Managing Irregular Menstruation in Young Girls: Treatment Insights and Concerns

Menarche in children?

The child is 11 years old and had her first menstruation on June 8.
She had normal periods on July 3 and July 31, but the flow was relatively light.
On August 17, she had another period that lasted for ten days, during which the flow became extremely light but did not stop.
On September 7, she visited a gynecologist who prescribed hemostatic medication, which was ineffective after three days.
On September 11, she returned for another consultation, and the doctor prescribed a three-day course of hormones.
After taking the medication for two days, her menstruation stopped on September 13, and she completed the third day's dose.
However, on September 20, her period returned, and this time the flow was more like a normal menstruation.
On September 21, the doctor prescribed Progyluton for 21 days, advising her to start on September 24 and to return for a follow-up in one month, recommending continuous use for 3 to 6 months to regulate her menstrual cycle.
Is this a common treatment method for irregular menstruation following menarche? Is it necessary to take the medication continuously for 3 to 6 months, or should we wait to see if her next period will regulate itself? What are the potential adverse effects of this medication on growth and development? Thank you!

Tracy, 40~49 year old female. Ask Date: 2015/09/21

Dr. Lü Lizheng reply Obstetrics and Gynecology

It is common to experience irregular menstruation in the first few years after menarche.
As individuals age, many will see improvements on their own.
Therefore, a conservative treatment approach is preferred.
Please ensure adequate sleep, engage in regular exercise, and avoid excessive stress.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/09/21

More Info

Managing irregular menstruation in young girls, especially those who have just begun menstruating, can be a complex issue that requires careful consideration and monitoring. In your case, your daughter started her menstrual cycle at the age of 11, and her experience with irregular and varying menstrual flow is not uncommon for young girls during their initial years of menstruation.
Irregular menstruation, particularly in the first few years after menarche (the first menstrual period), can be attributed to a variety of factors, including hormonal imbalances, stress, changes in weight, and other physiological changes as the body matures. It is important to note that the menstrual cycle can take time to regulate, and fluctuations in cycle length and flow are often normal during this period.

The treatment approach your daughter's physician has taken, which includes the use of hormonal medications such as Progyluton, is a common practice for managing irregular menstruation. Progyluton is a combined oral contraceptive pill that contains both estrogen and progestin. It is often prescribed to help regulate menstrual cycles, reduce heavy bleeding, and alleviate symptoms associated with hormonal imbalances.

Here are some insights regarding the treatment and concerns you raised:
1. Duration of Treatment: The recommendation to take hormonal medication for 3 to 6 months is based on the need to allow the body to adjust to the hormones and to establish a more regular menstrual cycle. While it may seem lengthy, this duration is often necessary to assess the effectiveness of the treatment and to help stabilize the menstrual cycle. It is not uncommon for healthcare providers to suggest continuing treatment for several cycles to see if the irregularities resolve.

2. Monitoring Progress: It is essential to monitor your daughter's response to the medication. If her menstrual cycles become more regular and manageable, it may indicate that the treatment is effective. If irregularities persist or worsen, it is crucial to follow up with her healthcare provider for further evaluation and potential adjustments to her treatment plan.

3. Potential Side Effects: As with any medication, hormonal treatments can have side effects. Common side effects of combined oral contraceptives may include nausea, headaches, breast tenderness, mood changes, and changes in weight. However, many young girls tolerate these medications well. It is essential to discuss any concerns about side effects with her healthcare provider, especially regarding her growth and development. Most studies indicate that when used appropriately, hormonal contraceptives do not adversely affect growth or development in adolescents.

4. Alternative Approaches: If you are concerned about the necessity of continuous medication, it is reasonable to discuss this with her physician. They may consider alternative approaches, such as lifestyle modifications, dietary changes, or non-hormonal treatments, depending on her specific situation and health status.

5. Follow-Up Care: Regular follow-up appointments are crucial to assess your daughter's progress and make any necessary adjustments to her treatment plan. It is also an opportunity to address any new concerns that may arise.

In conclusion, while the treatment plan your daughter's physician has proposed is a standard approach for managing irregular menstruation in young girls, it is essential to maintain open communication with her healthcare provider. This will ensure that her treatment is tailored to her individual needs and that any potential side effects are monitored and managed effectively. Regular follow-ups will help in evaluating the effectiveness of the treatment and making informed decisions about her care moving forward.

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