Guest article: Periods, Pain and Endometriosis Program (PPEP-Talk)

If you are a health practitioner who cares for patients with pain, then the majority of your patients will be women. And if you ask women what their first pain condition was, they will commonly describe severe period pain in their teenage years. Around one in five teenage girls suffer severe period pain (dysmenorrhoea). Around half of these girls will develop endometriosis, an unknown proportion will transition to chronic pelvic pain, and an unknown proportion will become opioid dependent.

With dysmenorrhoea comes the expected mix of additional symptoms including irritable bowel syndrome, painful bladder syndrome, painful pelvic muscles, dyspareunia, fatigue, poor sleep, anxiety, low mood, nausea, dizziness and impaired cognition. The ease of identifying this group of young Australians at risk provides a unique opportunity for early intervention and the prevention of chronic pain.

The Periods, Pain and Endometriosis Program (PPEP-Talk), developed by the Pelvic Pain Foundation of Australia, is an age-appropriate, neuroscience-based program that helps girls determine whether their pain is normal, how to manage pain, and when to seek help. It involves a one-hour interactive program provided by a trained educator, followed by an opportunity for students with pain to speak one-on-one with the presenter in the hour after the session.

In our first year in South Australia, PPEP-Talk visited 80 schools, and provided 95 sessions throughout metropolitan, regional and rural centres. The response was incredible, with 100 per cent of schools requesting that we return next year. So, what did we find? Pain in teens is an even bigger problem than we realised:

• 50% of students had experienced regular severe pain with periods
• 20% regularly missed school with their period
• 7% described pain for more than 10 days per month
• 1.3% described pain for more than 20 days per month
• 91% said that PPEP taught them things about their body that they didn’t know.

“This was an exceptional presentation. In over 30 years of teaching I have not attended a more relevant, interesting and well-prepared presentation.”

Our neuroscience focus provides useful information for all students, with and without pain. We provide the understanding to help them make wise health choices in the future, when confronted with a pain condition.

PPEP-Talk is co-funded by the Federal Department of Health as part of the National Action Plan for Endometriosis, and the state governments of South Australia and Western Australia. We seek to expand PPEP to all states in Australia, and welcome your contact at ppeptalk@pelvicpain.org.au

Dr Susan Evans
Chair of the Pelvic Pain Foundation of Australia