Any options for horrendous periods for teen girls?

[historically accurate]

Obviously, we'll be talking to the gynecologist, but anyone have any great ideas?

DD has horrible periods. She vomits, faints (she has POTS, but she will always pass out during the first 2 days of her period), diarrhea, and severe cramps. Since her POTS has stabilized with the right med mix, we've started focusing on fixing/ameliorating the periods, so far we're 0 for 2. 

To make matters more complicated, I carry the BRCA gene, so anything with estrogen is out.

She had the nexplanon implanted in December. It worked like a charm the first period. Second month, she passed out a couple of times. 3rd month, she was passing out so much, she reverted to using her wheelchair. We had it removed at the end of March. Long story about why it took so long - but that was the first available to get it removed. Her fainting/dizziness/general POTS symptoms stopped within a week of having it removed. Because of this, she refuses to try the Depo shot because there is nothing to remove if it goes horribly awry. 

She went on the minipill in early April. Only a little bit of cramp relief, but no vomiting and no fainting, so plus I guess. However, it caused a severe mental health crisis. So she has come off of that.

IUD? Any non hormonal options? Anything else? 

[busymama7]

Bio identical progesterone. Using synthetic birth control can sometimes mask symptoms but doesn't help with what the body actually needs. You would need to be open to an alternative practitioner

[Elona]

If her estrogen is overly high (which can be genetic) she could try things that help bring it down - high fiber diet, the supplement  DIM, exercise (to the extent that is possible.) These things would need to be done pretty much all month long. I paid out of my own pocket to have a DUTCH test which is done at home and mailed in. It is a complex, thorough test used by functional medicine docs to identify hormonal imbalances, and it helped me find my own estrogen excess (which for me contributes to horrible cramps, headaches/migraines, and mood issues.)

It is also possible that she has endometriosis or fibroids that are causing problems.

For the cramps, the best advice I have found is to begin taking ibuprofen 2 or 3 days BEFORE the expected period. This helps reduce prostaglandins, which are what lead to pain. Some doctors also recommend zinc in the days before, but I have had very good luck with the early ibuprofen.

Hugs to your daughter, it is really hard to deal with this sort of painful rollercoaster.

[smfmommy]

My daughter isn't near as bad as that, but did have an emotional rollercoaster each month plus bad cramps.  She takes "Go With the Flow" by Happy Healthy Hippie plus thyroid support meds and that has helped a lot.

My sympathies to your daughter and you (it's hard watching your child in pain).

 

[melbotoast]

You could look into seed cycling? Don't know how much it would help but probably would be safe to try. Hope she finds relief! 

[Kanin]

Oh, that sounds so awful. I didn’t have the fainting, but I did have awful cramps and would almost throw up. I was useless for about 8 hours on the first day of my period. The nurse practitioner had me take ibuprofen 3 days before my period. That helped a lot. It’s tricky if the periods are irregular though... you don’t want to be taking ibuprofen for 8 days each month or something.

I recommend using something to keep track of when she has her periods.

[barnwife]

I would throw up from the pain of cramps as a teen. That alone was awful, so I feel for her. In my 20s I figured out that eating less dairy helped make my cramps less intense. I also agree with tracking her periods. If she is irregular, then I'd even recommend charting her BBT. Then she could take ibuprofen the couple days before she expects things to get bad, and maybe help stay ahead of the pain. 

[bluemongoose]

I had this too minus POTS. For me it was abdominal migraine caused by the hormones. The key was to get on top of the migraine before it caused faintness, throwing up, intense pain, and diarrhea. To do this charting is a must because painkillers had to be started before the migraine was coming. So I needed to know when the first day would be and start the painkiller the day before and then keep taking them every 6 hours like clockwork for the first two days. Once the pain was out of control, there was almost no way to go back and I had to just wait it out. When I went to the Dr all they offered was BCP. 

