Delayed Menstruation: When to Seek Endocrine Care

Amenorrhea

My daughter is 14 years old and in the 9th grade.
While her classmates have started menstruating, she has not yet had her period.
An ultrasound showed that her ovarian development is at a level typical of a 7 to 8-year-old.
Should we continue to see an adult endocrinologist or a pediatric endocrinologist? What treatment options are available? Thank you for your help.

Hui, 40~49 year old female. Ask Date: 2023/06/03

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to see an obstetrician-gynecologist and have a blood test to check hormone levels.
Wishing you good health.

Reply Date: 2023/06/03

More Info

Delayed menstruation, or primary amenorrhea, is a condition where a girl has not started her menstrual cycle by the age of 15, or within three years of breast development. In your daughter's case, at 14 years old and with ovarian development equivalent to that of an 8-year-old, it is essential to seek further evaluation and care from a healthcare professional specializing in endocrinology.

Given her age and the developmental stage of her ovaries, it is advisable to consult with a pediatric endocrinologist. Pediatric endocrinologists specialize in hormonal issues in children and adolescents, and they can provide a comprehensive evaluation of her condition. They will likely conduct a thorough assessment, which may include blood tests to check hormone levels, imaging studies to evaluate the reproductive organs, and possibly genetic testing if there are concerns about chromosomal abnormalities.

The treatment options for delayed menstruation depend on the underlying cause. If the delay is due to hormonal imbalances, hormone replacement therapy may be recommended to induce menstruation and promote normal development. In cases where there are anatomical issues or developmental disorders, surgical interventions may be necessary.
It is also important to consider psychological support, as the emotional impact of delayed menstruation can be significant for adolescents. Counseling may help your daughter cope with any feelings of anxiety or inadequacy related to her condition.

In summary, it is crucial to continue seeking care from a pediatric endocrinologist who can provide specialized treatment and support. Early intervention can help address any underlying issues and promote healthy development. Regular follow-ups will be necessary to monitor her progress and adjust treatment as needed.

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