Menstrual problems are common during adolescence due to slow maturation of the system situated in the brain called hypothalamo-pituitary axis. The hypothalamo-pituitary axis is the mediator of the menstrual cycle. The failure of this system may lead to variations in the menstrual cycle. It can last up to two to five years after menarche (first occurrence of menstruation). More than two-third of adolescent problems are related to menstruation in the forms such as dysmenorrhea (painful period), amenorrhea or oligomenorrhea (absent or reduced periods) and menorrhagia (abnormal uterine bleeding).
It is one of the common gynecological complaint during adolescence. About 60% of girls in the age of 12-17 years complain of dysmenorrhea. However, only 15% seek medical advice. First few periods are pain free due to absence of ovulation. A dragging pelvic pain is common. This is due to pelvic vascular engorgement under reflex of sex steroids. Dysmenorrhea may be primary or secondary.
Primary dysmenorrhea (spasmodic) develops early after uterus menarche, within the first two years. It is defined as painful menstrual cramps in the absence of clinically detected pelvic pathology. A possible diagnoses in the case of atypical severe pain are endocrinal, myometrial disturbed action, prostaglandins and vasopressin.
Secondary dysmenorrhea (congestive) may occur many years after menarche. The pain is usually more severe and precede menstruation by several days. Colicky pain before flow is relieved with menstruation. Common causes are endometriosis, pelvic inflammatory disease (PID), congenital genital tract malformation, cervical stenosis, cervical polyp, fibroid, intrauterine adhesion and IUCD (intrauterine contraceptive device).
Diagnosis of Dysmenorrhea:
Primary amenorrhea is when a girl does not start menstruation by the age of 16 years. Amenorrhea can be diagnosed with clinical history and examination. Also, we need to check thyroid tests, ultrasound, laparoscopy and prolactin levels. Causes of primary amenorrhea are as follows:
Abnormal uterine bleeding is usually associated with anovulatory cycles. There are multiple reasons for anovulation.
The diagnosis of menorrhagia depends on thorough history, clinical examination, per abdominal and per vaginal examination, ultrasound and diagnostic hysterolaparoscopy.
For further information regarding adolescent menstrual problems, consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologistLast reviewed at: 07.Sep.2018