Research open access menstrual pattern and menstrual disorders among adolescents. The health problems of adolescents are very special. Using the menstrual cycle as a vital sign americanacademyofpediatrics. A number of medical conditions can cause irregular or missed menses in adolescents.
Menstrual pattern, menstrual disorders, menstrual cycle length, bleeding length, polymenorrhea, oligomenorrhea, dysmenorrhea, adolescents introduction adolescence is the time of life between puberty and psychophysical maturity when crucial endocrinological, metabolic, somatic and psychological changes occur in girls. Endometriosis uterine lining grows outside the uterus uterine abnormalities fibroids or adenomyosis iuds. Menstrual disorders there are a number of different menstrual disorders. Menstrual disorders reproductive age in the reproductive age, psychologic causes of menstrual disorers involve marital and sex life, a detailed history might reveal significant events that precedes anovulatory episodes. In the uk, girls enter puberty around the age of 10 years with a median age of menarche of 12. Menstrual disorders frequently affect the quality of life of adolescents and young adult girls and can be indicators of serious underlying problems. Menstrual disorders definition of menstrual disorders by. Assistant clinical professor of pediatrics university of florida. Although menstrual irregularities may be normal during the early postmenarchal years.
In addition, it has been postulated that lower concentrations of allopregnanolone, a progesterone metabolite with benzodiazepinelike effects, occur in the late luteal phase in women with pms and play a role in some men. In the setting of known bleeding disorders, puberty may increase anxiety about bleeding and risk of menstrual hygiene accidents at school for patients and their families. Hyperandrogenism is a cause of menstrual disorders in adolescents, with polycystic ovary syndrome pcos being the most common cause. Of 380 adolescents who attended eden hospital, calcutta medical college, india, over a 9 month period, 215 had some menstrual problem. History of broken relationships, alcoholism or drug addiction and school or social pressures. Menstrual health in india landscape analysis sponsored by the bill and melinda gates foundation. Distinguishing the etiology of heavy menstrual bleeding will guide treatment, which can include hemostatic medications, hormonal agents, or a combination of both. Menstrualrelated disorders 78 psapvii womens and mens health the development of premenstrual symptoms. Menstrual disorders in adolescence may present diagnostic and management challenges for the gynaecologist. Menstrual pattern and menstrual disorders among adolescents.
Heavy menstrual bleeding hmb is a common complaint among adolescent girls. Young patients and their parents often are unsure about what represents normal menstrual patterns, and clinicians also may be unsure about normal ranges for menstrual cycle length and amount and duration of flow through adolescence. It reflects an abnormal volume of blood loss during the menstrual cycle. Menstrual disorders reproductive age excessive regular cyclical bleeding or menorrhagia.
Modern management of menstrual disorders in adolescents. Menstrual disorders are a common presentation by late adolescence. Obrien, md, committee on adolescence, the north american society for pediatric and adolescent gynecology this document is ed and is property of the american academy of pediatrics and its board of directors. Adolescents with psychiatric disorders may be taking psychopharmacologic agents that can cause menstrual dysfunction and galactorrhea. Types of menstrual disorders causes of different types. There are many variations in menstrual patterns, but in. Pregnancy complications miscarriage common causes of dysmenorrhea menstrual pain include. Their periods come like clockwork, starting and stopping at nearly the same time every.
This article discusses four common menstrual disorders seen in adolescent girls and focuses on specific nursing interventions aimed at eliciting an accurate menstrual history, providing confidentiality and communicating therapeutically, administering culturally sensitive care, and promoting. A total of 800 questionnaires were administered to postmenarcheal. Pediatrics menstrual disorders clinic boston medical. Sep 05, 2003 menstrual disorders in adolescence may present diagnostic and management challenges for the gynaecologist.
These studies suggest that obesity does contribute to a significant proportion of menstrual disorders in young women. Using the menstrual cycle as a vital sign december 2015 during the first 2 years after menarche, cycles may be irregular, but 90% of girls will have cycles in the range. Apr 09, 2019 in adolescents, disorders of menstruation may present as abnormal uterine bleeding aub. A study on menstruation of indian adolescent girls in an. Risk factors for menstrual disorders by amy scholten, it looks like you have javascript turned off. Aug 11, 20 among the adolescents with ed, 21 had menstrual disorders 34%. Quint department of obstetrics and gynecology, division of gynecology, university of michigan health system, ann arbor, michigan, usa puberty and menstruation are dif. Definition a menstrual disorder is a physical or emotional problem that interferes with the normal menstrual cycle, causing pain, unusually heavy or light bleeding, delayed menarche, or missed periods. Assistant professor of obstetricsgynecology, university of pennsylvania school of medicine 2. The aims of this study were to identify menstrual patterns and associated disorders as well as the sources of menstrual health knowledge among egyptian adolescents. Menstrual disorders in adolescent girls adolescence is the time when there is sudden transformation in the body and many questions arises in the minds of the adolescents. Menstrual abnormalities are more common among younger girls, becoming less frequent as they grow older, 35 years after menarche 812.
