Child and Adolescent Gynaecology
The pubertal transition is a daunting time for most adolescents. Sometimes puberty is delayed or the first period does not occur by the expected time. In some girls there will be an underlying medical condition responsible for this delay and in others there will be no cause found and puberty will go on to progress normally. It is important to look for probable cause and any underlying medical issues if the first period has not occurred at age 15, if there is no breast development at age 13 or if the first period has not occurred 3 years after the onset of breast development.
Adolescents may also experience irregular, infrequent, heavy and or painful periods just as in later life. Irregular and heavy periods are particularly common just after the onset of menses due to immaturity in the hormonal pathways controlling the menstrual cycle. Just as in adult women, a thorough evaluation and plan for treatment is crucial to prevent iron deficiency from excessive blood loss, minimise pain and maximise time spent at school and enjoying other extracurricular activities.