Sometimes having your period can be a pain - literally. Most
girls have to deal with PMS, cramps, or headaches around the time
of their periods. These problems are usually normal and nothing to
worry about. Here are the facts on which period problems are common
and normal - and which ones might indicate there's something
else going on.
What Is PMS?
Premenstrual syndrome (PMS) is the term for the physical and
emotional symptoms that many girls and women get right before their
periods begin each month. If you have PMS, you might
- sore breasts
- food cravings
- depression or feeling blue
- difficulty concentrating
- difficulty handling stress
PMS is usually at its worst during the 1 to 2 weeks before a
girl's period starts, and it usually disappears when her period
Why Do Some Girls Get PMS?
Doctors have not pinpointed the exact cause of PMS, but many
believe it is linked to changing hormone levels. Following a girl's
period, the amounts of estrogen and progesterone (female hormones)
in a girl's body increase. Then about 1 week before her period
starts, levels of both of these hormones begin to fall. The
thinking is that these changing hormone levels can lead to PMS
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. There are other
theories as well. For example, some believe that what you eat can
affect how you feel, especially during the couple of weeks before a
Luckily, there are several things you can do to ease PMS
symptoms. Eating a balanced diet with lots of fresh fruits and
vegetables and cutting back on processed foods like chips and
crackers can help. You might also want to reduce your salt intake
(salt can make you retain water and become more bloated) and,
believe it or not, drink more water. Say no to caffeine (it can
make you jumpy and anxious) and yes to certain vitamins: B-complex
vitamins, calcium, magnesium, and vitamin E are thought to be
helpful. Also, daily exercise and stress-relief techniques like
meditation can help some girls.
When it comes to medicine, over-the-counter pain
medicines like ibuprofen can relieve achy heads and backs. But
for really serious PMS pain, see your doctor. He or she might be
able to prescribe a different medicine or birth control pills to
help with many of your PMS symptoms.
Why Do Some Girls Get Cramps?
Lots of girls have abdominal cramps during the first few days of
their periods. Cramps are most likely caused by
-dinz), chemicals your body produces that make the muscles of the
uterus contract. The good news is that cramps usually only last a
few days. But if you're in pain, medicine like ibuprofen may
Exercise may also make you feel better, possibly because it
releases endorphins, chemicals in the body that literally make you
feel good. Soaking in a warm bath or putting a warm compress on
your stomach won't make your cramps disappear but may help your
muscles relax a little. If you have severe cramps that keep you
home from school or from doing stuff with your friends, visit your
doctor for advice.
Why Isn't My Period Regular?
It can take up to 3 years from the time a girl starts
menstruating for her body to develop a regular cycle. Even then,
what's regular varies from person to person. Girls' cycles
can range from 21 to 45 days.
Changing hormone levels might make your period short one month
(such as 2 or 3 days) and more drawn out (such as 7 days) the next.
You might skip a few months, get two periods almost right after
each other, have a really heavy period, or one so light you almost
don't notice it. (If you're sexually active and you skip a
period, though, you should visit your doctor or a women's
clinic to make sure you're not pregnant.)
can make planning for your period a real hassle. Try to keep track
of when your last period started, and guess that about 4 weeks from
that day you could be due for another. If you're worried about
wearing that cute dress and suddenly starting your period at
school, just make sure you pack protection. Carry a pad or tampon
in your backpack, and wear a pantiliner to handle the first
When it comes to periods, every girl's body has a unique
(and unpredictable) timeline for getting on track. If your period
still has not settled into a relatively predictable pattern after 3
years, or if you have four or five regular periods and then skip
your periods for a couple of months, make an appointment with your
doctor to check for possible problems.
Why Haven't I Started My Period Yet?
Everybody goes through puberty at different speeds. Some girls
begin menstruating as early as age 8 or 9; others don't get
going until they're 15 or 16. It all depends on your hormones -
and your family. Want to guess when you'll get your period? Ask
when your mom and grandmothers (from both sides of your family)
started theirs. When you start puberty is partly linked to
genetics. So although there's no guarantee that you'll
follow in their footsteps, your relatives could give you a pretty
good clue about your own period.
One thing that can delay puberty - and your period - is
excessive exercising, usually distance running, ballet, or
gymnastics, combined with a poor diet. For exercise to be
excessive, it means more than just playing soccer for a couple of
hours a few times a week or working out once in a while with an
exercise tape. To exercise so much that you delay your period, you
would have to train vigorously for several hours a day, most days
of the week, and not get enough calories, vitamins, and
Unless compulsive exercise has postponed your period,
there's nothing you can do on your own to hurry things along.
