The patient: “Sylvia,” a 12-year-old girl who recently started her period.
Why she came to see me: “Mildred,” Sylvia’s mother, was concerned about her daughter’s moodiness and physical complaints, particularly migraines. These problems seemed to be associated in frequency and intensity with her menses, which had started, albeit fitfully, a few months ago. Both were uncomfortable discussing the issue and had had an unhelpful visit with Mildred’s gynecologist. They came to me because Mildred had a friend whose daughter was experiencing similar issues and whom I had been able to help.
How I evaluated her: Because Sylvia was a minor, it was important for her mother to be involved in all aspects of my interactions with her. Mildred’s gynecologist had performed a superficial pelvic exam on Sylvia and found nothing abnormal. I encouraged Sylvia to be completely open and candid with me, and to share her symptoms and concerns. Her periods were quite irregular, varying from a few weeks to a few months in separation. Her migraines and moodiness usually started a day before the flow and often continued for a few days into her bleeding episodes.
How I addressed these problems: I explained to Sylvia and her mother that the best way to bring regularity and freedom from many symptoms associated with a woman’s cycle is usually by supporting proper dietary choices (like limiting caffeine, fried foods, sodas with aspartame, and aged cheese and other foods that can trigger migraines), digestive function, and liver activity. Further that her migraines could be triggered by hormonal fluctuations associated with these factors.
I prescribed a fiber supplement that would bind hormonal waste products in the digestive tract…B vitamins to help the liver to remove these products from circulation…and a strong calcium and magnesium supplement to blunt the associated vasospasms (the constriction of blood vessels that, in Sylvia’s case, was triggering migraines). I also had her use the botanical butterbur when she needed some short-term relief from the migraines.
The patient’s progress: Under my care, Sylvia was better-able to manage and understand her physical and emotional issues and was encouraged that her periods were becoming more regular in frequency and duration, with fewer physical symptoms. Her migraines were also less frequent and less intense. I also encouraged Sylvia and Mildred to continue this newly open dialog about Sylvia’s symptoms.
A few weeks later, Mildred came in as a patient and is now being treated successfully by me as well.