 

[MercyA]

I have endometriosis and also had vomiting, diarrhea, and severe cramping as a young woman. The thing that helped the most dramatically was cutting out all meat, poultry, fish and dairy. After a few months on that diet, it was like a miracle had occurred in terms of reduction of pain. Red meat and dairy are the most crucial things to cut out. I'm in a huge hurry right now, but just google red meat and dairy and prostaglandins.

Taking ibuprofen or Aleve a day or two before her period starts and consistently during her period will likely help too.

Hugs to her.

[Elona]

13 minutes ago, bluemongoose said:

 For me it was abdominal migraine caused by the hormones. The key was to get on top of the migraine before it caused faintness, throwing up, intense pain . . .

I have never heard of an abdominal migraine! That's a thing? I am off to Google to learn more. Thx for mentioning!

[historically accurate]

42 minutes ago, bluemongoose said:

I had this too minus POTS. For me it was abdominal migraine caused by the hormones. The key was to get on top of the migraine before it caused faintness, throwing up, intense pain, and diarrhea. To do this charting is a must because painkillers had to be started before the migraine was coming. So I needed to know when the first day would be and start the painkiller the day before and then keep taking them every 6 hours like clockwork for the first two days. Once the pain was out of control, there was almost no way to go back and I had to just wait it out. When I went to the Dr all they offered was BCP. 

 

A different DD has migraines and abdominal migraines. So this may be an avenue to pursue; thanks!

[Katy]

I can’t recall the name of the site but there’s one for endometriosis that can help you find a good surgeon to get it removed. 

She can also try an extreme diet to lower estrogen and prostaglandins. It’s basically low fat, high fiber vegan with an extra emphasis on cruciferous vegetables like broccoli that are shown to lower estrogen. There’s a good explanation on the Physicians Committee for Responsible Medicine (PRCM) website. It’s very effective but she will need to take B12 & Iodine supplements. It may be better to take Thorne’s prenatal instead of individual supplements. They’re $25/month or so on Amazon and if she also has DNA methylation issues they should lower inflammation and improve iron-related heavy bleeding too. 

[Corraleno]

That's exactly what my life was like when I was in my teens/early 20s, and I would miss a couple of days of school every month. Then in grad school I got a prescription for Anaprox (high dose naproxen; this was before Aleve was available over the counter) and it changed my life overnight. Aleve is much more effective than ibuprofen or Tylenol, and it's more than just a pain killer; as Mercy mentioned, it reduces the level of prostaglandins in your system, and you need to start taking it a day or two before your period. 

[Amy in NH]

Have you tried red raspberry leaf tea for the cramps?  It is a uterine tonic, and in my experience wipes out the very worst cramps in a very short time.  It must be real raspberry leaf, and not just flavored tea.  I pick and dry fresh young shoots from our raspberry patch, but you can buy it in health-food stores.  It will curdle milk...

[almondbutterandjelly]

Aleve every 8 hours. Start a day or two before your period and continue until end of period. 

[kristin0713]

Has she had bloodwork done to check her hormone levels? 

We tried everything non-hormonal for my DD--RRL tea, ibuprofen and Aleve, vitamins, those special period vitamins. She ended up going on the pill and it was life-changing. It might be worth trying a regular pill, not the mini-pill. My DD is on Lo-loestrin. It has the lowest amount of estrogen of any regular BCP. 

Personally, I'm on my second IUD and that has been life changing for me. But I can't imagine subjecting my daughter to the insertion process. The first one was hellish, and that is after having had two kids. For the second one, they prescribed me something to dilate my cervix and numbed my cervix and it was bearable. But the whole experience is something that I imagine would be mortifying and possibly traumatic for my 16yo. 

[Ann.without.an.e]

How old is she? I’m sorry if that was there and I missed it. 

[bluemongoose]

2 hours ago, Elona said:

I have never heard of an abdominal migraine! That's a thing? I am off to Google to learn more. Thx for mentioning!

