10 year old daughter with heavy, painful periods

[GreenSunfish]

My daughter started her period a few months ago at 10 years old. They are really heavy and very painful (she has a high pain threshold but is totally floored). The GP prescribed Mefenamic Acid 250mg three times a day for day 1-3 to reduce pain and flow but the improvement is only slight and she vomits with them. She also takes maximum dose painkillers she’s allowed. The GP doesn’t want to prescribe the pill due to her age but we are desperate. Obviously if the pill is not safe I don’t want it for her but I feel like we’re out of options. Does anyone have any experience with this. Thank you.

Maybe find a specialist as I am
Gobsmacked how little notice is taken of women and girls in this position. My friends daughter kept going back and has finally been offered a scan to check all ok.

Take her to a gyno privately. Sounds horrific, that’s what I would
personally do without any hesitation.

I would take her to a private gyno, as soon as possible. I wouldn't trust a GP treating her.

Sounds terrible for her. Have you asked for a gynae referral? What does she weigh? Adult medications are based on a weight of 50kg+, so if she is less, maybe that is why the GP is reluctant to prescribe the pill?

If no referral then I'd look at finding a practe gynae with paediatric/teen experience if you can afford it.

Another option could be a family planning clinic. My local one holds specific drop in clinics- contraception, teens, menopause etc. They have specialist nurses, but also gynaecologists- and all on the NHS. Check if there is one in your area. Best of luck OP.

Poor love, it is bad enough as an adult having heavy periods let alone at her age. Can they try tranexamic acid instead? It would still be off-label as normally prescribed to 12+ like mefenamic acid. If that doesn't help then they need to refer to paeds/gynae if they are not happy to prescribe anything else. They should also be checking her iron levels.

If she is really bad and regular pain meds are not helping then A&E for pain management and anti-sickness, they may refer to gynae for review whilst she is there. As an adult I was admitted twice for IV fluids and meds due to pain and dehydration because of vomiting due to my period.

www.nhs.uk/conditions/heavy-periods/

Thank you all so much for your replies. @rightshoarder - it is really bad how women and girls are expected to get on with it (I’m a rights hoarder too ☺️) We’ve been back and forward to the GP’s a few times, the sexual health clinic have said to request a referral to a paediatrician which I was planning on doing on Monay. @VaccineSticker and @Aquamarine1029 I could get the money together for a private appointment but don’t want to pay loads and be fobbed off with “it’s just how it is” (will look into finding one that has good reviews). @MarmiteCoriander She’s tall and last time I checked 49kg but might be 50kg now. I think the GP felt she was too young and was trying to get us to hold off until she’s a bit older but it’s unmanageable. @Choconuttolata I will request tranexamic acid. Your periods sound horrendous 😢 I know someone who works in sexual health and they said the progesterone only pill for that age could be tried.
On Monday I’ll get her back to the GP’s and in the meantime try to find a private gynaecologist. Thank you again for all your replies.

I had the pill from 11 for awful periods but I had to stop at 35 as the doctor said there were no real records for taking it so long. I moved onto the injection and then the implant till my partner had the snip about 5 years ago. If they are wotprried about the number of years she will take it for and associated risks I would say take it now and worry about that later. It is excruciating and debilitating to be on so much pain as a young woman.

Sorry she's having problems.

I don't like to worry you but I'm afraid with these symptoms there's a high liklihood it's caused by endometriosis, which is statistically the primary cause of these symptoms in young patients. If so, there are benefits to early diagnosis and treatment. @RightsHoarder has mentioned a scan to check everything's ok, but actually a scan is of relatively little use - it can check she doesn't have some sort of congenital abnormality that's causing the pain, but endometriosis, the number one cause, can't be excluded that way.

It would really be best if you could get her seen by a specialist in endometriosis- someone at one of the BSGE's list of accredited centres - who's also used to dealing with teenagers and children.
A paediatrician might help but if they don't know about endometriosis they won't be likely to suspect it even if it's present.

Hope that's helpful.

My 15 year old started 9 months ago - heavy, painful and two days a month of vomiting. We saw the GP today and have the following action plan from her

1. 2 month trial of mefanic acid like you for two full cycles with ibuprofen on top DD is to monitor length and pain if no change
2. Referral for internal look for endometriosis which runs in the family to avoid long term fertility problems and also double this wait with
3. back to back pill so no bleeding through exams etc in the summer

the GP was insistent that pain in this age was unacceptable and she is a part time GP and specialist in gynaecology

PS meant to add the NHS is bad at dealing with this and the guidance doesn't in my view reflect the current state of evidence. There was an inquiry by an all-party parliamentary group into the treatment of women with endometriosis and the lengthy delays in diagnosis back in 2020, but the root causes of the delays haven't been addressed, and the problem starts with the very young patients, in my view - nobody is selecting out the very young girls who are likely to have it, and putting them down the pathway to diagnosis.

