Adolescent Period Problems

You need to see a Doctor when

- There is no period by 17 years.
- Your period has stopped for more than two months.
- A major change in your menstrual cycle.
- More than usual pain before or during a period.
- Bleeding between each period.
- Periods are very long, more than five days.


Introduction

Believe it or not teenagers are not fully grown adults. They will be still growing and changing between the years of 12 to 18. Add to this the hormones oestrogen and progesterone and life can be a bit difficult. However many teenagers live life to the full and have little or no problems.For the rest there can be emotional and physical discomfort and associated problems with puberty. The main issue, if there are problems, is to work out if the problem is just part of growing up and will go away. Or if the problem is more serious and that they should seek professional medical advice. Talking to friends of a similar age, being informed and getting help from family members are ways to work out if problems are serious or temporary. Visiting a health professional only takes some time, some money and communicating accurately any problem. There is a high chance any problem can be fixed early before it becomes a bigger problem later on.

Primary Amenorrhoea, delayed menstruation)

The start of menstruation is usually a mixture of excitement and anxiety and add to this a big increase in hormones means the start can be ok, difficult, delayed or confusing. Improved nutrition and general health means that the start continues to fall with each generation. Most girls start menstruation between the ages of 12-13, but its not unusual to start between 10-17. No menstruation after 17 suggests primary amenorrhoea or delayed menstruation. The main cause is the failure of the sex organs to mature which in turn does not produce the required level of the hormone, oestrogen. The start date of the mother and grandmother can help identify if its just typical of that family or there is a different reason. Other physical problems like obesity, blocked tubes etc and other diseases can be the cause but its rare. Psychological problems such as anorexia nervosa, severe depression, schizophrenia can also cause delays.

Secondary Amenorrhoea
(menstruation begun then stopped with no ovulation)

This is where menstruation has begun, become established and then stops. Pregnancy is the main reason, while severe shock, physical agitation, constant travel, drug use and ceasing use of the contraceptive pill are other reasons. The usual treatment for this is to wait and see, while some use the more aggressive treatment of hormone replacement therapy (progesterone).

Painful Adolescent Menstruation

Cramping pains can occur in the lower stomach, and sometimes also in the lower back and kidney region. They tend to start on the onset of bleeding or for those who suffer from pre menstrual syndrome, the day before the onset of bleeding. The reason? No one knows exactly but fluctuating hormonal levels probably oestrogen and recent research suggests hormones called prostaglandin's could also be a cause. Pain killers, contraceptive pill and anti-prostaglandin are all used but not with good results. Many just put up with the pain hoping over time it will go away and it frequently does.

Irregular Adolescent Periods

Irregular periods can be normal for teenagers. It is not uncommon for teenagers to menstruate on a 21 day cycle instead of the usual 28 day cycle, or they can have cycles as long as 35-40 days. Periods can be missed or absent and usually there is no increase in pain. The teenager however has no real indication of where they are in the cycle and periods can start suddenly with no warning that its about to commence. Being prepared for sudden onset is part of dealing with the problem. Hormone treatment has been tried but without much success, and like most teenage menstrual problems it usually improves with age.

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