Yep it is a thing! Agreed on the Aleve, Advil was better than Tylenol in a pinch though. Like other people suggested, limited dairy and meat beforehand seemed to help it be less bad as well. I do think it was basically a hormone thing causing the migraines. I was checked for endometriosis and other things...I didn't have anything else going on. And I still have migraines today. They are worse now with perimenopause, but they aren't the abdominal kind anymore. The abdominal ones lessened as I reached my 20s and everything was better after my first child. Ive not had any abdominal kind since then. 

 

Also, due to my family history of cancer...I never did any form BC, so I understand this aspect too.  

 

[Kanin]

2 hours ago, Corraleno said:

Aleve is much more effective than ibuprofen or Tylenol, and it's more than just a pain killer; as Mercy mentioned, it reduces the level of prostaglandins in your system

I didn't know this - thanks!!

[historically accurate]

4 hours ago, busymama7 said:

Bio identical progesterone. Using synthetic birth control can sometimes mask symptoms but doesn't help with what the body actually needs. You would need to be open to an alternative practitioner

Any ideas on how to find an alternative practitioner who is good? Her pediatrician actually is really good and knowledgeable about teen menstruation, but she's kind of at a loss too.

4 hours ago, Elona said:

If her estrogen is overly high (which can be genetic) she could try things that help bring it down - high fiber diet, the supplement  DIM, exercise (to the extent that is possible.) These things would need to be done pretty much all month long. I paid out of my own pocket to have a DUTCH test which is done at home and mailed in. It is a complex, thorough test used by functional medicine docs to identify hormonal imbalances, and it helped me find my own estrogen excess (which for me contributes to horrible cramps, headaches/migraines, and mood issues.)

It is also possible that she has endometriosis or fibroids that are causing problems.

For the cramps, the best advice I have found is to begin taking ibuprofen 2 or 3 days BEFORE the expected period. This helps reduce prostaglandins, which are what lead to pain. Some doctors also recommend zinc in the days before, but I have had very good luck with the early ibuprofen.

Hugs to your daughter, it is really hard to deal with this sort of painful rollercoaster.

Like the Everlywell test? Or is there another one?

3 hours ago, barnwife said:

I would throw up from the pain of cramps as a teen. That alone was awful, so I feel for her. In my 20s I figured out that eating less dairy helped make my cramps less intense. I also agree with tracking her periods. If she is irregular, then I'd even recommend charting her BBT. Then she could take ibuprofen the couple days before she expects things to get bad, and maybe help stay ahead of the pain. 

She has noticed that switching to almond milk in her cereal did lessen the diarrhea and bloating a little, but she hasn't cut it out completely. 

1 hour ago, Amy in NH said:

Have you tried red raspberry leaf tea for the cramps?  It is a uterine tonic, and in my experience wipes out the very worst cramps in a very short time.  It must be real raspberry leaf, and not just flavored tea.  I pick and dry fresh young shoots from our raspberry patch, but you can buy it in health-food stores.  It will curdle milk...

I actually bought this last month, but she hasn't tried it yet. 

1 hour ago, Ann.without.an.e said:

How old is she? I’m sorry if that was there and I missed it. 

She's 16, almost 17. 

 

Thanks, everyone! Lots to think about and try. I feel so helpless every month! FWIW, I had super bad cramping and bleeding (was fibroids), and both of her grandmothers had endometriosis. So, any of these could be a factor. 

[GoodGrief3]

Go check out Nancy’s Nook and have her evaluated by an endometriosis expert if at all possible. Unfortunately, the typical GYN is likely not to have the necessary knowledge or skill to perform excision (you don’t want ablation.) Hormonal solutions are only a bandaid and allow the problem to get worse. The teen years are an excellent time to get on top of the problem. My daughter had excision by Adam Duke in Idaho last fall. Game changer. 

[GoodGrief3]

Adding, there was an excellent article in n endometriosis n the New York Times last fall or so. Try to find it and read it if you can. 

