More Than Just a Period: Dysmenorrhea and Its Challenges for Teenage Girls

Breaking the Silence Around Teen Period Pain

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Dysmenorrhea, more commonly known as painful menstruation, is one of the most common yet overlooked health issues affecting teenage girls. Dysmenorrhea often consists of painful cramps, lower back pain, and other uncomfortable symptoms during the menstrual phase. This is an important yet under-discussed topic that deserves greater awareness. Unfortunately, many brush it off as a normal period.

On top of school, sports, and relationships, dysmenorrhea can make life much more difficult for teenage girls. Dysmenorrhea is more than typical menstrual discomfort; it is a medical condition that can impact a female's quality of life. This painful condition can lead to school absences, skipped sports, and even emotional struggles, all starting at a young age.

This research paper explores how dysmenorrhea impacts school attendance, sports participation, and emotional well-being among teenage girls. By combining my survey results with existing scientific studies, I reveal a clear need for better awareness, education, and support for teens experiencing menstrual pain.

Understanding Dysmenorrhea

Dysmenorrhea is a medical condition caused by uterine muscle contractions and hormonal changes that result in painful menstrual cramps. According to the Cleveland Clinic, prostaglandins are the main chemical responsible for period cramps. "Prostaglandins are a group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection" (Cleveland Clinic). Prostaglandins trigger muscle contractions, leading to painful cramps. These contractions help shed the uterine lining (endometrium), which then causes menstrual bleeding to occur.

Primary dysmenorrhea refers to painful cramps during the menstrual cycle without an underlying pelvic pathology. The pain most likely comes from hormonal or chemical imbalances in the body. However, Secondary dysmenorrhea does include a pelvic condition or disease. One of the most common underlying conditions is Polycystic Ovarian Syndrome. "Polycystic Ovarian Syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries (the organ that produces and releases eggs) create excess hormones" (Cleveland Clinic). PCOS can also include multiple ovarian cysts that, if they become too large or rupture, can cause intense pain.

Another underlying condition of secondary dysmenorrhea is Endometriosis. Endometriosis occurs when tissue that is similar to the inner lining of the uterus grows outside of the uterus. This tissue bleeds and causes inflammation and pain, but cannot leave the body like the uterine lining can, making this a chronic and painful problem, especially during menstruation. 

The Impact on Teen Girls

The American College of Obstetricians and Gynecologists has found that between 50% - 90% of teenage girls have experienced dysmenorrhea. Girls who started their first period at a young age, have long or heavy periods, or have a family history of menstrual disorders are more at risk for dysmenorrhea.

While each female may have different experiences with dysmenorrhea, common symptoms include cramping in the lower abdomen, lower back pain, pain that radiates down the legs, nausea, vomiting, fainting, and headaches. Emotional symptoms such as irritability, sadness, and anxiety are also common. Many of these symptoms occur to some degree in typical menstrual cycles, making it difficult to recognize when the pain is abnormal.

Many try to push through the discomfort, believing that if others can tolerate it, they should be able to as well. However, in reality, their pain is sometimes dismissed—even by healthcare providers—as simply part of a normal period. This misunderstanding can leave teenage girls feeling frustrated, dismissed, and unsupported. 

According to a 2024 study, 20% of teenage students with dysmenorrhea skip class because of menstrual pain, 51% had problems concentrating in class, 50% limited their social activities, and even 12% showed a decrease in academic achievement. These findings suggest that the level of pain experienced by these young women is high enough to alter their ability to concentrate, highlighting the need for better support.

Unfortunately, most of these young women don’t seek medical help because they don’t believe their level of pain exceeds what is considered normal menstrual discomfort. One significant factor contributing to this is the lack of education on dysmenorrhea.

Teen Girls' Experiences: My Survey Findings

To better understand how dysmenorrhea affects teenage girls in my community, I conducted a survey focusing on rising 10th-grade girls. This survey asked about their experiences with menstrual pain, its impact on school and sports participation, and the ways they cope with these challenges. This survey was anonymous to ensure honest responses.