I feel your daughters pain.

this was me at 10, passing out, throwing up, the worst pain - I’ve had two babies and the pain was almost as bad at times.

I was fobbed off by my gp. My poor mum didn’t know what to do and so I just learnt the go through it, thankfully I am much much better now but it really affected my life and someone so young should absolutely not have to go through it.

I would go through all the routes available, even private so you know you have done everything you can. There must surely be something out there to help her

The issues with the pill is that although it may well help it will not show why your daughter is having these problems. That is what needs to be determined - for her future fertility.
Ginger extract capsules can help to rescue bleeding - I actually find them more effective than the mefamenic acid I am prescribed. They seem to help with the pain too.
has she been checked for anemia? That can cause heavy periods. If she’s anemic it’s not enough to just take iron Tablets. She needs to have blood tests after some months to check the iron is being absorbed.
the poor girl.

Just to add that while private can be very useful, it won't necessarily help if it's the wrong person, unfortunately, even if it's a gynaecologist. There are shocking discrepancies in how they deal with this type of thing and some of them still wrongly believe it's vanishingly rare for a child/teenager to get endometriosis.

Some great suggestions from PPs

The only thing I would add is to start her on magnesium and vitB supplements- my gynae recommended this and it definitely improved symptoms

My DD is 15, didn't start until 14 and they've been awful. Transzemic acid has helped with flow and pain, and feminax also helps. Problem now is she's always on, she'll have two days of nothing then it starts again. GP has been great and she's starting the pill next week to see how that helps. Don't let them fob you off, she's too young to suffer like that.

DD takes iron, multivitamin, magnesium and B complex and liquid vitamin D daily without fail.

Two months is the max for a trial my GP said and then you have to try something else

This was me when I was younger. Doubled over in pain. Extremely heavy periods and also with massive palm sized clots.

I wouldn't trust an NHS GP to be able to diagnosis anything or treat it. I would urge you to take her to a specialist as others have said and also look into the root of the problem rather than just medicate it.

I ended up being diagnosed with endometriosis at 17 and had the surgery for it as well then which I do think made the world of difference in it not coming back severely and has allowed me to live a pretty pain free life in compared to many with endometriosis who didn't get diagnosed until later into adulthood. I have since been diagnosed with PCOS but that wasn't until I was nearly 40. I would look more into possible endometriosis if I were you.

Good luck to you and your girl

Thank you all for your replies.

@Greensleevevssnotnose i think they’re reluctant to prescribe the pill because so few 10 year olds have taken it that they don’t know the long term risks but I agree if it’s just to reduce the over all duration of pill use I would grab it right now.
@LittleRedTomato I’ll definitely look into endometriosis and the accredited centres. That information is really helpful- particularly to know it can happen in young girls.
@InSummertime - that’s good to know you’ve got an actual plan because at present my GP plan is wait until she’s older to get the pill - obviously I’ll challenge this on Monday and get the other supplements you suggested
@Justisme i was the same but at least I was 13 when I started mine so maybe a bit more manageable although looking back I think the GP’s could’ve been more helpful
@Blondlashes great point, I was really focused on alleviating the symptoms but we need to know what is causing it
@tenbob I’ll those supplements tomorrow
@DumpedByText - your poor daughter, it’s hard enough to manage heavy periods as an adult but when your in school it’s a nightmare
@AmazonPrim - that is great news that surgery helped you. It sounds crazy but if someone offered surgery tomorrow me and my daughter would jump at the chance to get rid of this.

Thank you so much for all your replies. Every one has been helpful.

For everyone that mentioned endometriosis- thank you. I’ve just started to read about it and it’s so useful to know that young girls can get it so that I have this knowledge before I speak with the GP. This is a thing I found (just adding it in case some other mum is in the same boat 😢):

nezhat.org/endometriosis-of-young-girls-and-teenagers/

This was me too when I was her age & wasn't allowed the pill until I was 14. I was eventually diagnosed with endometriosis.

I would second transexamic acid. Also lyig on her stomach on a hard floor like kitchen tiles will help for the lying in bed. Heat patches and ho water bottle will only help a little but better than nothing.

Would you consist contacting Endometriosis UK to see if they have any suggestions for someone so young?

@ThirtyThreeTrees thank you, I’ll go and look up Endometriosis UK and get as much information as I can before the GP appointment. Once I’ve got knowledge I can argue her case well but when you don’t know any of this it’s really hard to fight your corner!

I was in a similar state when my periods started at 13. My blood loss got worse and worse and they didn't stop for 6 months until eventually it got so severe I was going to bleed to death if something drastic wasn't done. I was put on the pill and have never looked back. I take it for 3 months at a time and it's been life changing.

@Augend23 -thank you, I was quite bad too and when I went on the pill it was like night and day. I’ve definitely got loads of things to take to the GP!!

this sounds like my DD hers started when she was 11. shes now 14 and been on the pill for a year. its helped loads