[busymama7]

1 hour ago, historically accurate said:

Any ideas on how to find an alternative practitioner who is good? Her pediatrician actually is really good and knowledgeable about teen menstruation, but she's kind of at a loss too.

Like the Everlywell test? Or is there another one?

She has noticed that switching to almond milk in her cereal did lessen the diarrhea and bloating a little, but she hasn't cut it out completely. 

I actually bought this last month, but she hasn't tried it yet. 

She's 16, almost 17. 

 

Thanks, everyone! Lots to think about and try. I feel so helpless every month! FWIW, I had super bad cramping and bleeding (was fibroids), and both of her grandmothers had endometriosis. So, any of these could be a factor. 

Look for Na pro practitioner or a functional medicine Dr. If you pm me I can share the practice we use and they do telemedicine but I am not sure if it is available in every state 

[ScoutTN]

Acupuncture is often very effective for female hormone/cycle issues.

[shawthorne44]

I used to have horrible periods.   I didn't have POTS, as far as I know, and I didn't faint.   Well, actually I did faint a few times but I never connected it up with the period.  I did pray for death a few times.  I did bleed myself anemic and a male OBGYN didn't believe me when I described my periods.   
The Estrogen thing is a problem.  BC pills helped me a bit.   Do NOT get the Depo shot.   I was on it for a year and then had a break-through period where I had a horrible period that lasted an entire month.   My OBGYN said she'd seen a lot of that.   I'd been an early adopter of it.  If she has bad periods now, imagine one that lasted a month.   

Some things which helped me.   

• I switched from Motrin to Aleve.   I'd been on prescription Motrin as a teen which was 800 mg.   Then when it went to over-the-counter, I used those and I'd take around 30 pills per period.  Now I do 1-3 Aleve pills each period, which the average probably 1.2.    
• I stopped using disposable pads and tampons.  I switched to mama pads and a cup.   

Helping my period wasn't why I did either of these things, but I noticed an improvement when I did.   I've since heard an explanation, something about the tail-end of the period being more about the bodies reactions to the Motrin or the chemical in the disposables.   Now my periods start with a trickle, then I gush for about a day, then I go back to a trickle for about 12 hours then I'm done.  Before, it would be take 7-10 days.  Those are tiny things and won't cure it, but any improvement is good.  

Have you checked her iron levels?     The prescription iron is nasty tasty stuff, but if low iron is the reason for fainting ...    
Also, the fainting got better once I learned to recognize the signs of it coming.   Then it was "Head to Knees."    Something as complicated as "Put your head below your heart" was waaayyy too complicated for my brain in the pre-faint stage.    I'd faint while figuring out how to do that.   But "Head to Knees" was easy enough.    I'd look at my knees and move my head in that direction.   Then some blood would go to the brain and I could think out a more permanent position.  

 

[AmandaVT]

5 hours ago, Corraleno said:

That's exactly what my life was like when I was in my teens/early 20s, and I would miss a couple of days of school every month. Then in grad school I got a prescription for Anaprox (high dose naproxen; this was before Aleve was available over the counter) and it changed my life overnight. Aleve is much more effective than ibuprofen or Tylenol, and it's more than just a pain killer; as Mercy mentioned, it reduces the level of prostaglandins in your system, and you need to start taking it a day or two before your period. 

The anaprox helped me a TON when I was younger. I can't remember the dose, but it was a lot higher than the recommended Aleve dose. Was an amazing help though! 

[historically accurate]

33 minutes ago, shawthorne44 said:

I used to have horrible periods.   I didn't have POTS, as far as I know, and I didn't faint.   Well, actually I did faint a few times but I never connected it up with the period.  I did pray for death a few times.  I did bleed myself anemic and a male OBGYN didn't believe me when I described my periods.   
The Estrogen thing is a problem.  BC pills helped me a bit.   Do NOT get the Depo shot.   I was on it for a year and then had a break-through period where I had a horrible period that lasted an entire month.   My OBGYN said she'd seen a lot of that.   I'd been an early adopter of it.  If she has bad periods now, imagine one that lasted a month.   

