Period Pains Not Normal

Endometriosis is where cells similar to the lining of the uterus grow at an extra-uterine unusual site
such as ovaries, pelvic peritoneum, and fallopian tubes. Actually, it can grow anywhere. In the
past it was believed that this disease affects only older women, but we now know that it is
common for a teen or young woman to get endometriosis says Dr Vimee Bindra - Fertility
Enhancing Surgery Specialist| Endometriosis Excision Surgery Specialist |Gynecologist
|Laparoscopic and Robotic Surgeon | Co-Founder “ENDOCRUSADERS”.

This young girl may think that the incapacitating symptoms are the norm and she has to live
with it and this feeling and misconception is deepened further by ill-informed people who
tell her that “period pain is normal”, “exercise will make it better”, “don’t behave like a kid,
it's your period”, “your mother and grandmother had the same pain so don’t worry”.
If the pain does not subside and she is taken to the doctor and in all probability, she may be told
that there is no problem. Everything is fine with you, no need to complain so much. If pain is
pretty bad, she will be introduced to the world of analgesics (painkillers). If this also doesn’t
work, contraceptive pills come to the rescue, and she starts functioning under the influence of
hormones. And if it is due to endometriosis the disease progression continues and after
years of suffering, she may be diagnosed when she undergoes laparoscopy.

Endometriosis symptoms in teens
Most women when asked tell that their period pain started in their teens or early 20s.
around 40% of women start experiencing period pain before the age of 15 years.
Evaluation of period pain
Mild discomfort on the first 1-2 days of a period is common but it needs further evaluation if
it causes distress or inability to do routine activities, missing school, sports activities and
doesn’t get better when treatments like simple painkillers are taken.

Which teens are at greater risk
Endometriosis runs in families, so young girls whose relatives have endometriosis have a
higher chance of having endometriosis. Girls who start periods early, and have low BMI run a
higher risk of endometriosis.

These girls may develop some other symptoms such as

• Heavy bleeding
• Bloating
• Lower back pain
• Muscle spasm
• Irritable bowel
• Painful overactive bladder
• fatigue.

If teenager girls are not responding to medical pain management and if laparoscopy is done,
almost 67-70 % of them will have endometriosis.

Diagnosis of endometriosis in teenage girls

Ultrasound and MRI can detect ovarian cysts quite well but in teenage girls these lesions are
rare and peritoneal lesions are more common. These lesions are small and are clear or
white or red and can be picked up on laparoscopy only. To identify these lesions properly
endo excision expert should be involved in diagnosis and treatment.
 

How parents can deal with their teenage suffering from pain

• Get good information about pelvic pain.
• To help them cope with pain and its effects on their emotional thought process which might leave them thinking they have to suffer like this whole life
• Help them develop a support team of gynaecologists, physiotherapists, pain management specialists, dieticians, counsellors, friends, teachers and school nurses.

Try to shift the focus away from pain Help your adolescent develop a plan to deal with bad pain day

What adolescents can do with pain to manage their symptoms

•  Keeping active will reduce their muscle spasm. Gentle exercise such as walking
• and stretching helps.
• Physiotherapists can help relax pelvic muscles as tightening the pelvic muscles increases pain.
• Improve diet, include an anti-inflammatory diet and avoid constipation, drink plenty of water.
• Involving yourself in a hobby helps distract you from symptoms. Meditation and breathing exercises also focus the mind away from pain symptoms and help in pain management.
• Acupuncture and alternative therapies can improve pain symptoms for some young women.

What’s best we can and should offer

Make the diagnosis early. If pain is severe, endometriosis should be considered a possible
diagnosis believe the patient and don’t tell them it happens, it is normal, you are over-
reacting. If it's endometriosis, it can be corrected surgically, and she can lead a pain-free life.
 

Simple Surgery to be relieved
Trained excision surgeons who can completely recognize the disease and remove it, can
reduce the recurrence rates of disease.
This can be a daycare surgery and the patient can go home the same day.
If complete excision is done, post-operative pain relief is miraculous. Menstrual cramps and
ovulatory pain may persist.
When these young girls are free from chronic pelvic pain, their healthy state of mind returns
and their productivity increases. They can themselves value their worth.