An 11-year-old cis-gender female with a history of epilepsy presents with her father to discuss heavy periods for 4 months.
The patient experienced menarche age 10 years (approximately 1 year ago). Initially she was skipping months of menses, with periods every 1-3 months. Now, for the past 4 months her periods have been regular, every 28 days, but are described as heavy for the first 2-3 days (changes her pads every 2 hours). Her periods usually last 5-7 days with day 6-7 involving a lot of brownish blood on her mini-pads. She soaks one pad overnight. She has painful cramping that is described as 6/10 pain on days 1-3 of her period and takes ibuprofen for her pain which helps slightly.