my teen do about painful periods?

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My teenage daughter gets excruciating period pain. She takes ibuprofen, which helps but does not take the pain away. What else can she do?

Period pain is something many women experience frequently and others rarely, if at all. Painful periods can cause a lot of distress. 

A large number of women I see with severe period pain have put up with it for years, believing it was something they had to suffer through. 

On top of the societal pressures to ‘just get on with it’, menstruation is something that’s still not freely discussed. 

Women experiencing period pain tend to assume that others feel what they do but manage better. There is also often a worry that they will be met with a dismissive doctor.

Research shows that more than 25% of women will take pain relief every month for period pain. 

Some women will experience cramping with each period but no further measures are needed if this doesn’t significantly impact your ability to enjoy your life. 

Period pain can often be fully managed with over-the-counter pain medication or with non-medication interventions such as gentle exercise — walking, jogging, swimming or cycling — which can help ease the pain. 

Hot water bottles or a warm bath can also give great relief.

It sounds like your daughter is experiencing severe period pain and may be missing school, sports or social events as a result. 

She likely has dysmenorrhoea (the medical term for excessively painful periods), which can be primary or secondary. 

Primary dysmenorrhoea happens shortly after a female starts her periods (usually within six to 12 months of her first period). 

This pain can be variable and will often become less severe and settle down as the menstrual cycle becomes established. For others, dysmenorrhoea starts several years after their periods start (secondary dysmenorrhoea) and can get worse as they get older. 

Secondary dysmenorrhea is sometimes caused by endometriosis, which is usually managed under the care of a gynaecologist.

If your daughter’s periods are causing distress and interruption to everyday life, I suggest she see her GP, who can discuss treatment options. 

Further investigation may be needed if there is a concern for endometriosis. I usually discuss stronger anti-inflammatories and medications targeting some of the processes causing pain in menstruation (tranexamic acid is a commonly used one).

I also discuss contraception. Hormonal contraception can give excellent relief from menstrual pain for some people. 

It’s usually safe to take up to three courses of the pill back-to-back. This will result in less frequent periods and, therefore, less frequent pains.

Overall, I would recommend everyone to be aware of how common period pain is, to look into the non-medication options to help with it, but also not to suffer in silence when this isn’t helping.

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