• Dr. Julie Granger PT, DPT, SCS, WHC

Heal your daughter's period problems without the pill

In any given month, I receive handfuls of inquiries from moms feeling desperate about how to fix their ‘tween and teen daughters’ periods.

They have said any number of things like…

“My 12 year old has the heaviest periods. I’d be horrified if she had to take the pill.”


"My 15 year old’s periods are so painful! Do you have any tips on what to do or do I just need to put her on the birth control pill?”


“I am concerned, and I’m trying not to freak out. And I’m trying to stay off of Google…”

Yes. I know it's reeeeeeally hard when there's that mini-computer in your pocket at all times, beckoning you to just check something online real fast to see if you can put your mind at ease.

But usually, the opposite happens. That's because there’s a lot of stuff that Google won’t tell you correctly about period health in girls. Young teens and ‘tweens fall at a bit of a crossroads in the medical community—they’re growing out of conventional pediatric care, but not quite old enough for standard OB/GYN care.

This means they don’t have a lot of people in their corner when it comes to translating what’s normal and abnormal for their child’s hormones, which can leave everyone confused, more stressed out, or freaked out.

Probably not what you were going for when you "just wanted to look something up real fast..."

This is especially true when people start applying adult concepts to children and teens. You’ve probably heard this before, but it usually merits a reminder:

Kids and teens have different medical and hormone needs than adults. Just because they might be old enough to take adult strength ibuprofen doesn’t mean they need adult strength medical treatments for everything else. Especially periods.

So, let’s get a few truths right out of the way to put your minds at ease.

Truth #1: There’s no such thing as THE “right” age to start a period.

The average age of starting the period is age 12. This means that she could start her period at age 9 or age 15 and still fall within the “normal” range. In fact, it’s not considered concerning, per se, until a girl is 16 and has not started her period.

Many things influence her start date, including genetics. If you’re a mom, take note of when you started your cycle and when others in your family started as well (your sister(s), her sister(s), your mom, etc).

Her activity and exercise level can also influence when she starts. This is why some athletes start their periods later. Too much exercise can lead to late periods. But not always.

Being a late starter can also mean she has other issues, like a risk for fractures and immune system issues.

But generally speaking, for most teens, her body will start when it is ready, and that is a great thing.

Truth #2: Wonky periods are normal for a few years.

Once she does start, it is completely normal for a girl’s period to be “wonky” for a few years. By “wonky,” I mean that the periods may be heavy, they may go on for a few weeks, they may come every 3 months, they may be as light as a feather or as heavy as a waterfall.

This is a normal part of her body’s “hormone factory” learning how to operate and communicate within itself. We want the hormone factory to do its job, and it normally takes it 2-3 years to get “on the job training.” It’s best to let it do its thing naturally. You cannot rush it along by taking the pill, because the pill shuts down the factory and starts doing all of the work itself, which doesn't give her body a chance to learn anything.

If she gets very uncomfortable or stressed by it, shows signs of anemia/fatigue/exhaustion with heavy or prolonged periods, her sports performance slumps, or she has other symptoms like pain that won’t go away with over-the-counter or conservative treatment, it’s best to always check in with your daughter’s primary care physician.

In fact, when in doubt, please always check in with her physician. And you can usually rest assured that within 2-3 years the symptoms will improve on their own.

Truth #3 Acne might be completely normal.

As annoying as it may be, acne is, in fact, a normal part of adolescent development. As the body starts to manufacture hormones in the “hormone factory,” it also starts to change the oils in the skin. This process is normal and healthy, and also may affect the texture of her hair.

While inconvenient and certainly not always “accepted” in a world that may be insidiously brainwashing her (and you!) to judge her worth based on how she looks on the outside, these changes are, in fact, a normal and healthy part of growing up.

If persistent or more bothersome than “just an inconvenience,” these things can certainly signify other underlying issues including certain food intolerances, an imbalance in the gut flora, or an imbalance in how her body handles stress. By fixing those problems directly and with more conservative means, the acne often clears up. No pill required! In fact, the pill can make all 3 of these things worse.

Now that we have those truths out of the way, I know you may be wondering, "So what am I supposed to do?"

Great news! You do not have to just sit and watch as she suffers in silence. You do not have to worry what people will think of her if her skin is constantly broken out. There's help if she is is bleeding so heavily and can’t make it to dance for 3 days in a row because she isn’t ready for tampons (or maybe she's ready, but it mortifies you to even bring up the topic).

Please know that while many of these symptoms are normal and will resolve themselves within 2-3 years of starting her period. If you feel like you (and really, she) can't wait 2-3 years the symptoms to decrease on their own, they can be lessened in the meantime by making simple shifts in lifestyle, mindset, and diet.

I have 3 top tips to managing and lessening these symptoms.

1. Keep your feelings to yourself

This is probably something you've heard before, but maybe the hardest thing to put into practice sometimes.

