Period Problems In Teenager

Hello all.

After the blog “NORMALISING MENSTRUATION”, ( coming up with some common period problems which a girl/woman can come across.

Menstruation is a vital part of the reproductive health of a woman. Young girls neglect problems related to menstruation due to lack of awareness and non-availability of adolescent friendly health facilities. 

Girls may be unfamiliar with what is normal and may not inform their parents about menstrual irregularities or missed menses. Girls often are reluctant to discuss this very private topic with parents. 

Menstrual health literacy is particularly important for school going girls, as it is during these years that adolescents will first experience menstruation. So parents, teach your daughter to pick up any abnormality in her period and discuss it with you and seek medical advice if needed. 

As discussed in last blog educating the girl to track her periods is very important aspect. Tracking itself helps to detect many of the period problems. Ask her to note the first day (that is day the bleeding starts) of every cycle.

Explain her that cycle length is counted from the first day of a menstrual period to the first day of the next menses. Before going directly to disorders, first know in short about stages of pubertal development. 

Adolescence is the transitional phase of physical and mental development between childhood and adulthood and is characterized by immense hormonal changes. 

Series of events occurring during pubertal development are:

Acceleration of growth→ appearance of breast bud (Thelarche)→ Appearance of pubic hair(Pubarche)→ starting of menstruation(Menarche). On an average it require a period of 4.5yrs (1-6yrs). The age of onset of menstruation or menarche is generally between 11-15 years.

Coming to the period problems in adolescent:

1)Delayed onset of periods:

period problems in teenager

  1. It is seen in some cases.
  2. You need to consult when there are no periods by 15 yrs of age or no periods within 3 years of breast development.
  3. No breast development by 13years of age also needs evaluation.

Why this happens?

a) Hormonal issues
b) Chronic disease   
c) Malnutrition
d) Familial

2) Painful periods:

Girls can have cramping pain during menses. This is due to contraction of uterine muscles. She may experience cramping and pain in the lower abdomen, Low back pain and pain spreading down the legs. It may be associated with symptoms like nausea, vomiting, diarrhea, tiredness, weakness, fainting and headache. Symptoms occur just before menstrual bleeding starts each month. The pain can last for 1 to 2 days or more. It then lessens at the end of the period. Simple measures like using hot water bag, moderate exercise, warm water bath, maintaining hydration can relieve pain. Medications to relieve pain can be used with doctor’s advice.

3) Irregular periods:

More common in adolescent. Periods usually are irregular after menarche for about 12-18months. Immaturity of the hypothalamic–pituitary–ovarian axis during the early years after menarche often results in anovulation and cycles may be somewhat long. However, 90% of cycles will be within the range of 21–45 days. By 3rd year after menarche in 60-80% of girls cycle becomes regular as in adults. It is advisable to consult doctor if a girl has no menses for more than 90days. Girls and adolescents with chaotically irregular cycles with more than 3 months between periods should be evaluated. They are not reassured that it is “normal” to have irregular periods in the first gynecologic years. Irregular menses may be associated with many conditions, including pregnancy, endocrine disorders, and acquired medical conditions, PCOS, significant weight loss, strenuous exercise, substantial changes in sleeping or eating habits, and severe stress.

4) Excessive bleeding:

First period usually is reported to be of medium flow, and the need for menstrual hygiene products is not typically excessive. Theoretically blood loss more than 80ml in a cycle is considered as heavy bleeding. But it is difficult to measure menstrual blood loss accurately. So menstrual flow requiring change of pads frequently (more than 4-6 times a day) and flow lasting more than 7 days at a time is considered heavy. It is more commonly seen due to anovulation but sometimes hematological or chronic disorders can also lead to such pattern of bleeding which needs attention. If your daughter is having such pattern of flow it is advisable to consult a doctor. period problems in teenager

5) Premenstrual Symptoms:

Experienced by 20% of teens. Usually seen in the week before starting period. Symptoms are relieved on 2nd or 3rd day of period. Common symptoms are mood swing, depressed mood, irritability, anxiety, sadness, crying spells, food cravings, social withdrawal and poor concentration. Common physical changes may include abdominal bloating, extreme sense of fatigue, breast tenderness, headache, dizziness. Premenstrual symptoms were significantly more common among girls who are overweight, in girls who are eating junk food regularly, who are eating less food (dieting) in order to lose weight and in those who are not doing regular physical activity.  period problems in teenager

Try some lifestyle modifications to minimize period problems.

  1. Exercise regularly.
  2. Eat a healthy, balanced diet with lots of fresh fruits and vegetables.
  3. Get good sleep (7 to 8 hours).
  4. Try reducing your stress by doing yoga or meditation.
  5. Avoid caffeine. It helps to reduce anxiety and pain to some extent.
  6. Lower salt in diet to ease bloating.
  7. Keep a diary of your symptoms

Seeing our children struggle or suffer is the most difficult part of being a parent.So moms, make an effort to listen and be attentive to her needs. period problems in teenager

©Dr. Smita Surana
Obstetrician & Gynaecologist