CHILDREN’S HEALTH: MENSTRUAL IRREGULARITIES IN ADOLESCENT GIRLS
Symptoms: severe abdominal pain or backache; menstruation before age nine; failure to menstruate by age 17; long-term absence of menstruation; excessive bleeding.
Home care:
Give aspirin or paracetamol for pain.
Encourage the girl to follow her normal schedule of activities during her period.
Consult her doctor.
- After a girl starts to menstruate it may take months or even years for her periods to become regular. This does not necessarily indicate a problem.
- Cramps and backaches may be related to tension or anxiety rather than to menstruation itself. However, these symptoms can also be caused by a hormone imbalance or an abnormal condition of the pelvis.
- Make sure that your daughter fully understands the process of menstruation.
Girls begin to menstruate sometime between nine and 17 years of age. The average age is 12. Following the onset of menstruation (menarche), it may take from several months to five years for the hormones to balance and produce regular menstrual periods. Menstrual irregularity during this time is to be expected and is not necessarily abnormal.
For about 5 percent of adolescent girls abdominal cramps and backaches – which last one or two days at the start of a menstrual period – may be severe enough to interfere with normal activities. In many instances cramps and backaches are related to emotional factors such as tension or anxiety. They also may be due to a hormonal imbalance or pelvic disease.
Because the range of normal is so broad, it is difficult to judge whether a menstrual abnormality exists or not. Symptoms that warrant investigation are: menstruation before age nine or failure to menstruate by age 17; absence of menstrual periods for six months (or for one month in a sexually active teenager where the failure to menstruate may indicate pregnancy); repeated excessive bleeding; or pain severe enough to interfere with normal activity.
Precautions
• Explain the facts about menstruation to your preteen daughter; this way you can counteract any “old wives’ tales” she may have heard from others, and prepare her for this important part of growing up.
• There are good books available (for both parents and teenagers) that can help explain the process of menstruation and provide accurate information.
Medical treatment
If a girl is having menstrual problems the doctor should conduct a complete physical examination, which includes a rectal and a limited pelvic examination. Chromosome and hormone studies may also be required. In some cases the doctor will order blood tests or tests of thyroid function. (The thyroid gland, located in front of the throat, regulates the body’s temperature, energy production, growth, and fertility.) If the girl is sexually active and has missed a period, a pregnancy test will be called for.
Your doctor may well find no abnormality and no treatment will be necessary. In some cases, the doctor will prescribe hormone medications to be taken over a period of several months. In other cases an iron supplement or a thyroid medication may be prescribed.
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