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 

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

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

At Welbeck, London’s leading paediatric gynaecologists use the latest innovations in healthcare to accurately diagnose and treat a wide range of conditions in state-of-the-art facilities. 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.

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.

Get in touch today to book an appointment.

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.