This is known as dysmenorrhea, which is defined as painful
cramps that occur during menstruation. It is the most common gynecologic
problem among adolescent girls. The onset is usually within 6 to 12 months
after reaching puberty, but can start even after 5 years of the first menstrual
period. The peak is in late teens or early twenties. 

Most of the cases of dysmenorrhea in adolescents are of
primary origin. Primary dysmenorrhea is caused by an excess production of a
substance called prostaglandins associated with inflammation, resulting in
unsteady contractions of the uterus (womb), with increased muscle tone and thus
not enough blood reaching the uterus. The pain usually lasts from 8 to 72 hours
and accompanies menstrual flow or precedes it by only a few hours. The pain can
be associated with other systemic symptoms such as vomiting, nausea, diarrhea,
fatigue, and headache.

Treatment options include:

§ 
Heat: applying with a
heating pad or hot water bottle to the lower abdomen.

§ 
Dietary: some claim that
avoiding fatty foods and dairy products may aid in reducing the symptoms of
amenorrhea.

§ 
Non-Steroidal
Anti-inflammatory drugs (NSAIDs): they are the first- line
treatment for primary dysmenorrhea. Most commonly used NSAIDs
include Ibuprofen and Naproxen, as
well as Mefenamic acid.

§ 
Hormonal Contraceptives: Oral
combined Estrogen/Progestin contraceptives (OCP) are the second line treatment
for dysmenorrhea if NSAID treatment fails after three menstrual cycles,
or if it cannot be tolerated.

Adolescents with dysmenorrhea who do not respond to a combined treatment
with NSAID and hormonal contraception should be evaluated for secondary causes
of dysmenorrhea.