PAGologist Profile picture
Apr 13 ā€¢ 4 tweets ā€¢ 2 min read
Myth: "My periods are so painful that I miss a couple days of school each month. Sometimes I think about calling 911 because of the pain. My doctor said this was normal and I'd grow out of them." šŸ˜±šŸ˜±šŸ˜±
THIS IS NOT NORMAL. šŸ§µ
#MedTwitter #obgyntwitter #tweetorial
Severe period cramps are common but they are absolutely not normal. If someone is missing school or activities because of cramping or heavy bleeding, this is not normal. There are so many options to make periods better and no one needs to have a period if they don't want to.
It's reasonable to treat the painful periods first and see if things get better. Not everyone needs an ultrasound to evaluate heavy, irregular, or painful periods. If cramping remains persistent or progressive, a pelvic ultrasound can check for an obstruction.
NSAIDs are first line treatment for period cramping, especially ibuprofen every 6-8 hours or naproxen every 12 hours around the clock. If that's not enough, hormonal suppression (often with medications that are also used for birth control) can be helpful.

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More from @yffei

Apr 13
There's actually nothing special about Sunday. It doesn't matter what day your period starts and you don't have to start your #BirthControl the Sunday after your period starts. šŸ§µ
#MedTwitter #tweetorial #obgyntwitter
Usually I tell people to start the first day of the period or as soon as they pick up the prescription. Starting during the period decreases risk of breakthrough bleeding and starting immediately gets them protected against pregnancy asap (and often makes next period lighter).
Pill packs come with these handy stickers so it's easy to change the labels to remember what day they're on.
Read 6 tweets
Mar 28
Ready for another #PAG mystery?
16yo with primary amenorrhea (never started periods).
What questions do you want to ask?
#MedTwitter #MedEd #tweetorial #OBGYNtwitter
There are many reasons someone might not have periods. I usually divide them into sections to make them easier to rule out:
- hormonal: either repro hormones not cycling normally and/or abnormal levels of other hormones
- structural: could be a blockage or underdeveloped organs
Things to think about:
- any evidence of puberty (breasts, pubic/axillary hair, growth spurt)?
- could she be pregnant?
- any other symptoms (acne, facial hair, breast discharge, hot flashes, night sweats)?
- any (cyclic/monthly) abdominal pain?
- exercise and eating habits?
Read 10 tweets
Feb 13
During each visit, I always try to talk about the #HPV vaccine if they need it. One mom said, "we don't need that yet, her PCP said she had until age 26 to get it." šŸ¤¦ā€ā™€ļø
Please start as early as possible (age 11-12). I'll tell you why šŸ§µ
#tweetorial #MedTwitter #MedEd #obgyntwitter
#HPV (human papillomavirus) is the most common #STI in the US; 80% of sexually active people will get it. There are 100s of different strains; many asymptomatic, others cause genital warts, abnormal pap smears, and cancer (cervical, vaginal, anal, penile, vulvar, oropharyngeal).
The HPV vaccine (gardasil in the US) protects against the 9 highest risk strains, significantly reducing the risk of cervical dysplasia and the cancers mentioned above. More than 90% of #cervicalcancer is caused by HPV.
Read 9 tweets

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