Dr wants 15yo dd to consider going on contraceptive pill

[Flamingoose]

I'm uncomfortable about how normal it is for women to start taking a daily hormone adjustment in early teens and to continue with that for the rest of our fertile lives. Is it really a good idea?

Dd has horrendous menstrual cramps. It's only one day a month that is unbearable, but on that day she is barely able to get out of bed. She has missed a day of school every month for about 6 months, and on and off before that. She cries in pain. It's awful. She is not generally one to make a fuss, and she hates missing school.
She has been prescribed very strong painkillers (which have risks of their own, but at least it is only one or two days a month).
The doctor is keen for us to consider dd going on the pill. Dd wants a solution to the pain, but she's not keen to go on the pill.
I have absolutely no moral or silly objection to her going on the pill, but I hesitate to start messing around with her hormones already.
Any thoughts?

Sometimes evening primrose oil can help. It's widely available in capsule form. You could check with the gp first as they aren't always fans of herbal type remedies.

@JudyGemstone the combined pill is the first thing you are told to try with endo to regulate the hormone levels. It isn't a fob off at all but the first step in controlling the agonising pain.

If you do suspect endo there is a wealth of information here

There is a reluctance to do surgery for diagnosis for many reasons, cost being one of them plus there is a high risk of adhesions following laparoscopy. I was diagnosed 22 years ago.

@Flamingoose She can try the pill and see if it helps. She doesn't have to be on it forever from this point. She could come off it in a couple of years to see if her periods are any better. I was put on the pill at 15 to control my period pain which did turn out to be endometriosis. But it was a life saver for me and allowed me to function which is a really low bar is it not?

It's not a case of scaremongering about the pill - OP has asked for opinions and people are giving their experiences.
I took the combined pill for years with no problems and only stopped when TTC.

My sister was prescribed the combined pill for symptoms much the same as your DD, OP. She had suffered for years and it was the only solution she was offered (yay, women's healthcare!)
She unfortunately got hit by one of the more nasty side effects and so can no longer take it, and it turns out that the pain management provided by the pill had masked her endometriosis. It's only now that she is unable to take hormonal medication for her symptoms that other treatments for managing her endo are being investigated, but it's slow going.

So while the pill is fantastic medication and may well help your DD, I'd push for it to be given alongside further investigation into her symptoms, not instead of that.

Do bear in mind that she doesn’t have to keep taking the pill if she doesn’t want to. If she’s in two minds, she could always try 3 months and then review.

I had really painful period cramps when they first started but by the time I was on my 20s, there were mild enough to just be a helpful warning that I was about to come one but not uncomfortable.

She might find that taking the Pill for a few years helps then if she doesn't require it for contraception later on, she might be able to stop

Really? When some girls are starting periods at aged 8 and 9 now? What’s the youngest you would prescribe it to help with pain or other symptoms?

I was put on the pill at the same age due to horrendous cramps that made me pass out. They also caused me to be anemic most of me teenage years. The pill helped a lot and I have found that doing exercise the 2 days before my period is due helps so much. I would suggest that you at least let her try for a few months and see if that helps. There is nothing worse that cramps that knock you off your feet. Your poor daughter.

Dd went on the pill at about 14yo for the same reasons. Was life changing.

I started the pill at that age for the same reason.
My periods as an adult (and since having my son) have gotten better to the point where I no longer need to take the pill- but I’m glad I was on it for that time. It’s not necessarily something she’ll be on forever.

My dd started taking it at 14. Her life is so much better now.

Much less pain, lighter periods, more predictable, and, most importantly for her, more emotionally stable.

I think it's worth trying to see if it makes a difference. It's not compulsory for her to stay on it forever, she can always stop it later on and the relief it may be able to give could be just what she needs right now.

'Messing around with hormones' makes me think 'Well, they aren't exactly helping with the way they are at the moment, maybe they need to be messed around with for a bit'. I know I was lucky with the timing of my GCSEs, as they fell either side of two absolutely foul periods; had I come on at any other time, I would have likely been unable to take at least two exams because I would have been curled up in a ball on the toilet floor sweating with the pain. By the time I took my A levels, I just back to backed two packs and did absolutely fine.

No way would I do this at 15! The pill is hormones, I would leave the system alone to develop without hormonal interjection. I would focus on pain management instead.

I think you're being very sensible, it's one day and the pill is taken every day OR has effects every day. I took a pill for 20 years and had literally not one ill effect that I could detect, but that doesn't mean it is a great idea to adjust hormones, as you say, which are delicate.

