Your Child's First Menstruation: When to Seek Medical Advice

Regarding a child's first menstruation?

My child was born at the end of January 2007.
Her first menstrual period came on March 1st of this year, with normal flow and duration, but she hasn't had a period for the past five months.
I understand that the first one or two years can be unstable, and I've consulted friends who say there's no need to worry and to wait a bit longer.
However, I am still a bit concerned.
I would like to ask the doctor under what circumstances we should seek medical attention, and what kind of examinations the doctor would perform.
Thank you.

natasha, 40~49 year old female. Ask Date: 2018/07/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The child was born at the end of January 1996.
On March 1st of this year, she had her first menstrual period, which was normal in terms of flow and duration.
However, for the past five months, her menstruation has not occurred.
I understand that the first one to two years can be unstable, and I have consulted friends who all say not to worry and to wait a bit longer.
Nevertheless, I am still a bit concerned.
I would like to ask the doctor under what circumstances she should see a doctor, and what kind of examinations the doctor would perform.
Answer: If menstruation has not occurred or remains irregular by March 1st of the following year, she should see a doctor.

Reply Date: 2018/07/23

More Info

Understanding your child's first menstruation can be a significant milestone, and it's natural to have concerns about irregularities in their menstrual cycle. In your case, your child had her first menstruation in early March, and it has been five months since then without another period. While it's true that the first few years of menstruation can be irregular, there are specific situations where seeking medical advice is advisable.

When to Seek Medical Advice
1. Absence of Menstruation (Amenorrhea): If your child has not had a menstrual period for more than three months after her first period, it is considered secondary amenorrhea. This can be a sign of underlying health issues that may need to be addressed.

2. Severe Pain or Discomfort: If your child experiences severe pain during menstruation (dysmenorrhea) that interferes with daily activities, it is essential to consult a healthcare provider.

3. Excessive Bleeding: If your child does get her period but experiences excessive bleeding (soaking through a pad or tampon every hour for several hours), this could indicate a problem that requires medical evaluation.

4. Other Symptoms: If your child has other concerning symptoms such as significant weight loss or gain, excessive hair growth, acne, or changes in mood, these could be signs of hormonal imbalances or other conditions that should be evaluated.

5. Family History: If there is a family history of menstrual disorders, polycystic ovary syndrome (PCOS), or other reproductive health issues, it may be wise to consult a healthcare provider sooner rather than later.

What to Expect During a Medical Consultation
When you take your child to see a healthcare provider regarding menstrual irregularities, the doctor will typically conduct a thorough evaluation, which may include:
1. Medical History: The doctor will ask about your child's menstrual history, including the age of menarche (first period), cycle regularity, duration, and any associated symptoms. They may also inquire about family medical history and any other health issues.

2. Physical Examination: A physical examination may be performed to check for any signs of hormonal imbalances or other health issues. This may include checking height, weight, and signs of puberty development.

3. Blood Tests: Blood tests may be ordered to check hormone levels, including estrogen, progesterone, and thyroid hormones. These tests can help identify any hormonal imbalances that may be affecting your child's menstrual cycle.

4. Ultrasound: In some cases, an ultrasound may be performed to examine the ovaries and uterus for any abnormalities, such as cysts or structural issues.

5. Additional Tests: Depending on the findings, the doctor may recommend further tests or referrals to specialists, such as an endocrinologist or gynecologist.

Conclusion
While it is common for young girls to experience irregular menstrual cycles in the first few years after menarche, it is essential to monitor the situation closely. If your child has not had a period for five months, it would be prudent to consult a healthcare provider to rule out any underlying issues. Early intervention can help address any potential health concerns and provide reassurance for both you and your child. Remember, open communication with your child about her body and health is crucial, and encouraging her to express any concerns she may have can foster a supportive environment during this transitional phase.

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