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
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 experience:
- 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 begins.
Doctors have not pinpointed the exact cause of PMS, but it seems
to be linked to changing hormone levels. During the second half
of the menstrual cycle, the amount of progesterone (a female hormone)
in a girl's body increases. Then about 1 week before her period
starts, levels of both progesterone and estrogen (another hormone)
drop dramatically. The thinking is that these different hormone
levels can lead to PMS symptoms. There are also theories that what
you eat can affect how you feel, especially during the couple of
weeks before a girl gets her period.
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
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 I Get Cramps?
Lots of girls have abdominal cramps during the first few days of
their periods. Cramps are most likely caused by prostaglandins
(pronounced: prass-tuh-glan-dunz), 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 help.
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
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.)
All this irregularity 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 wave.
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
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
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 minerals.
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 cycle.
Although most of the strange stuff that goes along with a girl's
period is completely normal, there are a few conditions that can
be more serious. If you suspect you have any of these conditions,
see your doctor for advice.
Amenorrhea (pronounced: a-meh-nuh-ree-uh) is the 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 developmental problem.
There's also a condition called secondary amenorrhea, when someone
who had normal periods stops menstruating for at least 3 months.
Low levels of gonadotropin-releasing (pronounced: go-nah-duh-troh-pun)
hormone (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 can all throw your hormones out of whack. To get everything
back on course, your doctor may use hormone therapy. 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 well.
Menorrhagia (pronounced: meh-nuh-ray-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
The most frequent cause of menorrhagia is an imbalance between
the amounts of estrogen and progesterone in the body. Because of
this imbalance, the endometrium (pronounced: en-doh-mee-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
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 bleeding.
Dysmenorrhea (pronounced: dis-meh-nuh-ree-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 condition).
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 2. 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 dysmenorrhea
All of these conditions require that a doctor diagnose the problem
and then treat you appropriately.
- endometriosis (pronounced: en-doh-mee-tree-oh-sis), a condition
in which tissue normally found only in the uterus starts to grow
outside the uterus
- pelvic inflammatory disease, a type of bacterial infection
- fibroids or growths on the inside wall of the uterus
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:
Chances are that your painful periods are nothing to worry about.
But if there is something going on, the sooner you get it taken care
of, the sooner you'll be on your way to feeling great again.
- You have not started your period by the time you are 16. This
may indicate that you have a problem that requires medical attention.
- 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 untreated.
- 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 anemia (iron deficiency) and leave you
feeling really weak and tired.
- 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 pelvic inflammatory disease.