I often joke with parents that my gynecologic knowledge is limited because most female adolescent patients prefer seeing a woman doctor. However, my daughter suffered with severe cramps, and I learned the following tip from my partner, Promise Ahlstrom, MD.
If your daughter has bad cramps, she should take 400 to 600 mg of ibuprofen as soon as her period starts. Then, she should repeat the dose every 4 hours for the first 24 hours of her period. The goal here is to “stay ahead of the pain.” If a girl takes the first does at 8am, she may be tempted to skip the noon dose if the cramps have subsided. This is a no-no. By missing a dose, the physiology that causes menstrual cramps will worsen. By the second day of her period, she can usually drop the dose to every 6 hours, but she should still take the medicine on schedule. By the third day of her period, she can take the ibuprofen as needed.
Three things can interfere with staying on course with this regimen. First, if a girl is at school, she may need to go to the nurse to get her medication. If the school has a strict policy about leaving class, a note from the doctor can help. Second, some girls forget to take their medicine. This can be overcome by putting reminders in her cell phone or getting a friendly text from mom at the right time. Third, her period may start right before bedtime. In this situation, I would consider waking her up for a dose of ibuprofen unless doing so would disturb her sleep and cause other problems the following day.
If this regimen doesn’t help, your daughter should see her pediatrician or a gynecologist to discuss other options.