Advice for adolescents with period pain and other symptoms

2017, Responses from: Mr Simon Edmonds

I’m the mother of 16 year old Abby and I am desperate to know what to do about Abby’s bad periods. Abby has at least 2 days off school every month and is now having pains at other times. Her periods started at 12 and they have always been bad. I have a diagnosis of endometriosis which was a real battle to have treated and I still suffer. But to see my daughter now heading down the same path, is so upsetting. We have been to two GP’s and the story seems to be the same – take the pill and it will settle. Well, we’ve tried that for several years and her periods are regular but the pain and other symptoms are still bad. She tried taking the pill continuously and even when she’s not getting a period, she still has awful pain. She’s frightened about going to the toilet now because it hurts so badly. The doctor has said we probably won’t get into the health system and even if we do, nothing can be done and surgery never works. I’m sure Abby has endometriosis but I don’t know what to do. We don’t have health insurance and I can’t afford to see someone privately. I’d love you to help us by offering advice.

PS. Abby hasn’t had a boyfriend yet and spends most of her time at home where she used to be a really outgoing and sporty girl. The doctor has put her on anti-depressants.

Mr Simon Edmonds: It can often be very distressing for women who have been given a diagnosis of endometriosis, to then see their daughters go through some of the same problems with their periods and pelvic pain.

There is certainly a familial/genetic linkage with endometriosis, but this is not always the case. If Abby has tried the pill and also taken it continuously, without improvement in her pain, then referral to a gynaecologist would certainly be appropriate. There may be other causes for the continuous pain throughout the month and the gynaecologist will take a careful history and exclude these.

There is no ‘correct’ time to perform the 1st laparoscopy to try and diagnose or exclude endometriosis, but we try to explore more conservative options in younger girls as this often works.

If not, then laparoscopy at least gives an answer as to the way forward, but it would be unusual to see severe disease in this age group. Insertion of a mirena coil at the same time, is also another option as this can give better control of the periods. Improving diet and exercise regimes can also help in this age group.

If you do not have private cover, all public hospitals should offer this service and a least a consultation to discuss the way forward.

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