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Patient Information

Menstrual Problems in Adolescents

Our specialist pediatric OB/GYN Physicians can diagnose and treat, if necessary, menstrual conditions for adolescents. Our Adolescent Gynecology clinic is the only one in Omaha that is specifically dedicated to providing special gynecologic care to teens and young girls.

When an adolescent girl first has her period (known as Menarche) it is not uncommon to have many questions and concerns about her cycle. At this stage, it is common for periods to be sporadic and sometimes involve heavy bleeding coupled with menstrual cramps.

Common menstrual conditions affecting adolescents that require the care of an OB/GYN or other healthcare provider include lack of periods (amenorrhea), partial periods, (dysmenorrhea), and premenstrual syndrome (PMS).

Amenorrhea

Amenorrhea is characterized by absent menstrual periods for more than three monthly menstrual cycles. It may be classified as primary (signs of no menstruation despite the presence of other outward signs of puberty) or secondary (the cessation of menstruation anytime after menarche).

Causes

Possible causes of Amenorrhea include:

  • Pregnancy
  • Anatomical abnormality, birth defect or other medical condition
  • Eating disorder
  • Over-exercise or too much strenuous exercise
  • Obesity
  • Thyroid disorder
  • As a normal aspect of early adolescence

Diagnosis

Diagnosis of Amenorrhea begins with the OBGYN or doctor evaluating the adolescent’s medical history followed by a physical examination and other medical conditions are ruled out.

Treatment

Treatment is determined by the OBGYN physician based on the adolescent’s age, overall health, extent and cause of the condition, adolescents tolerance for medications and therapies, as well as expectations, opinions and preferences. Treatment may include correction of an underlying medical condition, hormone treatment, dietary modifications, or or weight loss. If amenorrhea is found to be a normal aspect of early puberty, observation may be recommended.

Dysmenorrhea

Dysmenorrhea is characterized by pain associated with menstruation. It may be classified as primary (from the beginning of menstruation (menarche) or secondary (later onset with the painful menstrual periods possibly caused by another medical condition.)

Common causes for Secondary Dysmenorrhea include:

  • Pelvic inflammatory disease (PID)
  • Abnormal pregnancy (such as ectopic)
  • Infection, tumors or polyps in the pelvic cavity
  • Endometriosis

Diagnosis

Diagnosis of Dysmenorrhea begins with the OBGYN or doctor evaluating the adolescent’s medical history followed by a physical examination. All other menstrual disorders, medical conditions or medications that could be causing or aggravating the condition must be ruled out before diagnosing the condition. Additional diagnostic procedures may include:

  • Ultrasound
  • Laparoscopy
  • Hysteroscopy

Treatment

Treatment is determined by the OBGYN or physician based on the adolescent’s age, overall health, extent and cause of the condition, adolescents tolerance for medications and therapies, as well as expectations, opinions and preferences.   Treatment may include non-steroidal anti-inflammatory inhibitors (such as naproxen or ibuprofen), hormone treatment, exercise, or dietary modifications.

Premenstrual Syndrome (PMS)

Some women have a broad range of symptoms that can last from a few hours to multiple days during and before their menstrual cycle that can temporarily disturb normal functioning. Though the type and intensity of symptoms vary, the group of symptoms is referred to as premenstrual syndrome or PMS.

Symptoms

Nearly 85% of women during their reproductive years experience at least one of the common PMS symptoms. There are a wide range of symptoms that may include:

  • Psychological, such as: nervousness, irritability, anger, sleep disturbances, forgetfulness, moodiness, emotional hypersensitivity.
  • Fluid Retention, such as edema (swelling of extremities), periodic weight gain, and breast fullness and pain.
  • Gastrointestinal symptoms such as: abdominal cramps, constipation, nausea, diarrhea, backache.
  • Skin problems such as acne, itching, and aggravation of other skin disorders.
  • Neurologic and vascular symptoms such as: headache, numbness or heightened sensitivity in extremities, heart palpitations, and muscle spasms.
  • Other symptoms may include appetite changes, food cravings and diminished libido.

Causes

The cause of PMS is unclear, but it appears to be related to fluctuations in estrogen and progesterone levels in the body. However, social, biological, cultural and psychological facets have been identified as possible contributors.

Treatment

For some women, lifestyle changes such as a well-balanced diet, regular exercise, adequate sleep and not smoking helps to reduce the occurrence of PMS.  However, your OBGYN or doctor can counsel you and possibly may prescribe non-steroidal anti-inflammatory inhibitors (such as aspirin or ibuprofen), oral contraceptives, diet changes, vitamin supplements, antidepressants, or hormone treatments.