Menstrual Cramps (Dysmenorrhea) in Teens

What are menstrual cramps in teens?

Menstrual cramps are severe, painful cramps that occur during a period. There are two types:

• Primary. This type starts soon after a girl gets her first period. It's usually lifelong. But it may get better over time.

• Secondary. This type is caused by another health problem, such as a growth or infection. It usually starts later.

What causes menstrual cramps in a teen?

Most cramps are caused by abnormal tightening of the muscles of the uterus (contractions). This is from changing hormone levels. The hormone prostaglandin controls the contractions of the uterus.

Secondary menstrual cramps are often caused by endometriosis. This is when tissue that forms the inside lining of the uterus also grows outside the uterus. It can grow on other organs inside the pelvis or belly (abdomen). This can also cause internal bleeding, infection, and pelvic pain.

Other causes of secondary menstrual cramps can include:

• Infection of the reproductive organs (pelvic inflammatory disease)

• Fibroids (noncancer [benign] growths in the uterus)

• Fertilized egg that implants outside the uterus (ectopic pregnancy)

• Pregnancy loss (miscarriage)

• Other infection in the pelvis

• Growths in the pelvis such as tumors or polyps

Which teens are at risk for menstrual cramps?

A teen is more at risk for menstrual cramps if they have:

• Their first period at an early age

• Long or heavy periods

• A family history of menstrual cramps

Smoking also increases the risk.

What are the symptoms of menstrual cramps in a teen?

Symptoms can occur a bit differently in each teen. The most common symptoms include:

• Cramping and pain in the lower abdomen

• Low back pain

• Pain spreading down the legs

Other symptoms can include:

• Nausea

• Vomiting

• Diarrhea

• Tiredness

• Weakness

• Fainting

• Headaches

Symptoms occur just before menstrual bleeding starts each month. The pain can last for 1 to 2 days or more. It then lessens at the end of the period.

Symptoms of secondary menstrual cramps can start several days before menstrual bleeding starts. The pain may get worse and last for days, weeks, or longer.

Menstrual symptoms can be like other health conditions. Make sure your teen sees their healthcare provider for a diagnosis.

How are menstrual cramps diagnosed in a teen?

The healthcare provider will ask about your child’s symptoms and health history. They may also ask about your family’s health history. The healthcare provider will give your teen a physical exam. The physical exam may include a pelvic exam. Your child may also have tests, such as:

• Ultrasound. This painless test uses sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function. They also assess blood flow through various vessels.

• Laparoscopy. This procedure uses a thin tube with a lens and a light (laparoscope). The scope is inserted into a small cut (incision) in the abdominal wall. The healthcare provider can see abnormal growths in the pelvis and abdomen.

• Hysteroscopy. This is an exam of the cervix and inside of the uterus. It's done with a viewing tool (hysteroscope) inserted through the vagina.

How are menstrual cramps treated in a teen?

Treatment will depend on your teen’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment options include:

• Pain medicines that block prostaglandins, such as ibuprofen

• Acetaminophen

• Birth control pills (oral contraceptives)

• IUD with progesterone

• Good diet

• Enough sleep

• Regular exercise

• Heating pad across the lower abdomen

• Hot bath or shower

• Transcutaneous electrical nerve stimulation (TENS)

• Surgery

• Acupuncture

• Abdominal massage

• Relaxation methods

Talk with your teen’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of menstrual cramps in a teen?

Possible complications include missed school or work because of severe pain. Menstrual cramps can be caused by a condition such as endometriosis. If left untreated, this may have an impact on your teen’s future ability to get pregnant.

How can I help my teen live with menstrual cramps?

Painful periods can be difficult to cope with every month. You can help by making sure your teen has the tools to treat pain symptoms quickly. Your teen may also need emotional support during painful days.

When should I call my teen’s healthcare provider?

Call the healthcare provider if your teen has:

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about menstrual cramps in teens

• Menstrual cramps are severe, painful cramping that occurs with a period.

• Menstrual cramps often start soon after a teen gets their first menstrual period. It's usually lifelong. But it may get better over time. It is caused by abnormal tightening of the muscles of the uterus (contractions). This is due to changing hormone levels.

• Secondary menstrual cramps are caused by another health problem, such as a growth or infection. It's often caused by endometriosis.

• There are many treatment options. They include pain medicines, hormone treatment, using a heating pad, surgery, and other methods.

• Painful periods can be hard to cope with every month. You can help by making sure your teen has the tools to treat pain symptoms quickly. Your teen may also need emotional support during painful days.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.