In some situations, very severe cramps may be a sign of other gynecologic problems, such as an abnormality in the way the uterus and other structures formed in embryonic life, or a medical problem such as endometriosis. Oral contraceptives turn off ovulation and can therefore substantially relieve menstrual cramping. They can be particularly helpful in girls who experience stomach upset when they take anti-prostaglandin medications or who vomit with every period. Oral contraceptives are recommended for adolescent girls of all ages, when needed, regardless of whether or not the girl is sexually active. Your doctor can help determine whether this option is best for your teen.
Endometriosis occurs in a small percentage of teen-age girls and is much more common in adult women.
In endometriosis, small nests of the type of cells that line the uterus attach themselves to abdominal organs outside the uterus. These endometriosis cells swell and bleed each month, in response to hormonal stimulation, and cause a great deal of pain in the back and pelvis during periods. Your doctor can help you determine whether your teen might have endometriosis or another gynecologic problem and can refer her to a gynecologist with a special interest in teen problems. Your teen's doctor will be able to offer a plan for pain relief that will keep her active and involved every day of the month. Dr. Carole A. Stashwick is a pediatrician and an associate professor of pediatrics at Dartmouth Medical School, where she also director of the pediatric residency program.