My sister got her periods after six months. Should she visit a doctor?

Question

Hi doctor,

My sister is 12.6 years old. She got her first period about six months ago. Just about four weeks ago, she got her second period. I know when you go through your first menstrual cycle it can be on and off, so that did not really bother me. But then, her second period just keeps coming back every day. Some days, it would only be blotchy and very dark. The other day, she bled heavy in bright red with severe cramps. It usually starts and ends at the same time every day. It starts around 10 AM and ends around 3.30 PM. She has PE in school three days a week and she would get plenty of exercise. My mom thinks that she has been taking Guanfacine and it has something to do with my hormones. Do you think that she should go to my local endocrinologist? What do you think could be wrong? My mom heard of people taking low dosages of birth control medication. Is it advisable for my sister?

Answer 1

Hello,

Welcome to icliniq.com.

You are right. Periods can go haywire during puberty. One of the reasons for this heavy cycle is because it has come after six months and the uterus is getting rid of six months of the endometrium. It would be wise to visit a gynecologist to find out the causes of prolonged bleeding other than hormonal imbalance. Also, it is advised to do the following tests:

Get a serum TSH and PRL levels done (TSH - thyroid stimulating hormone and PRL - prolactin).
Ultrasound pelvis.
Von Willebrand factor (vWF) levels - puberty menorrhagia can be due to bleeding disorders.
Complete blood count to assess blood loss and platelet count.

I suggest tablet Tranexamic acid 500 mg thrice a day for bleeding for five days. Hormonal drug should be started only after the above mentioned investigations are done. Also, I suggest Iron supplement to help build up the depleted storage of iron. Consult your doctor, discuss with him or her and take the medicine with consent.