Adolescent girls generally start menstrual periods approximately two years after the onset of breast development during puberty, generally between 12 and 14 years old. For the first two years, periods are generally inconsistent and sporadic but painless. It is common to have spotting, then large periods, then no periods for several months. After about two years, menstrual periods generally become more regular although some girls take longer – especially if they had a delayed onset of the start of menstrual periods.
Abnormalities in menstrual periods can indicate a variety of health concerns. Hormone or anatomic problems can delay the onset of periods. No menstrual period by the age of 15 is concerning. Painful periods or severe cramping can be exaggerated pain from normal periods or may represent endometriosis, vaginal obstruction, or other anatomic problems. Periods before 10 years of age can arise from precocious puberty or other hormone conditions. Not menstruating by 15-years old or beginning regular menstrual periods then stopping altogether can represent pituitary or ovary abnormalities, hormone problems, pregnancy, polycystic ovarian syndrome generally associated with obesity, or female athlete triad from exercise and undernutrition. Some causes of abnormal menstrual periods can be dangerous or affect bone health or emotional and mental well-being.
Pediatricians and Canyon View Pediatrics have trained in the detection, evaluation, and treatment of abnormal menstrual conditions. We have in house lab and ultrasound to facilitate the diagnostic process and have Ob/Gyn specialists in Canyon View Medical Group for consultation and referral if warranted for specialized cases.
Please let our pediatricians know if you have concerns about your daughter’s menstrual periods. These issues can be discussed briefly during routine well-care visits but often required extended consultation appointments for a thorough evaluation.