When I was about 13, I had really bad cramps. The doctor told me that I was experiencing a form of "internal bleeding" but not to worry. This has continued all my life. I am now nearly 27. Last year I became pregnant but miscarried at 12 weeks. I did not have a D&C. Since then, I have had periods lasting four to eight weeks in duration. I experience cramps as well as dull aching pains. My periods are constantly heavy for the six weeks that I bleed, and they are often "chunky" with clots. My doctor has told me that this is normal. He gave me drugs to stop me bleeding, but within a week of completing the course, I was menstruating again. It doesn't feel normal, and I am scared. Can you help?

Nikki

Unfortunately, too many physicians do not take women's concerns about pelvic pain seriously. Having your concerns seriously considered is even harder for teens with painful menses. PELVIC PAIN WITH MENSES IS NOT NORMAL! Neither is six weeks of menstrual flow.

While I can't be sure what your doctor meant by internal bleeding, your early menstrual discomfort may have been related to endometriosis. Endometriosis is a condition in which cells of the uterine lining are grow outside the uterus. These cells may invade deeply into pelvic structures, causing pain and cramping, and sometimes such symptoms as painful sex, urinary frequency and diarrhea near the onset of menses.

For painful periods, a three- or four-month trial of birth control pills and non-steroidal anti-inflammatory medicine -- such as ibuprofen (Advil, Motrin) -- may provide sufficient relief of your symptoms so that they do not interfere with your normal activities. If these steps do not help, laparoscopy should be strongly considered to diagnose and treat the cause of your condition. Laparoscopy is the one sure way to diagnose endometriosis. On average, the diagnosis of endometriosis is delayed nine years from the onset of symptoms, and women see three or more physicians before reaching that diagnosis. For additional support with endometriosis issues, check the website of the Endometriosis Association.

It is not likely that your miscarriage or the subsequent abnormal bleeding is due to your painful periods. A history and physical exam as well as blood testing for hCG (pregnancy hormone), TSH (thyroid-stimulating hormone) and prolactin (a pituitary hormone) may indicate an underlying hormonal cause for your long periods. Another possibility is that a small piece of placental tissue from your pregnancy is still in your uterus and is causing the abnormal bleeding. One test to diagnose this is a saline sonogram, a painless procedure that can enable doctors to identify abnormalities inside the uterus. This procedure involves placing a tiny catheter (tube) through the cervix into the uterus. Saline (saltwater) is slowly injected through the tube while a transvaginal ultrasound is performed. Fibroid tumors and endometrial polyps may also be discovered using this procedure.

I would advise you need to find a more caring physician who will address your concerns and fears and will order the necessary tests to make a diagnosis and help you choose the appropriate treatment options.