Postmenarcheal irregularities in menstrual cycle in adolescent girls

Overview

The first menstrual bleeding, referred to as menarche, albeit an important point in a woman's life, does not yet mean her full sexual maturity.

The hypothalamus-pituitary-ovary axis is fragile during this period and depends on many factors. Their mutual interplay occurs individually and gradually over the next few years, therefore menstrual irregularities of the menstrual cycle occur physiologically, and not all of them need to be regulated. However, it is one of the most frequent reasons for visiting a paediatric gynaecologist’s office.

The average age of menarche in girls in the Czech Republic is 12 years and 6 to 9 months, the physiological limits are 10–15 years. After menarche, anovulation cycles are predominating, resulting in estrogenic activity not controlled by gestagen, which may result in dysfunctional bleeding with subsequent anaemia from blood loss. The opposite possible problem is the absence of menstruation, either primary or secondary.

Correct complete gynaecological examination of adolescent girls with a purposefully thought-out next schematic of laboratory, imaging and counselling examinations leads to the correct diagnosis. This article clearly outlines and breaks down the most common disorders.

The paediatric gynaecologist chooses "tailor-made" treatment with respect to the patient’s age, always strictly individual and justified.

Keywords:

sexual maturity, menarche, menstrual cycle, hormonal cytology, menstrual disorder, anovulation