Extreme menstrual pain in 18 yr old

[thecatislying]

Dd is 18.

She has very painful periods and manages them with prescription painkillers and anti-cramping medication. She is pretty organised and although she still feels pretty rotten on day 1 especially, she manages to go about her life.

There has been a lot going on recently and somehow she forgot to pre-emtively take her anti-cramping pills prior to day 1 of her period this month. She woke up and realised that she was in a lot of pain. I was not at home. The next thing she knew she found herself on the living room floor, having passed out. No way of knowing how long she was out. She managed to crawl to the bathroom (hands and knees). She tried to take her meds but was throwing up from the pain and couldn't keep them down. Fortunately her sister found her and called me to come home at this point. She continued to throw up throughout the day. The pain is incapacitating.

I guess it has been a while since we have seen the unmedicated force of her menstrual cycle. It has worried me tbh. I am thinking we should book another doctor's appointment, but I know he'll say that there's nothing he can do. I'm worried about the possible effects on her fertility, should she ever want a baby in the future.

She has so far chosen not to take a hormonal contraceptive pill. She says that she usually manages her medication better. It's not for me to second guess her choices - my only concern is what the underlying cause of all this pain is.

Endometriosis? Would be my guess.
See your GP.

Sorry - was a bit unclear in my OP - she has seen different doctors on various occasions about this. There is nothing they can offer other than treatment of symptoms, which she has the anti cramping and painkillers.

I could have written this about my 18yo. She was often like this despite managing her pain meds well. The first day she would be laying on the floor unable to move and almost translucent she was so pale. I persuaded her to go on the pill and things have improved. But I’m going to go privately and get her seen by a gynaecologist. She still gets pain and it’s miserable. I’m sorry your daughter is going through this. Passing out because you’re in so much pain is unacceptable. Insist she gets on the list to see a gynaecologist.

This:

Insist she gets on the list to see a gynaecologist.

My 18 year old daughter’s gyno suggested pill taken to avoid periods. She chooses to have them every 2-3 months and pain is better.

Annoyingly it's a very common problem that can't be fixed just managed. The pill will ease it for some and do nothing for others. It's nothing to do with fertility or other problems it's almost luck of the draw. For some a simple hot water bottle and feminax will work to feel more comfortable. I always said in clinic the pain can be as bad as labour pains for some. But lots of tests etc won't really change anything.

Has she tried Mefenamic acid? My daughter (15) has similar symptoms and has recently been prescribed it. She hasn’t needed it yet as during her last period the pain was manageable.

My dd is the same. She has PMDD - not diagnosed but ticks all the boxes. She doesn’t want to take the hormonal pill due to side effects, so she manages the pain by pre-emptily taking painkillers and keeping on top of it. She has also passed out with the pain a few times. It’s grim.

She tried mefenamic acid but had bad side effects with that too.

Your dd may have endometriosis. It’s worth going back to GP and being referred to a specialist. Bear in mind that it’s hard getting a diagnosis for any menstrual issues, but your DD’s life is being significantly affected to keep on.

I think even though she is usually managing the pain I would still be wanting her to go to the GP and basically the first thing she should say is I am looking to be referred to a gynaecologist because my period pain is not normal. They need to look at the why she is in so much pain every month.

If she does have endo then she is effectively allowing it to go "untreated" and it will just continue to grow and put down more deposits which in turn could render her infertile. My own "painful periods" were managed with the combined pill from 15 and pain meds. I then had to come off the pill at 26 and immediately saw a massive change in my pain levels. I was diagnosed at 27 with endo from a laparoscopy (18 months of other treatment before finally getting that) and at that point although married I was not looking to have children but surgery gave the gynae a proper chance to look at my pelvic organs and I was told I would need ivf to get pregnant due to scar tissue.

Endo can also cause lung collapse (thoracic endo) which you can die from, deposit on the diaphragm, damage uretas, kidneys, bladder, bowel as well as the usual ovaries and tubes. People have had stoma bags fitted. This is serious, she needs to know what the underlying cause is. She needs a specialist.

I am wondering though if it is also worth considering not assuming she passed out with pain? I would be wondering if she also has POTS as the two issues can be linked - or whether she needs a heart Holter monitor for 24hrs next time her period starts?

Home - PoTS UK

Thank you for these replies. I'm very sorry to hear that so many of your daughters are dealing with something similar.

It's the 'laying down scar tissue' and causing problems later that I don't really understand and am worried about. I will advise her to ask for a referral to a specialist. It really isn't a normal amount of pain to be dealing with. Plus, dd has a couple of other health issues that I worry about in combination with this.

The POTS thing is interesting. I think my whole family has that!! We've always just put it down to low blood pressure.

I was like this.

endometriosis.

hormonal medication means she can either reduce or completely cut out periods (hopefully).

my endo was confirmed by laparoscopy and I have had two operations.

Sorry commenting twice -

you can get endometrial deposits on lots of other tissues around the abdominal cavity. They then bleed into the abdominal cavity/wherever they are when the hormones say “have a period”.

obviously lots of these tissues are not expecting blood and so this can cause problems.

for example, I had significant endometrial deposits on my bowels, which got lasered away in my first laparotomy. They had been causing significant digestive issues throughout my menstrual cycle, not just during a “period”.

I have endo and was very similar as a teen. I can vividly remember being doubled over in pain during a lesson at school and wondering how I'd stand up to leave the room or walk home. Fun stuff...

If it's reassuring, my endo didn't affect my fertility (and that's after two laparoscopic surgeries, two rounds of meds to force me into a chemical menopause and many years on the combined pill / mirena). But it does sound like your daughter could do with some more help in managing the pain. I sympathise, I had a similar "system" of tricks to keep myself upright but that's exhausting in itself.

If you're very keen to avoid hormonal pill, maybe consider looking into tranexamic acid or mefenamic acid. I also have a TENS machine which is useful and great as an option without medication. I also find acupuncture useful to help manage my symptoms, albeit expensive.

Hello,

I'm a herbalist and if your daughter has been seen by a GP and ruled out any diagnosis, I would recommend trying Vitex Agnus Castus tincture every day and also Crampbark tincture for the pain during periods. I have my own formulas that I use with young girls and they are very effective. These two herbs are fairly easy to get online, but if you want any more information, just let me know!

This was precisely me at 18 down to the passing out through pain and I was eventually diagnosed with endometriosis. Extreme pain is not normal and should not be seen as such. Whilst it did not directly affect my fertility it certainly did not help matters when ttc. Her GP sounds bloody hopeless frankly and if they remain unhelpful change GP practice.

She needs a diagnosis first and foremost and in order to do that she needs to see a gynaecologist. I would also advise her to keep a daily pain and symptom diary noting everything up to and including menses. This will also help the gynae.

If you can pay for her to see a gynae as a private patient do so. I say this as waiting times to see a gynae in many areas are miles long and she should be seen sooner rather than later. You will need to be persistent in order to get answers.

Endometriosis UK is a very good website and a link to this is below
https://www.endometriosis-uk.org

In my case both tablets (mefanemic acid and transexamic acid tablets) were of no real benefit whatsoever although they can help some women.

The pill can help pain wise but the underlying problem will remain. Endometriosis is usually diagnosed via a keyhole surgery op called a laparoscopy.

My daughter has the same. Gynecologist has confirmed a cyst that has just burst.