Screening and management of bleeding disorders in adolescents. Dysmenorrhea, or painful menstruation, is the most common gynecologic problem that occurs during adolescence. Menstrual disorders american academy of pediatrics. Description typically, a woman of childbearing age should menstruate every 28 days or so unless she is pregnant or moving. Recognizing the paucity of data on menstrual disorders in singaporean adolescents, we have endeavored to quantify them in this crosssectional study. Pdf menstrual disorders in adolescents researchgate. Confidential1 oxtober 2010 adolescent sexual health.
There were 75 cases with primary amenorrhoea, 28 with secondary amenorrhoea, 42 with oligomenorr. Menstrual patterns and disorders among secondary school. Types of menstrual disorders causes of different types of. There were 75 cases with primary amenorrhoea, 28 with. Although secondary amenorrhea has been defined as the absence of menses for 6 months, it is statistically uncommon for girls and adolescents to remain amenorrheic for more than 3 months or 90 daysthe 95th percentile for cycle length. Menstrual cycles are often irregular during adolescence, particularly the interval from the. Endocrine abnormalities in adolescents with menstrual disorders. Abnormal uterine bleeding disorder is of three types heavy menstrual bleeding, no menstrual bleeding amenorrhea and bleeding between the two periods metrorrhagia. It is estimated that 75% of menstruating women experience dysmenorrhea, making it the leading cause of school and work absenteeism among young women. Normal menstrual cycles in young females acog committee opinion 651. This risk factors for menstrual disorders page on empowher womens health works best with javascript enabled in your browser.
Associate professor of medicine and pediatrics, university of pennsylvania school of medicine. Menstrual disorders are a disruptive physical andor emotional symptoms just before and during menstruation, including heavy bleeding, missed periods and unmanageable mood swings. It is a period when rapid physiological and psychological changes demand for new social roles to take place. Nutritional behavior may be affected by expected developmental and behavioral changes of adolescence, includ. Treatments for menstrual disorders range from overthecounter medications to surgery, with a variety of options in between. In the ednos group, menstrual disorders corresponded to four secondary amenorrhea cases and six mi, with a global frequency of 20%. Adolescence is the time when there is sudden transformation in the body and many questions arises in the minds of the adolescents. These findings have been corroborated by lake et al. Some women get through their monthly periods easily with few or no concerns. Menstrual management for adolescents with disabilities. Delayed, irregular, painful, and heavy menstrual bleeding are leading reasons for physician office visits by adolescents, 35 and dysmenorrhea is the leading reason for school absenteeism among girls. The most challenging problems are related to menses, in girls.
There is a higher prevalence of bleeding disorders in girls with heavy menstrual bleeding than in the general population. Identification of abnormal menstrual patterns in adolescence may improve early identification of potential health concerns for adulthood. Menstrual disorders in adolescents do mirror some common menstrual disorders in adults, but amenorrhea, systemic bleeding disorders, abnormal bleeding due to exogenous hormones, and sexually transmitted infections stis are more common in this population. There is need for further research to understand the impact of menstrual healthinterventions on life outcomes.
Pdf the health problems of adolescents are very special. Clinicians should educate girls and their caretakers eg, parents or guardians about what to expect of a first menstrual period and the range for normal cycle length of subsequent menses. Management of menstrual disorder in adolescent girls with intellectual disabilities. All these findings confirm that the association between menstrual disorders, hyperandrogenism, obesity and metabolic risks is already evident in adolescence, which strengthens the importance of recording menstrual disorders at an early stage. Menstrual disorders and hyperandrogenism in adolescence. Problems can range from heavy, painful periods to no periods at all.
