15-year-old Xiaoli has been facing irregular menstrual periods since her menarche, which has brought a lot of trouble to her study and daily life. Initially, Xiaoli's mother thought that this was a common physiological phenomenon in adolescent girls, but as time went on, the menstrual irregularities did not alleviate and began to seriously affect Xiaoli's daily life.
In gynecological clinics, menstrual irregularities are one of the common diseases that not only affect adult women, but also plague many adolescent girls. Adolescent girls are often reluctant to disclose their concerns to their parents due to the shortness of menarche and the increased awareness of privacy, which can lead to delays in the disease. Menstrual irregularities are particularly prevalent among adolescent girls, affecting quality of life and potentially reducing learning efficiency. Irregular menstruation can manifest in a variety of ways, including dysmenorrhea, irregular cycles, prolonged or shortened menstrual periods, and heavy or too little menstrual flow. There are many factors that affect menstrual disorders, such as a family history of dysmenorrhea, unbalanced diet, excessive dieting to lose weight, eating raw and cold foods during menstruation, frequent use of instant noodles instead of meals, and sleeping less than 7 hours.
What is puberty?
Adolescence is the transition from a child to an adult, and it is the stage when the genitals, endocrine, and physique gradually develop to maturity. The World Health Organization (WHO) stipulates that puberty is 10~19 years old.
(i) Age of menarche: Menarche refers to the first menstrual period in a woman's life, usually between the ages of 10 and 16. This age range varies depending on individual differences, genetics, nutritional status, and environmental factors, among other things.
(ii) Menstrual cycle: The menstrual cycle refers to the time interval from the first day of one menstrual period to the first day of the next menstrual period. The normal menstrual cycle length is 21 to 35 days, with an average cycle length of 28 days. The length of the cycle can vary from person to person, but it is important to maintain some regularity.
(3) Menstruation: Menstruation refers to the duration from the beginning to the end of each menstrual period. A normal menstrual period length is usually no more than 7 days.
(4) Menstrual flow: Menstrual flow refers to the total blood loss during a menstrual period. Generally 30 to 50 ml.
(5) Menstrual color: The normal color of menstrual blood is dark red. Menstrual blood is not just blood, it also contains fragments of the endometrium, cervical mucus, and exfoliated vaginal epithelial cells, which are all components of normal menstruation.
(6) Cycle regularity: A normal menstrual cycle should have a certain regularity. If the change in cycle frequency is less than 7 days in the last year, it is generally considered regular. A change in cycle frequency greater than 7 days may indicate some reproductive health problem that requires concern.
What is menstrual disorder during puberty?
Menstrual disorders during puberty are mainly due to imperfect neuroendocrine regulation of the hypothalamic-pituitary-ovarian axis, as well as unstable ovarian function, resulting in irregular menstruation in adolescent women.
(1) Imperfect neuroendocrine regulation of the hypothalamic-pituitary-ovarian axis: due to the imperfect neuroendocrine regulation function of the hypothalamic-pituitary-ovarian axis due to the shortness of menarche in adolescent women, the response to gonadotropins is low, and the follicles in the ovaries have not yet matured.
(2) Ovarian function instability: Because the ovarian function of adolescent women is not stable, they are susceptible to various internal and external factors, such as mental stress, malnutrition, tumors, metabolic disorders, excessive exercise, obesity, dieting and weight loss, dietary disorders, drugs, and various life change factors such as examination pressure, environmental and climate changes, resulting in ovarian dysfunction, resulting in menstrual disorders.
When do I need to bring my child to the doctor?
(1) Abnormal menstrual cycle: within 1-3 years after menarche, if the menstrual cycle is less than 21 days or more than 45 days.
More than 3 years after menarche, if the menstrual cycle is less than 21 days or more than 35 days, or the number of menstrual periods is less than 8 times in a year, there may be an imbalance in hormone levels or other health problems.
(2) No menstruation for a long time after menarche: If there is no menstruation for more than 90 days in any menstrual cycle more than 1 year after menarche, this may be a sign of amenorrhea.
(3) Delayed puberty: If a girl has not had menstruation more than 3 years after the age of 16 or the beginning of pubertal breast development, or if there is no development of secondary sexual characteristics after the age of 14, it may be a sign of developmental delay.
