What is the reason for painful periods in a 13-year-old?

Question

Hi doctor,

My daughter is 13 years old. She has been developing some symptoms that worries me. I think she may have endometriosis. She got her first periods in her fifth grade and the symptoms started when she began her sixth grade. She is having extremely heavy periods with painful cramping, nausea and diarrhea. Also, she has occasional spotting. I have researched it a lot. It gets worse every time and it is getting to the point where she sometimes has pain at all times of the month. What is wrong with her?

Answer 1

Hello,

Welcome to icliniq.com.

As she is just 13 there are menses which are anovulatory in the initial two years and the hormones are not matured at all. Endometriosis in adolescents is fairly uncommon unless they have been sexually active. An endometriosis pain is typically only during menses and not in mid cycle or throughout the cycle. That is likely due to progesterone or estrogen imbalances.

So, if she is bleeding really heavy and the menses and premenstrual symptoms are painful, then you may opt for depot injections to fairly stop her menses and allow natural maturation of hormones. It shall serve as a contraceptive as well. If not, then I suggest her tablet Meftal Spas (Mefenamic acid) twice a day for three days from the start of pain to relieve pain along with hot fomentation to soothe yourself. Hormonal pills as of now are not advised though an ultrasound pelvis can be undertaken to look for any adnexal abnormalities.