The survey revealed that 100% of the participants experience menstrual pain, and 62% consider it a moderate level. Moderate pain refers to discomfort that sometimes interferes with their daily activities. While only 25% reported missing school, 74% said menstrual pain made focusing difficult. High school is hard enough for teenage girls with managing schoolwork, sports, and friendships, but adding the side effects of menstruation can make it even more difficult to cope.

How Pain Affects Activities and Emotions

Sports and athletic events have been shown to help ease some of the symptoms by increasing endorphin levels. When someone exercises, endorphins are released throughout the body. This reduces the pain because endorphins are the body's natural painkiller. They block pain receptors and can also improve mood. Producing endorphins also helps prostaglandins break down more easily, reducing cramping and discomfort.

In the survey, I found that only 12% of the respondents have felt the need to skip physical activity during their period, which supports the idea that physical activity can relieve symptoms. However, 50% of the participants reported having to stay home from a social event due to their period. This can be a result of both the emotional and physical side effects of hormonal changes.

Sadness, crying easily, anxiety, frustration, and irritability were the most agreed-upon emotional symptoms according to my survey. Only 25% of participants said that they felt fine emotionally during their period. These emotional side effects are all due to hormonal fluctuations. More specifically, it has to do with the rising and falling of the hormones estrogen and progesterone. These hormones can also alter the levels of neurotransmitters such as serotonin and dopamine, which are linked to mood regulation. Low levels of serotonin can result in depression, anxiety, and irritability, which are common throughout the menstrual cycle. 

Coping with Pain

The most common physical symptoms that were recorded in my survey were bloating, breast tenderness, headaches or migraines, and, of course, cramps. On a scale of 1-10, with 1 being no pain and 10 being the worst pain imaginable, 36% of these girls reported in the 3-5 category while 62% reported their cramp pain levels as a 6-7.

In a 2018 article, John Guillebaud, a University College London reproductive health professor, stated that patients have described their menstrual cramping pain as “almost as bad as having a heart attack.” Many of the women with these higher pain levels think that they are overreacting, and they don’t seek medical help. However, this can pose many challenges to their lifestyle and even create future medical issues.

Common coping methods teens use for the pain, according to my survey, are sleeping, heat therapy, over-the-counter medications, and a hot shower or bath. These coping strategies aren’t always effective. Only 25% of participants said these methods completely relieve their pain, while 50% reported that they only provide partial relief.

Despite experiencing significant discomfort, none of the girls surveyed had spoken to a healthcare professional about their period pain. The two most common reasons they gave were uncertainty about whether their pain was serious enough and feelings of embarrassment. 

The Need for Education and Support

The majority of these teenage girls seek advice on periods from similarly aged friends or off the internet rather than from a doctor or a trusted adult. This reflects the social stigma and lack of open communication surrounding menstruation today. Many young girls are not properly educated about menstruation and the pains that are involved.

In fact, more than half of the participants stated that they don’t feel like there is enough education about periods at school. Many schools tend to either fall short in providing education regarding periods, or they are targeting the wrong age group. The schools that do choose to educate their students often choose to do so at a much older age than is needed. 67% of the schools that provided menstrual education focused on high school students, while only 45% included middle schoolers in these lessons.

Most girls start their periods at the ages of 11-13, however, some girls start even sooner at the age of 8 years old. Therefore, these simple discussions need to be held for the younger grades as well. 

 In another section of my survey, I asked the participants if they had ever heard of dysmenorrhea. To my surprise, 85% answered no. This is a serious problem because, as noted earlier, girls who suffer from dysmenorrhea tend to push through thinking it is normal due to the lack of education on the condition. These findings help explain the widespread impact of dysmenorrhea and why more awareness and support are needed.

Moving Forward

Although menstruation is a normal part of life for many teens, the severe pain caused by dysmenorrhea should not be considered normal or ignored. My research and survey reveal that most of the participants experienced moderate to severe menstrual pain. Several reported missing school, physical activities, or social events due to their periods. The majority of these teenage girls also expressed how they don’t feel like they were taught much about managing periods in their school systems. These results show that dysmenorrhea presents a real challenge for teenage girls in my community, and more conversations, education, and support systems are needed to help them cope with the impacts of their menstrual cycle.