Q**My daughter had painless menstrual periods for about a year and a half. The last few times she has had bad cramps. Why is this starting? Is there any medicine she can take?
A**During the first one to two years after a teen-ager begins to menstruate, she infrequently ovulates (produces the egg) during each cycle.
When she begins to ovulate regularly, her body also produces chemicals called prostaglandins. These cause contractions of the muscles in the uterus, which lead to decreased blood flow and pain. The more prostaglandin in the uterus, the more painful the cramps.
Fortunately, some excellent medications are available. Ibuprofen, a drug that inhibits the production of prostaglandins, is available in a low dose without prescription, and in higher doses with a prescription.
Sometimes, Ibuprofen doesn't work. In these cases, other types of drugs, such as naproxen, naproxen sodium or meferamic acid, which require a prescription, may prove helpful. Individuals who experience difficulty taking aspirin or other medications that can irritate the stomach lining may be unable to use these drugs. If none of these drugs helps your daughter, she should consult her doctor again.
Q**What is your feeling about having the interior of a house painted while a 1-week-old is there? This doesn't sit very well with me, but the mother thinks it's all right.
A**Our feeling is quite negative. We fear the baby may absorb toxic substances, particularly solvents or heavy metals. Although lead is no longer permitted in interior paint, other ingredients, which may be similarly toxic, are. For example, we know of an older child who developed mercury poisoning after exposure to interior paint fumes.
In addition to avoiding possible toxic effects from the paint, the mother of a one-week-old is wise to avoid scheduling added disruptions to the household. She needs all her energies to care for her baby, herself and the rest of the family.
If she is breast-feeding, that can be a full-time job since many newborns nurse as often as every two hours.
*Dr. Wilson is director of pediatric primary care of the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.