Irregular Menstruation in Adolescents: When to Seek Help

Menstrual issues

A middle school student has not had her menstrual period for over six months.
The last period she had was also after nearly six months.
Could this indicate a medical condition? Should she see a doctor? There are no other physical symptoms.

Xin, 10~19 year old female. Ask Date: 2021/07/15

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
It is recommended to visit a gynecology clinic for examination.
2.
If it has been less than 3 years since the onset of menstruation, the reproductive endocrine system may not be fully developed, so observation can be considered; however, if the menstrual cycle has been prolonged for more than 3 years, polycystic ovary syndrome should be ruled out.

Reply Date: 2021/07/15

More Info

Irregular menstruation, particularly in adolescents, can be a concerning issue for both the individual and their caregivers. In your case, where a middle school student has not had a menstrual period for over six months, it is essential to understand the potential causes and when to seek medical help.

Firstly, it is important to note that irregular menstruation is relatively common among adolescents. During the first few years after menarche (the first menstrual period), many girls experience irregular cycles as their bodies adjust to hormonal changes. This can result in periods that are infrequent, unpredictable, or even absent for extended periods. However, when a young person has not menstruated for six months or more, it is referred to as amenorrhea, and it warrants further investigation.

There are several potential causes of amenorrhea in adolescents, including:
1. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) can lead to irregular periods. Hormonal imbalances can also arise from issues with the hypothalamus or pituitary gland, which regulate the menstrual cycle.

2. Stress and Lifestyle Factors: High levels of stress, significant weight loss, excessive exercise, or changes in diet can all impact menstrual regularity. Adolescents are particularly susceptible to these factors due to the various pressures they face.

3. Medical Conditions: Certain medical conditions, such as thyroid disorders or diabetes, can also affect menstrual cycles.
4. Genetic Factors: Some girls may have a family history of irregular menstruation, which can play a role in their own menstrual health.

Given that the individual in question has not experienced any other physical symptoms, it is still advisable to seek medical attention. A healthcare provider can conduct a thorough evaluation, which may include:
- A detailed medical history and physical examination.

- Blood tests to check hormone levels, thyroid function, and other relevant markers.

- An ultrasound to assess the ovaries and uterus if deemed necessary.

It is crucial to approach this situation with sensitivity and care. Encourage the adolescent to speak openly about their experiences and feelings regarding their menstrual health. Seeking help from a healthcare professional can provide reassurance and clarity, as well as appropriate treatment options if needed.

In summary, while irregular menstruation can be common in adolescents, the absence of periods for six months is a sign that medical advice should be sought. A healthcare provider can help determine the underlying cause and recommend appropriate interventions. Early intervention can help address any potential issues and promote overall health and well-being.

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