Health and Periods 

Managing Period Pains

Prior to their periods, some girls may experience premenstrual syndrome (PMS). PMS can cause fluctuations in mood along with uncomfortable physical symptoms such as tender breasts, backaches, and headaches. According to the Nemours Foundation, "It isn’t clear why some girls develop PMS and others don’t. It’s possible that those who develop PMS are simply more sensitive to the changes in hormone levels" (2014). Eating healthy foods, staying hydrated, and getting enough sleep can all help teen girls with PMS to feel better (Nemours Foundation, 2014). 

The first day or first few days of a girl's period can often be painful. Pain may range from mild to severe. Stomach cramps, along with leg, head, or back pain, are very common. Cramps are caused by prostaglandins, chemicals that make the walls of the uterus contract. For some teenage girls, the pain might be so bad that they have to stay home from school. Girls who are experiencing stomach cramps for the first time may need extra comfort and reassurance. Tea, peppermints, hot water bottles, and pain relievers such as ibuprofen (Advil) or naproxen (Aleve) can help to ease the pain. 

Occasionally, teenage girls may develop dysmenorrhea, in which menstrual periods are extremely painful and result in "nausea, vomiting, headaches, backaches, diarrhea, and severe cramps"(Nemours Foundation). In teenagers, dysmenorrhea is usually not caused by a disease, and it typically goes away quickly (Nemours Foundation). 

Another condition that young ladies may experience is menorrhagia, periods that are heavy and long, lasting more than seven days. Menorrhagia in teens is usually caused by "an imbalance between the amounts of estrogen and progesterone in the body"(Nemours Foundation). This excessive bleeding can be a cause for concern as it can lead to anemia if not treated. A teenage girl who develops menorrhagia should be taken to a doctor who can identify the reason behind the problem and prescribe a remedy. Occasionally, a girl might be prescribed birth control pills for the sole purpose of preventing these heavy, painful, and potentially harmful periods. Other treatments include tranexamic acid and oral progesterone (Mayo Clinic). 

Overall, girls should know that they do not have to feel powerless when it comes to period pains and that there are many helpful solutions.    

Pads, Tampons, & Cups

The market makes both sanitary pads and tampons available, along with the lesser-known menstrual cups. Girls who use pads should be given a variety of different sizes to best accommodate them on different days of their menstrual flow. Some pads have no scent, while others are scented. However, scented pads "can irritate the vagina or cause an allergic reaction in some girls" (Nemours Foundation, 2019). It is generally better if girls use unscented pads. Pads should be changed once they have been used up to prevent irritation.

Tampons are inserted into the vagina and absorb menstrual blood. Girls who are active in sports or swimming may prefer tampons to pads. However, these products can pose a risk to teenagers. It is extremely important for girls wearing tampons to remember not to leave them in for more than 8 hours and not to wear super-absorbent tampons. Adults must remind them of this and explain the dangers to them. Wearing a tampon all day or all night can put girls at risk for "a rare but very dangerous--and sometimes life-threatening--disease called toxic shock syndrome (TSS)" (Nemours Foundation)*.

Toxic shock syndrome is a medical emergency resulting from accumulation of bacteria. Super-absorbent tampons that are left inside the vagina too long can cause this severe infection. 

Symptoms of TSS include:

• Fever of 102 degrees or above 
• Vomiting
• Headache
• Sore throat
• Muscle aches
• Fatigue
• A rash that looks like a sunburn
• Bloodshot eyes
• Broken blood vessels on the skin
• Extreme thirst
• Weak, fast heartbeat
• Rapid breathing

If a girl exhibits these symptoms during her period, caregivers should expect TSS and get emergency medical help immediately. In the hospital, antibiotics to fight the infection will be given along with intravenous fluids (American Academy of Pediatrics, 2015). Time is critical, as the faster the child receives treatment, the greater the chance that she will recover. 

A New Jersey mom tragically lost her 19-year-old daughter to TSS in 2017. In this article, she details the risks of super-absorbent tampons as a reminder to other parents: https://abcnews.go.com/GMA/Wellness/my-daughter-died-toxic-shock-syndrome-plea/story?id=66968755

Overall, given the risk of toxic shock syndrome, it is generally safer for teenage girls if they do not use tampons. Pads or menstrual cups can be substituted and will often work just as well. Menstrual cups are silicon devices that are inserted into the vagina, but they are not as dangerous as tampons.   

Girls first beginning their periods may need a little help at first with the changing process, regardless of what product they choose. If they are using a cup or a tampon, they may need assistance with proper insertion, or at the least, an explanation of how to correctly place the device inside.  

Eventually, teens become proficient at managing their sanitation needs during their periods without any help from adults!

References

American Academy of Pediatrics. (2015). Toxic shock syndrome. AAP.  Retrieved Oct. 31, 2020 from https://www.healthychildren.org/English/health-issues/conditions/infections/Pages/Toxic-Shock-Syndrome.aspx#:~:text=Toxic%20shock%20syndrome%20(TSS)%20is,1978%20in%20children%20and%20adults. 

Mayo Clinic. (2020). Menorrhagia (heavy menstrual bleeding). Mayo Clinic. Retrieved Oct. 31, 2020 from https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834 

Nemours Foundation. (2014). Coping with common period problems. Rady Children's. Retrieved Oct. 31, 2020 from 

https://www.rchsd.org/health-articles/coping-with-common-period-problems/

Nemours Foundation. (2019). Tampons, pads, and other period supplies. TeensHealth. Retrieved Oct. 31, 2020 from https://kidshealth.org/en/teens/supplies.html#catgirls

* This page from the Nemours Foundation was updated and this particular quote no longer exists.