If you haven't started to menstruate by the time you're 16,
consult your doctor. He or she will probably do a pelvic exam and
take a blood test to determine the hormone levels in your body.
Then the doctor might prescribe hormones to jump-start your
Even if it seems strange to you, most of the stuff that
goes along with a girl's period is completely norma. But there
are a few conditions that can be more serious. If you suspect you
have any of these conditions, see your doctor for advice.
is the term doctors use for absence of periods. Girls who
haven't started their periods by the time they are 16 may have
primary amenorrhea, usually caused by a hormone imbalance or
There's also a condition called secondary amenorrhea, when
someone who had normal periods stops menstruating for at least 3
months. Low levels of
(GnRH), which controls ovulation and the menstrual cycle,
frequently bring on amenorrhea. Stress, anorexia, weight loss or
gain, stopping birth control pills, thyroid conditions, and ovarian
cysts are examples of things that can throw your hormones out of
whack. To get everything back on course, your doctor may use
hormone therapy. If a medical condition is affecting your monthly
cycles, then treatment of the condition will help to resolve the
problem. As mentioned earlier, lots of strenuous exercise combined
with a poor diet can also cause amenorrhea. Cutting back on
exercise and eating a balanced diet with more calories will help
correct the problem, but be sure to talk with your doctor as
-jee-uh) is the term doctors use for extremely heavy, prolonged
periods. Menorrhagia is more than just 1 or 2 days of a
heavier-than-average flow. Girls who have menorrhagia soak through
at least a pad an hour for several hours in a row or have periods
that are more than 7 days long. (Clotting during your period is not
necessarily a sign of menorrhagia, though - lots of girls, with
both heavy and light periods, pass clots when they menstruate.)
The most frequent cause of menorrhagia is an imbalance between
the amounts of estrogen and progesterone in the body. Because of
this imbalance, the
-tree-um, the lining of the uterus) keeps building up. Then when
the body gets rid of the endometrium during a period, the bleeding
is very heavy.
Many girls have hormone imbalances during puberty, so it's
not uncommon to experience menorrhagia during the teen years. Other
cases of heavy bleeding may be caused by thyroid conditions, blood
diseases, or inflammation or infections in the vagina or cervix. To
help figure out the cause of abnormal bleeding, a doctor can do a
pelvic exam, a Pap smear, and blood tests. If you do have
menorrhagia, it can be treated with hormones, medicine, or removal
of any growths in the uterus that may be the cause of excessive
Extremely Painful Periods
-uh) is the medical term for very painful periods. Primary
dysmenorrhea - painful periods that are not caused by a disease or
other condition - is more common in teens than secondary
dysmenorrhea (painful periods caused by a disease or
The culprit in primary dysmenorrhea is prostaglandin, the same
naturally occurring chemical that causes cramps. In large amounts,
prostaglandin can cause nausea, vomiting, headaches, backaches,
diarrhea, and severe cramps when you have your period. Fortunately,
these symptoms usually only last for a day or two. Doctors usually
prescribe anti-inflammatory medicines to treat primary
dysmenorrhea. As with cramps, exercise, hot water bottles, and
birth control pills might also bring some relief.
Some of the more common conditions that can cause secondary
- endometriosis, a condition in which tissue normally found
only in the uterus starts to grow outside the uterus
pelvic inflammatory disease (PID)
, a type of bacterial infection
or growths on the inside wall of the uterus
All of these conditions require that a doctor diagnose the
problem and then treat you appropriately.
What to Do if You Suspect a Problem
When you have questions about your period or anything else
related to your development, talk to your doctor. This is
particularly true if you notice a change in your menstrual cycle.
Though most period problems turn out to be nothing to worry about,
it's always good to be safe.
See your doctor if:
- You have not started your period by the time you are 16. This
may indicate that you have a problem that requires medical
- You stop getting your period or it becomes really irregular
after it has been regular for a while (like 6 months or more).
This can be a sign that you may have a hormone imbalance or a
problem with nutrition, which can harm your body if left
- You have very heavy or long periods, especially if you have a
short cycle and get your period frequently. In rare cases, lots
of blood loss can cause
(iron deficiency) and leave you feeling really weak and
- Your periods are really painful. You might have endometriosis
or benign growths that should be removed. Or if you're
sexually active, you might have PID.
Chances are that your painful or irregular periods are nothing
to worry about. But if there is something going on, the quicker you
get it taken care of, the sooner you'll be on your way to
feeling great again.
Elana Pearl Ben-Joseph, MD
Date reviewed: November 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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