Q: My daughter has heavy, painful periods and suffers from mild anxiety and depression. Her medical doctor has prescribed birth control pills to help with all of her symptoms. Is it safe for her to take the pill? Her doctor also recommended an antidepressant if the birth control pills don’t help with her mood. Is there another way to treat her? In addition, he strongly advised that I have her vaccinated to prevent HPV—a sexually-transmitted disease. She’s only 16 years old and not sexually active. Should she get this vaccine so that she’s protected when she does become sexually active? What are the potential side effects of the vaccine? All of this seems like too much medication for such a young person.

A: You’re not alone; many mothers face these questions. You want to do what’s right for your daughter—you don’t want her to suffer from menstrual issues, anxiety or depression—but you also don’t want her to be on medications that may have side effects. In a world dominated by the notion that there’s a pill for everything and that “doctor knows best,” you’re understandably perplexed about how to proceed—especially when it comes to your precious daughter’s health and well-being. 

Before making decisions about medical intervention, it’s important to look at why so many teenage girls suffer from menstrual disorders, anxiety and depression. Even in the best of times, it’s challenging to be a teenager. Today’s teenage girls live busy lives, and they’re faced with exhausting academic demands, extracurricular schedules, peer pressures about sex and recreational drugs, a barrage of unhealthy fast food and yo-yo or starvation diets—and through it all they’re constantly engaging with social media. They have little time to take care of themselves, not to mention get in touch with what they really want. 

When a teenage girl’s body becomes imbalanced and begins showing the effects of a busy, demanding life, pharmaceutical medication is our culture’s answer to hiding symptoms—an “out-of-sight, out-of-mind” mentality. Unfortunately, birth control pills and antidepressants don’t resolve the underlying conditions they purport to treat, and both can have short- and long-term side effects. 

Birth control pills, which have been around for about 50 years, are a form of hormone replacement therapy. They’re frequently prescribed to teens for irregular, heavy and painful menstrual periods, and they may also be used to mitigate premenstrual symptoms, which can be associated with depression. Birth control pills consist of hormones (estrogen and progesterone) that are synthetic, which means they’re very different in their chemical structure than those a woman’s body naturally produces. However, they’re similar enough to suppress the action of the body’s own hormones, thus preventing ovulation. In addition, they can alter fallopian tube function, change cervical mucus to make it hostile to sperm and cause changes in the lining of the uterus. 

Birth control pills are effective in preventing pregnancy 98 to 99 percent of the time, but at what cost? According to Planned Parenthood, their potential short-term side effects include bleeding between periods, nausea, vomiting and breast tenderness, and many women report weight gain and low sex drive. Serious side effects include strokes, hypertension, liver tumors and blood clots in the legs, lungs, heart and brain. It’s also common for long-term pill users to develop gallstones. 

Antidepressants can be life-saving for those with severe depression, but they may be unnecessary or have too many side effects to warrant their use in teens with mild depression. Their potential side effects include weight gain (which can significantly affect a teenage girl’s self-esteem), diarrhea, nausea, headaches, insomnia, fatigue and dry mouth. The long-term side effects for teens are unknown, due to a lack of data on their use in this population.

The good news is that there are alternatives for treating your daughter’s menstrual imbalances, anxiety and depression. Assessing the underlying causes of her symptoms is paramount to successfully resolving her health issues. In fact, simple lifestyle changes could make the difference between a stressed-out, unhappy teen and one who is thriving. As an article in the journal Paediatrics and Child Health reported in 2008, teens’ rapid rate of development and growth requires that they get more sleep—approximately nine to 10 hours a night—in order to not feel sleepy during the day. (The typical teen gets only 7.4 hours a night.) Poor sleep can also increase risk of depression in teens, according to a study published in Childhood Development in 1998, which showed that students who consistently slept less than six hours and 45 minutes a night had more depressive mood symptoms, daytime sleepiness and sleep-wake behavioral problems than those who went to bed earlier and slept more. 

Diet and exercise also play a huge role in overall health, and especially hormone health. Whole foods that provide dense nutrition and steady blood sugar throughout the day are essential for stabilizing levels of stress hormones and maintaining “happy” brain chemicals like serotonin. 

In addition, natural herbal and nutritional medicines can help to treat your daughter’s menstrual symptoms, as well as her anxiety and depression. See a qualified naturopathic doctor for a comprehensive treatment plan that will help bring your daughter back to wellness.

As for the HPV vaccine (also known as Gardasil), it’s intended to prevent a sexually transmitted viral infection that can cause increased risk of cervical cancer and genital warts. There’s much controversy surrounding this new vaccine. Its side effects, though rare, include seizures, strokes, paralysis and cardiovascular disease. I recommend that you refrain from having your daughter vaccinated until more research has been conducted, and that you talk with your daughter about using condoms if she becomes sexually active.