Menstrual Disorders  Article Reprint

Original Article: http://www.menstrual-disorders.com/articles/menstrual-disorders-in-adolescence/index.php

 

Menstrual Disorders in Adolescence

Adolescence is often viewed as the emotional and physical bridge between childhood and adulthood. This transitional period is filled with hormonal changes, character development and testing. It’s often a time when developing children start to discover who they are. For girls, adolescence is a time of major body development and hormonal shifts. While menstruation is an easy transition for some, for others, it may be delayed, irregular or painful.

Menstrual disorders in adolescence are common. Although girls may begin menstruating as early as 8 years old or as late as 16, 12 is the average age for the onset of menstruation. While having a period every 28 days has become the “textbook” explanation of normal, cycles vary. In fact, it is especially common for teen girls to have irregular cycles.

Amenorrhea

Amenorrhea, or the absence of a menstrual period (usually characterized by a missing period for more than three months), is a common disorder in adolescence. Primary amenorrhea describes the condition of no menstruation at puberty. This is usually a lifelong condition. Secondary amenorrhea, the more common form, describes once “normal” periods that have become abnormal, irregular or absent.

Amenorrhea has a number of different causes. Because adolescence is a stressful time, stress can be a leading contributor to cycle changes. If menstruation has not begun by the age of 16, however, a medical condition may be suspected. A physician should be consulted in this instance for further evaluation. Other common causes of amenorrhea include:
  • anatomical abnormalities
  • birth defects
  • pregnancy
  • specific medical conditions.

Once a girl has started menstruating, reasons that she may develop amenorrhea may include:

  • Eating disorders: Anorexia or bulimia can contribute to amenorrhea. When body weight is too low to sustain a pregnancy, the reproductive system will shut down. This state generally reflects a severely malnourished individual.

  • Obesity: Although many people are aware that a very low bodyweight can interfere with a healthy menstrual cycle, they may not be aware that too high a bodyweight also has an effect on periods. An excess of fat cells can interfere with normal ovulation and lead to amenorrhea.

  • Strenuous exercise: Adolescent athletes often begin their periods later in life than non-athletes. The non-stop strain and physical demands of competitive training and sports can lead to such a low fat content that bodies are not able to menstruate.

  • Thyroid disorder: Hypothyroidism (underactive thyroid gland) or hyperthyroidism (overactive thyroid gland) can lead to menstrual cessation.

Polycystic Ovary Syndrome

Too few periods may point to a mild hormonal imbalance called Polycystic Ovary Syndrome (PCOS). Symptoms of PCOS include acne, excessive hair growth and weight problems. If left untreated, PCOS can cause infertility.

Dysmenorrhea

Painful periods, or dysmenorrhea, are another common complaint among adolescents. Usually symptoms can be treated with over-the-counter medications (such as acetaminophen and ibuprofen) and heating pads. If cramps are severe or prolonged, doctors may prescribe birth control pills or other medications.

Pre-Menstrual Syndrome (PMS)

One of the most common menstrual disorders in adolescence is PMS. Generally characterized by an array of physical and emotional symptoms that begin about a week before menstruation begins, PMS can be a very difficult condition. Girls may experience:
  • anxiety
  • breast tenderness
  • depression
  • fatigue
  • headaches
  • mood swings
  • nausea
  • weight gain.
PMS can often be handled with a healthy diet and exercise, but parents of adolescent girls should not hesitate to discuss concerning symptoms with their daughters’ physicians (and encourage their daughters to do the same). Mild antidepressants are sometimes indicated in more severe cases.

Evaluation and Diagnosis

Diagnosis of the adolescent with menstrual irregularities will consist of obtaining a detailed medical history, growth chart reviews, general physical examination (the doctor will look for acne and excessive hair growth to rule out PCOS), a gynecological assessment (with possible ultrasound) and blood tests (to check hormone levels).

Treatment

Treatment of menstrual disorders in teens will vary depending on the problem and its underlying cause. Sometimes, just observation and the passage of time will result in normal periods. Other situations might require hormone replacement therapy (progesterone or oral contraceptives).

Parents and adolescents should keep in mind that problems in this age group are common. Adolescence can be a tough time in general, and girls may feel especially self-conscious or uncomfortable if they are also dealing with menstrual disorders. Parents should help their daughters to take an assertive role. Explain that it is healthy to openly speak with a doctor. Support is key, and girls should remember that most people will experience menstrual abnormalities at some time during their reproductive years.

Resources

Children’s Hospital Boston (2006). Menstrual/Reproductive Disorder. Retrieved June 30, 2007, from the Children’s Hospital Boston Web site:
http://www.childrenshospital.org/az/Site1293/mainpageS1293P0
.html

Lucile Packard Children’s Hospital (2007). Adolescent Medicine: Menstrual Disorders. Retrieved June 30, 2007, from the Lucile Packard Children’s Hospital Web site:
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/adolescent/
mensthub.html

NCBI (n.d.). Adolescent Menstrual Disorders. Retrieved June 30, 2007, from the NCBI Web site: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=6352128&dopt=Abstract.