Heavy Menstrual Bleeding

A 13 year old girl presenting to her pediatricians office with several months of fatigue. Despite getting eight to nine hours of sleep every night, she says that her periods are fine. But when you ask further, she she tells you that she started menstrating at aged 9. Her periods have always been a regular coming every month or two and last on ten days. They require her to change her tampon in between almost every class during the school day. And she also gets painful cramps the first two days of each period.