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- $Unique_ID{BRK00190}
- $Pretitle{}
- $Title{The Meaning of Teenage Abnormal Periods}
- $Subject{period teenager abnormal Genitourinary System Teenage Abnormal
- Periods Irregular vaginal bleeding menstruation menstruating menstruate
- ovulate ovulation ovulating estrogen endometrium hormone uterus endometrium
- progesterone menstrual teenagers cervical polyps pelvic inflammatory disease
- hemoglobin iron supplements progestins progestogens}
- $Volume{J-14}
- $Log{
- Anatomy of the Female Reproductive System*0006101.scf
- Diseases of the Female Reproductive System*0009001.scf
- The Menstrual Cycle*0009101.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
-
-
- The Meaning of Teenage Abnormal Periods
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-
- QUESTION: My daughter won't discuss this with me openly, but I know she is
- worried and anxious. I need some information before I open the conversation
- with her. What does it mean when a teenager gets abnormal periods?
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-
- ANSWER: Irregular vaginal bleeding is fairly common in adolescents because
- even though menstruation begins, it initially is not accompanied by ovulation
- in almost 50% of all teenage girls. Initially the bleeding occurs after
- estrogen (a female hormone) causes a buildup or thickening in the endometrium
- (the tissue which lines the uterus), which sheds and bleeds irregularly after
- a few months because the endometrium cannot support the thick layer. A
- temporary reduction in estrogen levels can also cause the bleeding, as can a
- lack of progesterone, the hormone responsible for ovulation. Since a true
- hormonal balance and the onset of ovulation frequently don't develop until
- mid- or late puberty, menstrual irregularity can be quite common.
- However, in managing teenagers exhibiting such irregularities, it is
- important to distinguish a normal variation from an actual abnormality.
- Bleeding is usually labeled clinically abnormal when painless heavy bleeding
- persists for over a week and occurs more frequently than at 21-day intervals.
- These symptoms, as well as the development of secondary anemia due to large
- losses of blood, should be investigated.
- To diagnose an abnormality, tests are performed to rule out other serious
- causes such as congenital uterine abnormalities, cervical polyps, pelvic
- inflammatory disease, or coagulation defects. Once these and other possible
- complications are eliminated, evaluation and treatment can be initiated. In
- nonemergency cases, when the girl is not actively bleeding and has a
- hemoglobin count of ten or more grams, management is fairly simple. The
- patient is instructed to keep a menstrual calendar and is placed on a high
- protein diet with adequate rest and recreation. In some cases, oral iron
- supplements are given. Ultimately, the hope is that ovulation will develop
- spontaneously and with it, regular and mildly painful periods.
- In emergency cases, when there is active bleeding and low hemoglobin,
- treatment is more complicated. Since progesterone is responsible for
- ovulation, oral progestins or other synthetic progestogens are administered
- with small amounts of estrogen. One tablet taken four times a day after meals
- should stop the bleeding within two days. The dose should then be reduced to
- one or two tablets for a couple of weeks. Withdrawal bleeding follows.
- After this initial hormone treatment, the patient is given a low-dose
- oral contraceptive for three to four months to prevent a recurrence. Oral
- contraceptives can be very effective in regulating cycles and after a few
- months of treatment, patients will usually resume ovulation and regular
- periods. However, all patients who exhibit dysfunctional uterine bleeding
- should receive continuous long-term observation because some may never ovulate
- and will continue to experience recurrent clinical problems.
- Quite simply, none of this evaluation or treatment can start until you
- and your daughter have a heart to heart, "sit-down" conversation. Sure she's
- worried, and maybe a bit frightened as well. Remember your first experiences?
- Once you're past the anxieties, and a little time has passed, it will all
- probably straighten out by itself. If not, a visit to the physician is then
- in order.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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-