A recent phone call at the office prompted me to relay the following information to our young female adolescent readers.
This 14-year-old teenager was very concerned about the irregularity of her menstrual cycle. She had her first period when she was 11 1/2 years old. It had never been regular. She would go 40 to 60 days between periods. But this time it had been three months. She was not sure if this was normal for someone her age. Should she be seen by a pediatrician or perhaps make an appointment with a gynecologist? Or should she just wait it out? It was her understanding that rigorous sports activity could cause a change in one’s cycle. But she was not a participant of these kinds of sports. The only stress in her present life was starting high school in the fall, but she was looking forward to that with excitement and anticipation.
My answer to her was that irregular menstrual periods are not unusual during the first three years after menarche (the occurrence of the first menstrual period). In early adolescence menstrual cycles may occur unpredictably. Missing several cycles should not cause undue concern. After the first three years of menstrual activity, a female adolescent who misses three to four consecutive periods should be evaluated by a physician.
This young lady need not suffer increased physical or emotional stress in order to bring on “skipped periods”. They can occur without any discernible cause.
Local and systemic causes of missed periods can be evaluated with a physical examination and appropriate laboratory tests. For example, decreased thyroid function can cause an absence of menstrual flow. Likewise, in the sexually active female, pregnancy must always be considered as a potential cause of cessation of menses.
No matter how many cycles are missed or how long ago menarche occurred, if there are other signs or symptoms in addition to the absence of menstrual periods, a consultation with her personal physician is mandatory.