Maybe you’ve had your own trouble with periods, fertility, acne, or any other number of issues, and seeing her go through this is triggering whatever feelings you used to feel about it.

Ugh. I totally have your back, Mama.

I like where your head’s at, because it means you are caring and you want the best for her. And I honor your feelings—they are real and you are allowed to feel them!

But that doesn’t mean that your feelings need to be her feelings. Sharing your stress with her may drive more stress in a growing brain that already doesn’t know how to manage stress. And to add insult to injury, stress makes periods worse.

But it's important that you not shove the stress down and hide from it—you're allowed to feel your feelings. And you're welcome to share with someone else! I'd be happy to support you, so reach out to me to set up a free call and let's chat about it!

2. Do consider eliminating dairy and sugar (discussed in next point), but please allow her to still eat carbohydrates.

As is common in today’s culture, please do not confuse carbohydrates with sugar. Yes, sugar is a carbohydrate. However, she needs good, complex carbohydrates (including grains) for healthy period health, for energy, and to fuel her growing body while she is busy at school, sports, and all the other activities she does.

Diets like Paleo, Keto, low-carb, or Atkins may be good for some adults in some cases, but they aren’t necessarily good for kids and teens. Moreover, these types of diets may be great for men, but they may not always be great for women due to our hormonal needs.

You may be wondering about gluten. If you choose to eliminate gluten, this can be successfully and healthfully done without eliminating grains or all other carbohydrates.

When in doubt, please consult with a dietician, nutritionist, or health and nutrition coach skilled in working with active, growing ‘tweens and teens and preferably one knowledgeable about female health.

3. Do consider eliminating dairy and added sugars from her diet.

Both of these can trigger periods to be heavier or more painful, and can make acne worse.

For more reasons than we have time to discuss in this blog, it’s possible that these foods can trigger increased inflammation in her body. Inflammation may not only show up as heavy or painful periods, but also other things like seasonal allergies, upper respiratory and chest infections, skin breakouts (eczema, psoriasis, and yes, acne), anxiety and mood swings.

And I’m guessing you don’t have time to deal with any of that!

But wait, before you go throwing out all of the cheese and milk, there are 3 cardinal rules you may need to take into consideration when eliminating foods.

Teen Food Elimination Rule #1: She has to buy in.

If you've ever been a child or teen or parented a child or teen, you probably know what I"m talking about here. If it's your idea, she won't want to do it. If she hears it from someone else, then she's more likely to do it. If it's her idea, then she is totally sold--in fact she is probably nagging you about whatever it is she wants to do.

Of course, if you are one of the few families where your kids will wholeheartedly embrace eliminating food, then you can skip this section and move on.

For the majority of families there may be fights or power struggles over food. Maybe she refuses to eat certain things because they’re “gross,” sneaks food when you’re not looking, lies about what she does or doesn’t eat, argues at the dinner table over “just one more bite before dessert,” proclaims that she’s “just not hungry” when you know she hasn’t eaten in 12 hours, and my favorite: she absolutely refuses to consume vegetables.

In that context, imposing new rules to eliminate 2 staples in her diet is a quick way to deepen the divide in the relationship between you and your daughter.

It’s most important that she agree to this idea, and—taking it one step further—feel like it is her idea.

If you need tips here, please reach out and schedule a free strategy call with me! I have a special knack for “speaking teenager” and I love to help teens and families find simple and peaceful ways to make health and lifestyle changes without creating fights in their household.

Teen Food Elimination Rule #2: Introduce new, replacement foods for 2-4 weeks before removing others

Consider this your "test run."

Unless she has a diagnosed allergy to a certain food, I do not recommend making changes “cold turkey.” This goes for grown-ups too. Give yourself 2-4 weeks to practice new recipes, read labels, make new grocery lists and meal prep so it can be a smooth transition. And most importantly: for every food you take away, please ensure you have added 2-3 substitute foods that she agrees are suitable, palatable, and maybe even exciting.

The brain needs to feel like it is not being deprived. If it does, it may trigger unexpected things like disordered eating, binge eating, and body image issues.

Teen Food Elimination Rule #3: Diet changes need to be a family affair

I said #1 may be the hardest part. But actually, when I talk to parents, this is often a huge thing they say gets in the way as well.

As you may be well aware, the ‘tween and teen brain craves feeling included and like it belongs. This is part of the normal process of brain development.

So when she notices that she has to be the “only one” in the family eliminating dairy and sugar, she might feel not only like she doesn’t belong, but also that is something wrong with her. Taking it one step further—if the food elimination is for her alone, chances are she may feel like she has done something wrong to cause this and she will begin to associate “being female” with “being not good enough” or “being in trouble.”

And I’m guessing for you, that’s completely beside the point of empowering her to be healthier.

So I suggest that as parents, you have a conversation with yourselves and with your kids about what is most valuable to your family and what role food plays in your family. Notice any places where food habits are emotional or act as a reward. Then make a decision about how supporting your daughter’s diet and health can be a great way to support your whole family’s health.

