Period cramps: What is normal for girls?

Menstrual cramps are a literal pain. That pain can vary in severity and length of time — what do period cramps feel like? When should you seek care for your child?

Menstrual cramps, also called period cramps, often are considered just an annoying, painful part of the menstrual period to be endured. However, period cramps can vary widely in frequency and severity. It can be tough for parents to know what’s normal, but pediatric gynecologists can help. Here’s what’s normal and what’s not  ––  and when you should seek help for your child.

What do period cramps feel like?

Period cramps can feel like an ache – they can be sharp and stabbing or a consistent, dull pain. You’ll feel them lower in the abdomen than your stomach and the pain can reach your upper legs and lower back.

You’re stomach may be upset, but period cramps will be lower in your abdomen than a stomach ache.

During menstruation, the uterine lining sheds itself, along with blood. At that time, the body releases chemicals called prostaglandins which cause an inflammatory response that causes the uterus to contract –– these are cramps. The cramping usually starts the day before or the day bleeding begins. The cramping should not last for the entire period.

“Two to three days of cramping is what is considered average,” said Maggie L. Dwiggins, M.D., pediatric gynecologist with Norton Children’s Gynecology.

How much period cramp pain is too much pain?

“The pain level can vary from child to child, but the pain should be able to be controlled by over-the-counter anti-inflammatory medications such as ibuprofen or Aleve,” Dr. Dwiggins said. “Combining heat and ibuprofen will provide even more relief. Disposable heat patches are thin and easy to wear to school or activities.

“Your child should not miss school or activities due to period pain. If their pain can’t be managed by these strategies, they should be evaluated.”

Pay attention to sudden or subtle changes in cramps over time

For some, the cramping pain is accompanied by nausea, fatigue, headache, vomiting, loose stool or diarrhea. What’s important to know is that these and other accompanying symptoms of cramping can be “normal” for one child from the time they start their period.

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However, if your child’s cramps are usually mild and then they start to feel different, with increased pain, heavier bleeding or other changes in symptoms, you should make an appointment with a pediatric gynecologist. Additionally, seek care if the child begins experiencing pelvic pain outside of their period.

“Most girls’ periods are irregular at first, with the cycles becoming regular within one to three years,” Dr. Dwiggins said. “Once the period becomes regular and your child recognizes how her body feels before, during and after a period, she understands her ‘normal.’ If something doesn’t feel right or is not ‘her normal,’ she should be evaluated.”

When to seek help for period cramps

Dr. Dwiggins advises parents to seek help for their child for any of these reasons:

  • Cramps interfere with your child’s daily life; they’re missing school or activities.
  • Cramps are lasting for the entirety of your child’s period.
  • Pain isn’t relieved by over-the-counter pain medicines and heat therapy.
  • Cramps start to feel different; the “normal period” for your child changes suddenly or over time.
  • Your child experiences pelvic pain at times other than during their period.