Adolescent Menstrual Dysfunction
Adolescent menstrual dysfunction describes irregularities or abnormalities in the menstrual cycle of young people, such as absent, irregular, or heavy periods.
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What is adolescent menstrual dysfunction?
Adolescent menstrual dysfunction is a term used to describe irregularities or abnormalities in the menstrual cycle in children and young people.
During puberty, most teenagers will experience variations in menstruation, but sometimes these problems can be severe or persistent, so they may need further investigation. Sometimes, menstrual dysfunction can be a sign of complex underlying issues, and these can take time to diagnose and treat.
At Welbeck, our consultants currently diagnose and treat adolescent menstrual dysfunction in children and young people aged 12 to 18.
Types of menstrual dysfunction in adolescents
Adolescent menstrual dysfunction can include:
Absent periods (Amenorrhea)
Amenorrhea is the medical term for the absence of periods. There are two types of amenorrhea - primary and secondary.
Primary amenorrhea is when a girl has not started having periods by 15 years old, or within 3 years of breast development.
Secondary amenorrhea is when someone who has previously had regular periods stops menstruating for 3 or more consecutive months.
Amenorrhea can be a sign of other underlying issues, so it’s important to talk to your doctor if your child has symptoms of primary or secondary amenorrhea.
Irregular periods (Oligomenorrhea)
On average, periods occur every 28 days, but this can range from around 21 to 35 days in some people. It’s very common for periods to happen at irregular intervals for the first 2 to 3 years of menstruation, and this is not usually a cause for concern. If your child’s periods remain irregular after the first 3 years or are absent for over 3 consecutive months, then it’s important to seek medical advice.
Heavy or long periods (Menorrhagia)
Long or heavy periods, or menorrhagia, is a common symptom that should always be discussed if it keeps occurring. If your child is having symptoms of heavy or prolonged menstrual bleeding, it’s important to find out if there are any underlying issues and get advice about how to address the symptoms correctly.
In some cases, your doctor can recommend treatments like the combined contraceptive pill, progesterone-only pill or intrauterine system (IUS) - commonly known as the hormonal coil. These can reduce heavy bleeding by up to 95%.
Symptoms of heavy or prolonged menstrual bleeding are:
- needing to change pads or tampons every 1 to 2 hours, or a menstrual cup more often than recommended
- needing to use more than one type of menstrual product at a time to prevent bleeding through onto clothes
- bleeding that lasts for more than 7 days
- passing blood clots that are bigger than 2.5 cm
- being unable to carry out regular activities during menstruation
- periods that affect your child’s quality of life or mental health
- periods that impact your child’s school and social life
Moderate to severe period pain (Dysmenorrhoea)
Mild cramps just before or during menstruation are considered normal, but pain that interferes with regular activities usually needs further investigation. As well as pain, dysmenorrhoea can be accompanied by nausea, diarrhoea and tiredness. Dysmenorrhoea may not always have an underlying cause, but it can be a sign of other conditions such as endometriosis or fibroids, so it’s important to seek medical advice.
Vaginal bleeding before the first menstrual period (Pre-menarchal bleeding)
Pre-menarchal bleeding is vaginal bleeding that happens before the typical age when menstruation begins (usually between the ages of 9 and 15) and before a girl's first menstrual period (menarche). The most common symptom of premenarchal bleeding is bleeding from the vagina. This can be light or heavy and may vary in length from a few days to weeks. The bleeding may also be accompanied by pain or cramping in the abdominal area, similar to period pains and unusual vaginal discharge. Pre-menarchal bleeding is uncommon, but can be a sign of a serious underlying issue, so it’s important to seek advice if you notice symptoms.
What causes adolescent menstrual dysfunction?
Adolescent menstrual dysfunction can be caused by a wide range of issues that may take time to diagnose.
Causes can include:
- lifestyle factors such as stress, exercise and diet
- hormonal imbalances
- infection
- certain medications
- pregnancy
- polycystic ovary syndrome (PCOS)
- endometriosis/adenomyosis
- fibroids
- structural issues in the reproductive system
- disorders of the thyroid or pituitary glands
How is adolescent menstrual dysfunction diagnosed at Welbeck?
Our team will talk to you and your child about your child's medical history, their menstrual cycle and any specific symptoms and will ask to carry out a physical examination. It can be useful to keep a diary of menstruation and other symptoms to share with your doctor.
Menstrual disorders can be caused by a wide range of underlying issues, and blood tests are usually required to make a correct diagnosis. A range of further diagnostic tests may be used to help in this diagnosis.
Additional tests may include:
- urinalysis to check the urine for signs of infection and other issues
- urine sample collection for laboratory testing
- vaginal swabs
- sexual health screening
- pregnancy test
- ultrasound
- genetic testing
Imaging and scans may include:
- abdominal and pelvic ultrasound
- MRI or CT scans
- bone DEXA scan
How is adolescent menstrual dysfunction treated at Welbeck?
The treatment for any menstrual dysfunction will depend on the type of dysfunction and the underlying cause of the condition. Our specialists will recommend the best treatment for your child based on their diagnosis.
Treatments may include:
- lifestyle changes such as exercise, weight management and reducing stress
- hormonal therapies, including oral contraceptives and hormone replacement therapy
- other medications, for example, to manage thyroid, prolactin or androgen levels
- surgery if the issues are due to structural problems such as ovarian cysts or pituitary tumours
Why choose Welbeck
At Welbeck, London’s leading paediatric gynaecologists use the latest innovations in healthcare to accurately diagnose and treat a wide range of conditions in our world-class outpatient centre. Your child will receive the best possible care in a welcoming and supportive environment where you both feel listened to.
With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if needed to ensure your child receives the best possible treatment as quickly as possible, all under one roof.
Appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments. If preferred, initial and follow-up appointments can sometimes be done remotely via video call.
Book a private consultation
Your child’s health is of utmost importance to us, so we strive to offer same-day and next-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance for your child, their treatment at Welbeck can begin once your provider has confirmed authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
FAQs
Will menstrual dysfunction affect my child’s fertility in later life?
This will depend on the underlying cause of the issue, but often once this is diagnosed and treated, periods return to normal and future fertility is not affected.
When should I be worried about periods not starting or being irregular?
An irregular menstrual cycle is common for adolescents in the initial 2 to 3 years, and periods will start to become more regular with age. You should seek advice if your child:
- has not had a period by the age of 15 or within 3 years of breast development
- started having periods but has not had one for 3 or more consecutive months
- continues to have an irregular menstrual cycle after the first 2 to 3 years of menstruating
- has worsening symptoms
When should I be concerned about premenarchal bleeding?
Any unexplained bleeding before puberty should be checked by a doctor, and it’s especially important to do so if the bleeding is ongoing, heavy or accompanied by other symptoms such as pain, fever or discharge.
Could premenarchal bleeding be a sign of puberty starting early?
Yes, some girls may experience a small amount of bleeding as their body begins to prepare for puberty. This is often anovulatory bleeding (bleeding without ovulation) and may not necessarily indicate the start of full menstrual cycles.
Condition overview
Delayed Puberty
What is adolescent menstrual dysfunction?
Types of menstrual dysfunction in adolescents
What causes adolescent menstrual dysfunction?
How is adolescent menstrual dysfunction diagnosed at Welbeck?
How is adolescent menstrual dysfunction treated at Welbeck?
Why choose Welbeck?
Book a private consultation
FAQs