Decoding period pain: What every teenager and parent should know

Discussions around period pain often brings up conditions like Polycystic Ovary Syndrome (PCOS), Premenstrual Dysphoric Disorder (PMDD) and endometriosis. With these conditions becoming more commonly discussed, is this an indication that young girls are experiencing more pain than previous generations? 

Dr Anel Mostert, a General Obstetrician and Gynaecologist from Mediclinic Kloof, sheds some light on the issue.

“The fact that women’s health is not an off-limit topic tends to make teenagers more open about their symptoms, which might make it seem like dysmenorrhea (pain associated with menstruation) is worsening over time. However, there is no evidence that this is the case,” Dr Mostert says. Suggesting that, in most cases, there is no reason for immediate concern if a teenager is experiencing period pain.

Understanding period pains in teenagers

Dr Mostert explains, “It is normal for some women to experience a certain degree of pain or significant discomfort during their menstruation, including pain in the lower abdomen that can sometimes spread towards the back or down the legs. The pain is caused by the uterus (womb) contracting to shed the lining or endometrium. Mild to moderate pain might be standard, but more severe pain that impacts your normal daily activities or wakes you up when you sleep is not considered standard.”

The physical and emotional symptoms

While physical symptoms are more evident to teens experiencing their periods, there are emotional effects that they need to look out for. “Period pains can affect the mental wellbeing of a teenager as the pain and hormonal fluctuations can lead to irritability, mood swings, anxiety and a depressed mood,” Mostert says.

However, some teenagers do experience more severe pain than normal, and that can be a sign of a more significant health issue. Dr Mostert explains some of the reasons behind this phenomenon. “There are several causes for dysmenorrhea, including endometriosis, fibroids, adenomyosis or pelvic infections. Endometriosis is one of the more common causes; however, not all women with endometriosis will experience severe pain and not all women with pain have endometriosis. Endometriosis is a progressive disease but can affect women of all ages. Severe endometriosis is rare in teenagers, and surgery should never be a first-line intervention in this group. Endometriosis is picked up by subtle signs on ultrasound and pelvic examinations, but the diagnosis is confirmed when a laparoscopy is done, and tissue can be sent to a pathologist.”

In patients who suffer from PMS or PMDD, the symptoms might be exacerbated by the associated pain due to: 

• The drop in oestrogen during the menstrual period might impact mood 
• The severe pain can heighten emotional distress and anxiety
• Patients who are prone to PMS might react worse to dysmenorrhea.

How to manage period pains

However, not all hope is lost; managing the emotional and physical symptoms periods can be done by combining the power of medication and some lifestyle choices. “This can be addressed by treating the physical symptoms with pain medication and heat therapy. Stress-relief techniques can also alleviate some symptoms. Exercise will improve blood flow to the pelvis and will improve pain. Exercise is also beneficial for mental health. Emotional support from family members is also beneficial, for example, making her a nice warm drink.”

Seeking professional help

Teenagers need to be empowered with information and support to take charge of their health from an early age. Dr Mostert emphasises that if period pain is persistent, severe or affects their daily routine, they should consult with their family doctor or gynaecologist for an accurate diagnosis and appropriate management.

Are you or your daughter or niece experiencing severe period pain? Please consult with one of our expert gynaecologists at Mediclinic for personalised care and support.