DEAR DR. DONOHUE: I started having menstrual periods when I was 12. I am now 16. My periods have always been painful with cramps. I have had to stay home from school a few times because of them, and that’s not helping my grades. My friends tell me they don’t have this problem. What can I do about it? — K.S.

ANSWER: If you haven’t done so already, tell your mother about this. Does your mother have a job? If she doesn’t, what do you tell her when you stay home from school? This is an issue that’s not going to be settled until you see a doctor. Sometimes the causes of menstrual cramps are anatomical abnormalities. At other times, an illness like endometriosis is the cause. Endometriosis does occur in teenage girls. These and other conditions are discovered only through a doctor’s examination.

I admit, no cause is found in the majority of girls with this complaint. And it’s a common complaint — two-thirds of teenage girls have menstrual cramps, though perhaps not to the degree you have them. Such cramps are the leading cause for medical absenteeism in this age group. They’re due to prostaglandins, chemicals produced by the lining of the uterus. Prostaglandins cause uterine arteries to clamp down and stimulate contractions of the uterine muscles. That’s the cause of the cramps and pain you feel.

An NSAID (nonsteroidal, anti-inflammatory drug) can calm prostaglandin cramping. The two NSAIDS most often used are naproxen and ibuprofen. These medicines block the production of prostaglandins. If your periods are regular enough that you can predict their onset, take one of the medicines before your periods occur, and continue taking them according to label directions for the next two or three days.

If NSAIDS don’t bring you relief, you can talk to your doctor about taking birth-control pills. This isn’t a lifelong commitment to the pill; it’s a short time commitment to get you through your present situation.

TO READERS: Questions about the causes and treatments of headaches can be found in the booklet on that problem. Readers can obtain a copy by writing: Dr. Donohue — No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My penis has become curved, and it makes intimate relations next to impossible. I have never heard any other man talk about this. What is it, and what can be done for it? — W.W.

ANSWER: That’s Peyronie’s (pah-row-KNEES) disease. Scar tissue has formed in the penis and makes a bend in it. Lots of men have it at older ages. Few talk about it. For some, the bend is slight and stays slight. For others, it progresses and makes intercourse painful. In a little more than 10 percent of affected men, it resolves on its own in a year or so. In 50 percent, the curve gets worse in a year. In the remainder, it stays the same.

Pentoxifylline (Trental) often is the medicine that is tried first. If no results are obtained, injecting the scar tissue with a drug called verapamil or with interferon alpha-2 might work. At one time, vitamin E and Potaba were the most-often-used treatments, but they have lost their popularity.

If these treatments aren’t successful, surgeons have devised a variety of surgical treatments to correct it. A urologist is the doctor to see for this problem.

DEAR DR. DONOHUE: Table salt is sodium chloride, right?

When my wife was in the hospital, she was on IV fluids and the bottle said: Sodium Chloride. Is this the same as table salt? — L.M.

ANSWER: It is. It is dissolved sodium chloride, and the fluid has been sterilized. Sodium and chloride are two of the body’s electrolytes, minerals that balance the body’s positive and negative charges and are involved with maintaining blood pressure, among other things.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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