Q& A

Irish Independent - Health & Living - - HEALTH MATTERS -

TMy 13-year-old daugh­ter has just got her pe­riod and suf­fers from a lot of pain for two days each month. It is re­ally in­ter­fer­ing with her play­ing sports. She is also very self-con­scious, but I think if we got the pain un­der con­trol, she could start to en­joy play­ing sports even when she has her pe­riod. We have tried ibupro­fen and parac­eta­mol with codeine, but she still feels pain and say she feels muggy. I don’t want to put her on the Pill so young, un­less I have to as I am wor­ried about the risks. We have tried spe­cial ex­er­cises also, and get­ting out and about, but noth­ing seems to work. Have you any ideas?

She is on a team at school and doesn’t want to give it up. he med­i­cal term for painful pe­ri­ods is ‘dys­men­or­rhoea’. This is a very com­mon con­di­tion. More than half of men­stru­at­ing women will have some level of pain. How­ever, in most cases, the pain is mild and only lasts one or two days, but in some cases, it may be more se­vere and last longer.

There are two types of dys­men­or­rhoea. Pri­mary dys­men­or­rhoea starts within months of the first men­strual pe­riod. This pain usu­ally comes on with men­stru­a­tion and goes away once it passes. Pri­mary dys­men­or­rhoea usu­ally gets bet­ter as the years pass and may go away af­ter preg­nancy. There is no un­der­ly­ing phys­i­cal ab­nor­mal­ity with this pain. It is due to the pres­ence of prostaglandins. The lev­els of these chem­i­cals rise around the time of men­stru­a­tion, in­creas­ing the chance of cramps and pain.

Se­condary dys­men­or­rhoea usu­ally comes on later in life. This pain is as­so­ci­ated with un­der­ly­ing prob­lems and the pain may in­crease over time and last longer. Causes of se­condary dys­men­or­rhoea in­clude pelvic in­fec­tion; en­dometrio­sis; a con­di­tion called ade­no­myosis, where the tis­sue that usu­ally lines the womb grows in the womb mus­cle; fi­broids, which are growths in the wall of the womb; and nar­row­ing of the cervix.

Cramps that are not se­vere and only last one or two days may be nor­mal and don’t nec­es­sar­ily re­quire re­view by a doc­tor. If pain has started re­cently, de­spite pre­vi­ously pain-free cy­cles, or if the pain is se­vere or last­ing days, it is worth see­ing your doc­tor for a check up. Your doc­tor can per­form an ex­am­i­na­tion, rule out in­fec­tion and may rec­om­mend an ul­tra­sound or other exam to fur­ther recheck the womb and ovaries.

Spe­cial­ist re­fer­ral is some­times ad­vised. There are spe­cial­ists that spe­cialise in teenage gy­nae­col­ogy.

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