One day of agonising pains? I would want a different solution too.

I have the same; one day of bad pains, not agonising though, not anymore. But when I was teens they were bad enough to make me go home from college.

If your daughter is not keen then don't do it. Instead pamper her that day in the knowledge she will be better the next?

Sounds like you already don't want to put her on the pill and why should you? Try other things first if that's what you feel is best.

If you have the option in your area and your daughter would be interested in trying it, I'd really suggest finding a well qualified acupuncturist (many of them have specialist areas, so look for one that talks about women's health) or if the needles idea is too much, shiatsu is a gentle acupressure option based on similar principles.

I passed out from the pain of cramps a couple of times in my teens. Went on the pill at 16 and wished I had done it sooner for the pain - my mum was angry enough that I did it at 16 though. I agree that it awful that there are so few options but it works. At least discuss it together if she has gcse exams approaching, it doesn't need to be a long term thing.

Period pain that leaves her stuck in bed is not normal. The pill doesn’t treat endometriosis, it just masks the symptoms while the disease progresses.

My periods were awful from day one, contrary to a PP who seems to be a medic stating this isn’t how endo presents. I was on the pill for 10 years along with mefenamic acid which although helped the pain, just allowed the disease to progress without me being aware. I was finally diagnosed at age 30, during investigations for infertility. I found a query of endometriosis in my medical notes from 15 years earlier. Gynae weren’t interested in investigating my pain either.

I recommend Nancys nook for education on endo. They proffer the modern approach that early treatment helps to avoid future fertility problems, not to mention helping to avoid years of suffering pain in the meantime for the woman.

Ask your GP for further investigations, blood tests, ultrasound scans etc if your daughter hasn’t already had them. I’d highly recommend acupuncture too but make sure they’re registered on the British acupuncture website.

Further investigations may show more information but please keep in mind endo isn’t usually seen on ultrasound. My scans were always clear and I was still riddled with it. Laparoscopic surgery is the only certain way to diagnose or rule out.

There is nothing natural about menstruating month after month after month for thirty years. Nature has a treatment for debilitating periods: pregnancy, but that comes with undesirable side effects of its own.

Basically unless you're planning to stay on the breeding treadmill from age 15 to 45 then all your options are unnatural. You can go with the painful and inconvenient option of menstruation, which increases your risk of anaemia and ovarian cancer, or you can go with hormonal contraception, which may cause mental health side effects and increase your risk of breast cancer. Her choice.

@passport123 and if they find out it’s endometriosis then the pill would be a sensible choice, except none of us know that’s the case? And simply putting her on the pill won’t confirm that either. There’s no easy test for endo, I know, but ruling out anything else would also be sensible. “ Uneducated nonsense” is that better or worse than “armchair diagnosing”?

poor girl - I was also your daughter and the pill changed my life. That pain was unbearable. I used to faint from it!

btw have you tried Buscopan for the cramps? It's best to take the minute she even thinks they are coming, like literally the minute she even has a twinge and if you take them like that, they do stop the worst of the pain (they are anti spasmodics). I forget what the dose is but you can take it the full day she has that worst pain (just check what is age appropriate).

@Flamingoose when did your Dd start her period? If she’s only had them for 2 years then hopefully the pain and other symptoms will calm down. If it’s been happening since she was, say 11, then this needs to be investigated. They’ll probably put her on the pill (worth trying for 3 months).

I started when I was 11 and it was only last month (I’m 25) that dr finally told me that I most likely have endometriosis (I’ve been saying that for years…). I have super super heavy periods and in so much pain that I pass out. Drs kept fobbing me off.

Went to an excellent talk by an adolescent gynaecologist recently who said she is happy to prescribe for any girl who has been through the menarche and that there is good evidence it doesn't hinder growth. Think the youngest girl I have given it to has been 12. Periods at 8 or 9 are still unusual, though they do happen occasionally, as periods aren't the first sign of puberty.

The pill is the correct choice for primary dysmenorrhoea (period pain with no pathological cause) and it's also the correct choice for endometriosis, so unless the OP's daughter wants surgery at this point, it's a sensible thing to suggest. And even if she does want a laparoscopy she's going to wait months for the initial appt and months more for the surgery so it's a sensible thing in the meantime. I've been very clear that I'm not giving individual advice, but on the information given they seem to have a sensible GP. Laparoscopies are not without risk.

Exactly. In the pre contracepive era, women had many fewer periods than we do now, because they spent most of their time pregnant or breastfeeding!