Some things which helped me.   

• I switched from Motrin to Aleve.   I'd been on prescription Motrin as a teen which was 800 mg.   Then when it went to over-the-counter, I used those and I'd take around 30 pills per period.  Now I do 1-3 Aleve pills each period, which the average probably 1.2.    
• I stopped using disposable pads and tampons.  I switched to mama pads and a cup.   

Helping my period wasn't why I did either of these things, but I noticed an improvement when I did.   I've since heard an explanation, something about the tail-end of the period being more about the bodies reactions to the Motrin or the chemical in the disposables.   Now my periods start with a trickle, then I gush for about a day, then I go back to a trickle for about 12 hours then I'm done.  Before, it would be take 7-10 days.  Those are tiny things and won't cure it, but any improvement is good.  

Have you checked her iron levels?     The prescription iron is nasty tasty stuff, but if low iron is the reason for fainting ...    
Also, the fainting got better once I learned to recognize the signs of it coming.   Then it was "Head to Knees."    Something as complicated as "Put your head below your heart" was waaayyy too complicated for my brain in the pre-faint stage.    I'd faint while figuring out how to do that.   But "Head to Knees" was easy enough.    I'd look at my knees and move my head in that direction.   Then some blood would go to the brain and I could think out a more permanent position.  

 

She is on prescription iron (well, prescribed but over the counter). Her iron levels had come up for a while, and they knocked her back to 1 pill a day about a year ago. She's due for another check with that prescriber soon, so I'll make sure to have them check it.

She uses period panties, but still uses a disposable pad or tampon with them. Cloth is an option to explore - she tried sewing her own a couple of times, but hasn't made any recently.

 

[shawthorne44]

I am due to make another batch of mama pads.   One thing I don't like about my current ones is that all the layers are sewed together.   I always wonder if all the blood really gets out of the inner layers.  I'll hand rinse first in the sink and I think I'm done then I give one more rinse/squeeze and more blood comes out.  Of course I wasn't a huge fan of the all-in-one diapers for the same reason, but then I have a laundry compulsion.   

For my next batch I think I'm going to take some cheap underwear and sew a tube around the between the legs area.   I'll either use an old T-shirt of my husband's or an old wash cloth.   Then I'll sew some microfiber towels into accordion shapes of various thickness.   Like maybe I'll have one that is just one layer thick, and another that is four.  I'll sew a straight line on each fold.   Then I'll shove the folded microfiber into the tube on the underwear.   I'll make the microfiber longer than needed so that the end is clean and I'll have a clean bit to yank on to separate.   

I say an old wash cloth because I saw an idea online when I first did that of using old wash cloths and laying the absorbent part at an angle from corner-to-corner, then adding snaps on the other corners.  

[ktgrok]

Has she tried high doses of NSAIDS? You can find the dosage on the internet, but Aleve at the right dose can really help lower the prostaglandins causing a lot of the symptoms, including reducing bleeding up to 50%, and the diarrhea/stomach stuff. If she's super regular she can start it right before her period, but otherwise start at first sign of period. 

[Indigo Blue]

Sorry I don’t  have anything useful to contribute except to say that my niece and my son both had abdominal migraine/cyclic vomiting syndrome. My niece’s was associated with her period. I think it went on for quite awhile, maybe a year or so. It did go away on its own, in her case, all by itself. I would recommend taking Jarrow CoQ10. I say that brand because it’s one of the few that is of very high quality, a specific type made in Japan. It could help, but it shouldn’t cause any harm. Of course, speak to your doctor first. There has been solid research that it is effective in SOME types of abdominal migraine, meaning it’s effective against cyclic vomiting occurring with certain root causes. L-carnitine (specifically this and not any other type of carnitine) is also a part of the vitamin cocktail for CVS, taken along with the CoQ10. Again, Jarrow brand is a good choice, but for the CoQ10 it’s most important.