Take 5: Managing period pain in very young females

2 minute read

Young women experiencing dysmenorrhea for the first time may need reassurance and treatment


Dysmenorrhea affects more than one half of women who menstruate – but very young women experiencing symptoms for the first time may need reassurance and treatment.

“It’s about educating them that periods are often irregular, heavy and painful initially,” explained Dr Yasmin Tan, a gynecologist at the Royal Hospital for Women in Sydney.

“That’s because menstrual cycles are anovulatory, so they are not ovulating for a lot of the time for up to three years after their periods begin. So reassurance that they are normal is the number one thing.”

If period pain starts to impact the girl’s life through absenteeism then doctors need to offer some treatment, said Dr Tan.

“The least you can do is offer them a non-steroidal anti-inflammatory drug,” she said.

“You know that will reduce blood loss and help pain in a significant number of patients. If they are happy with that then that’s great.”

To help with heavy periods, doctors can give young women tranexamic acid, which will significantly reduce the blood loss.

“The difficulty comes if their periods are really irregular and they are bleeding all over the place,” continued Dr Tan.

“In that case they need some kind of hormonal manipulation to improve things. The best thing is really a low dose pill in that scenario. There are some 20 microgram estradiol pills around that you can use safely.”

In the following five-minute video, Dr Tan addressed the following questions:

– How do you approach women who have just experienced period pain for the first time who are not interested in the pill?

– How do you approach hormonal treatment in these women?

– Will the low dose pill cause mid-cycle bleeding?

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