(4) Menstruation-related symptoms: If the child has symptoms such as prolonged menstruation, excessive menstrual flow, and dysmenorrhea, it is necessary to rule out endometriosis, adolescent blood or other gynecological diseases.
(5) Hirsutism, obesity with acne: these symptoms may be related to abnormal hormone levels, such as polycystic ovary syndrome (PCOS).
(6) Precocious puberty: If the child develops any of the secondary sexual characteristics before the age of 8, such as breast development, or menstruation before the age of 10, it is considered precocious puberty and requires timely medical attention to determine the cause and receive appropriate treatment.
How to treat menstrual irregularities?
(1) Principles of treatment
1. Hemostasis: For patients with long or excessive menstrual periods, the first task is to control bleeding and prevent excessive blood loss.
2. Correction of anemia: Long-term menorrhagia may lead to anemia, which needs to be corrected by supplementing iron, vitamin B12 and folic acid.
3. Adjust the menstrual cycle: Adjust the menstrual cycle through medication or other methods to bring it back to normal.
(2) Treatment
1. Medication: It is the main method of treating menstrual irregularities. Commonly used medications include:
2. Hormonal drugs: such as oral contraceptives, progesterone, estrogen, etc., which are used to regulate hormone levels and adjust the menstrual cycle.
3. Non-hormonal drugs: such as hemostatic drugs, anti-inflammatory drugs, etc., used to control bleeding and reduce inflammation.
4. Surgical treatment: In some cases, menstrual irregularities caused by uterine fibroids and ovarian cysts require surgical treatment.
(iii) Prognosis
The prognosis of menstrual irregularities in adolescence is related to the length of the disease, and the prognosis is better if a normal menstrual cycle can be established within 4 years of onset. Studies have shown that 63.2% of patients have established a normal cycle within 4 years of onset. Disease duration longer than 4 years: If the disease lasts longer than 4 years, the likelihood of spontaneous recovery is reduced. In particular, certain conditions, such as polycystic ovary syndrome (PCOS), require long-term management and treatment.
Maintaining a healthy lifestyle is essential for treating menstrual irregularities. Suggestion:
Eat a balanced diet to ensure you are getting enough nutrients.
Moderate exercise can help regulate hormone levels and reduce stress.
Manage stress and help reduce it through meditation, yoga, or other relaxation techniques.
Maintaining a healthy weight, being obese or underweight can affect your menstrual cycle.
Treatment of menstrual irregularities requires regular follow-up to monitor the effects of treatment and adjust treatment regimens.
How to prevent menstrual irregularities during puberty?
(1) Don't be bulimic and don't blindly diet: Studies have shown that women's fat must reach a certain standard in order to maintain normal menstruation. When excessive dieting, due to the insufficient energy intake of the body, a large amount of fat and protein in the body is consumed, resulting in estrogen synthesis disorders, which in turn affects menstruation, and even causes oligomenorrhea or amenorrhea. Therefore, women who pursue a slim figure must not blindly diet.
(2) Regularity of life, relaxation, and avoidance of overwork: Adolescent girls should have a regular daily routine and avoid staying up late to be "night owls".
(3) Maintain stable emotions and avoid emotional ups and downs: long-term emotional fluctuations and stimulation will also affect the normal regulation of the hypothalamic-pituitary-ovarian axis and lead to menstrual irregularities.
(4) Don't mess with irregular menstruation: When there is irregular menstruation, do not blindly self-medicate, it is best to find a doctor first, and then treat the symptoms after clarifying the cause.
(5) Pay attention to menstrual hygiene: pay attention to the cleanliness and hygiene of the vulva, wash and change underwear frequently, do not do too strenuous physical activities during menstruation, and avoid cold, spicy and irritating foods during menstruation and about a week before menstruation.
Adolescent girls should know more about physiological menstruation, and once there is abnormal menstruation, they should tell their parents in time, seek medical treatment in time, and actively cooperate with the doctor's treatment plan if treatment is necessary.
Author: Liu Liyuan, Department of Obstetrics and Reproductive Health, Jiangxi Provincial People's Hospital
Correspondent: Le Xiwen Luo Shan
Editor: Huang Menglin
Reviewer: Chen Shirui
Issued: Daley Red
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