Firstly they are not able to cope with the changes and secondly the changes bring along problems with them. Menstrual disorders angela washer msn whnpbc cefm clinical nurse specialist cleveland clinic fairview hospital womens and childrens services. Menstrual disorders in adolescence university of florida. Apr 09, 2019 menstrual disorders in adolescents do mirror some common menstrual disorders in adults, but amenorrhea, systemic bleeding disorders, abnormal bleeding due to exogenous hormones, and sexually transmitted infections stis are more common in this population. Menstrual disorders such as amenorrhea, abnormalexcessive uterine bleeding, dysmenorrhea. Menstrual issues in adolescents with physical and developmental disabilities elisabeth h. Abu ishak nurkhairulnisa, 1 kah teik chew, 1 ani amelia zainudin, 1 pei shan lim, 1 mohamad nasir shafiee, 1 nirmala kampan, 1 wan salwina wan ismail, 2 sonia grover. Director, craigdalsimer program in adolescent medicine, hospital of the university of pennsylvania, childrens hospital of philadelphia dysmenorrhea. The menstrual problems experienced by this population are often unique and management is restricted due to signi. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. This article discusses four common menstrual disorders seen in adolescent girls and focuses on specific nursing interventions aimed at eliciting an accurate menstrual history, providing confidentiality and communicating therapeutically, administering culturally sensitive care, and promoting independence and selfcare. Research open access menstrual pattern and menstrual. Menstrual problems can also have a significant impact on the quality of life and academic performance of adolescent girls. It is important for clinicians to have an understanding of the menstrual patterns of adolescent girls, the ability to differentiate between normal and abnormal menstruation, and the skill to know how to.
The menstrual disorders clinic mdc is located in the adolescent center and diagnoses and treats a variety of menstrual disorders. This causes the menstrual phase of the next cycle to begin. Hypogonadism may be primary or secondary and cause pubertal delay or menstrual disorders. Problems associated with menstruation affect 75% of adolescent females and are a leading reason for visits to physicians. Adolescents and young adults, from 12 years of age though their 20s, may come to the division of adolescent and young adult medicine at massgeneral hospital for children with complex medical or psychosocial problems, or to obtain primary medical care.
Abstract of 380 adolescents who attended eden hospital, calcutta medical college, india, over a 9 month period, 215 had some menstrual problem. This collection features afp content on menstrual conditions and related issues, including abnormal uterine bleeding, amenorrhea, dysmenorrhea, endometrial ablation, endometriosis, heavy menstrual. Variations in the type and the frequency of periods may create anxiety regarding ill health or serious underlying disorders. Primary amenorrhoea stood out as the commonest serious disorder. The definition of normal menstrual function and the approach to menstrual disorders differ between adolescents and adults, but currently, there is no consensus on the adolescent age range and a lack of data on the numbers of adolescents with different gynaecological problems. Premenstrual syndrome pms among high school students nattapong buddhabunyakan, srinaree kaewrudee, chompilas chongsomchai, sukree soontrapa, woraluk somboonporn, jen sothornwit department of obstetrics and gynaecology, faculty of medicine, khon kaen university, khon kaen, thailand background. Diagnosis and management of heavy menstrual bleeding and. Adolescents with known bleeding disorders should be counseled before menarche and have a plan in place for the possibility of heavy menstrual bleeding with menarche. A normal menstrual cycle counting from the first day of one menstrual period to the first day of menses of the next cycle is 21 to 35 days in adults but has a slightly wider range of normal in adolescents during the first 2 years after menarche. Jan 24, 2018 hypogonadism may be primary or secondary and cause pubertal delay or menstrual disorders. In adolescents, disorders of menstruation may present as abnormal uterine bleeding aub. It is important to be able to educate young patients and their parents regarding what to expect of a first period and about the range for normal cycle length of.
As a diagnostic criterion for an, amenorrhea was present in 100% in this group. Pregnant adolescents who take psychopharmacologic agents present a special challenge in balancing the potential risks of. Menstruation disorders in adolescents with eating disorders. Menstrual health in india country landscape analysis. Menstrual disorders in adolescence mukherji 1986 asia. The onset of menstruation may be characterized by a number of irregularities. Management of menstrual problems in adolescents with. Menstrual disorders in adolescence maureen kays, m. Using a systematic approach to evaluating this population will. Menstrual management for adolescents with disabilities elisabeth h. Yet, in some cases menstrual healthprograms are designed assuming thes e linkages.
Frequently due to benign organic disease of the reproductive tract such as fibromyomas or pelvic inflammatory disease. Adolescence is a time of great psychological and physical change. Girls and young women, from ages 1021, experiencing heavy menstrual periods, painful periods or who are missing periods. Management of menstrual disorder in adolescent girls with. Study aims to determine the prevalence and pattern of menstrual disorders in adolescents and their effect on everyday life. Menstruation is a natural and routine part of life for healthy girls and women. Your treatment options will depend on your diagnosis, its severity, which treatment you prefer, your health history and your health care professionals recommendation. The timing of this process is individualspecific, within a broad range of normality. Factors contributing to nutritional disorders in adolescence include poverty, child maltreatment, political upheaval, sociocultural in. The most frequent menstrual disorders are polymenorrhea, oligomenorrhea and dysmenorrhea 47. Premenstrual syndrome pms is a common health problem among adolescents.
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