Empowerment, not isolation or deprivation, is key for getting teens to buy in.

Your turn: What do you think?

How are you feeling about all of this? Supercharged and ready to take action? Or maybe you’re feeling some trepidation and not sure how this might go for you?

Or maybe you don’t like what I had to say.

I get it. Not everyone loves to hear that dairy and sugar may be affecting their health in unfavorable ways. Believe me, when I learned that about this my own health, I kicked, screamed, and found every reason to throw under the bus the brilliant people who told me that it was time for change.

So I salute you if you feel this way—I’ve been there!

But if you are feeling a little lost or you do have more questions, please don’t hesitate to reach out and set up a time to do a free chat with me about it. This is what I LOVE to do—to help girls and families peacefully and confidently bridge the gap between where they are now and where they want to go without creating drama, arguments, or stress.

Perhaps the biggest thing you’re thinking right now is something along these lines:

You get how important these things are. But you’re feeling like yours and your kids’ lives are just too busy right now and you don’t see a way to work in food and meal changes, and the pill just sounds like an easier and quicker route.

And ultimately, that may be the best decision for your teen and your family. I honor that. But I urge you not to make the pill decision lightly.

While proven to benefit sexually active teens who otherwise aren’t going to practice safe sex or discuss their sexual activity with you, there are more negative consequences to birth control pill use than there are benefits in most ‘tweens and teens.

And there are other safe and proven forms of contraception for teens that don’t necessarily involve taking synthetic hormones that affect her long term health. That discussion is outside the scope of this blog.

As we have discussed: when a girl first starts her cycle, it takes her brain and body a few years to learn how to communicate normally with each other in the "hormone factory." Her body has to learn how to manufacture the right types and amounts of hormones. It takes time for her body to learn that.

If the body is not given the time to learn how to manufacture hormones, it is possible it will affect her ability to manufacture good, healthy hormones for the remainder of her life.

Translation: once she gets off the pill later, she might have trouble ovulating, may have conditions like PCOS or fibroids, and could have trouble with fertility down the line.

She may also have impaired bone density, which is a big problem in her teen years because she stops laying down new bone by the time she’s 20.

The pill has also been associated with a higher risk for eating disorders in elite female athletes, and has been shown to cause depression, anxiety, and migraines in teens and young adults.

I know you probably aren’t thinking of many of these longer term things when she is 13 (especially sexual activity), but when making these decisions, I urge you to consider the long term consequences of choosing a solution that seems easy and quick right now (i.e., the pill).

I know this is an issue, because I coach so many young, professional women who say "I wish someone had told me" or "I wish I had known" when it comes to the long term side effects of the pill. The thing is--even just a decade ago we didn't know as much as we do now about this. When we know better, we have a chance to do better.

And—I know what some of you may be thinking—whether for you or for your daughter--"Well SHOOT Julie, I'm/she's already on the pill. What do we do now?"

Great news! It’s never too late to reverse or lessen the pill side effects by discontinuing the pill. And just a heads up--there are some steps you can take to do this the right way that are outside the scope of this blog, so if you’re thinking of doing this, be sure to reach out for help and I am happy to coach you through it.

You may also be thinking “but her periods are so much better now that she is on the pill!” Let’s be very clear: while on the pill, she is not actually having a period because she is not manufacturing her own hormones. By definition, she must be manufacturing her own hormones to have a period. Because the pill shuts down her hormone factory, it simply masks what was going on before she started taking it. It doesn’t fix it.

And what’s the best news of all???

It’s possible for her to manufacture her own hormones and have pain free, smooth, non-heavy periods without being on the pill or medication for that. It takes patience and dedication, but in the long run, it is likely what is best for her health.

Wrap it up!

Let’s summarize what we’ve discussed today.

The 3 truths about periods in girls and teens:

(1) There’s no such thing as the “right” age to start a period.

(2) Wonky periods can be completely normal for a few years.

(3) Acne may be completely normal for a few years.

My 3 top tips to improving periods in girls and teens:

(1) Keep your feelings to yourself

(2) Eliminate dairy and sugar by following the 3 cardinal rules of food elimination in teens

(3) Do not eliminate carbohydrates or grains in teens

Most importantly: I urge you to consider use of the birth control pill with great research and thoughtfulness.

Still not sure how best to go about all of this?

Reach out to me to chat. I would love to chat with you, and I just love talking to moms and women about these issues. You can go directly to my schedule to set up a complimentary 1-hour health strategy session.

I can’t wait to hear from you!

#integrativehealth #bodyimage #fertility #periods #decisionmaking #teenhealth #girlhealth #bonehealthingirls #bonedevelopment #hormonehealth #periodhealth #functionalmedicineforpediatrics #functionalmedicineinathletes #girlathlete #teenathlete #ParentingAthletes #parentingteens #menstrualhealth

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