Clinicians should discuss girls’ menstrual cycles at their preventive care visits and be able to identify abnormalities, according to the American Congress of Obstetricians and Gynecologists (ACOG).
Clinicians should discuss girls’ menstrual cycles at their preventive care visits. AAP News photo by Jeff Knox“Just as abnormal blood pressure, heart rate, or respiratory rate may be key to diagnosing potentially serious health conditions, identification of abnormal menstrual patterns in adolescence may improve early identification of potential health concerns for adulthood,” ACOG said in a committee opinion Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign, which the Academy endorsed.
The median age of first menstruation is 12 to 13 years and typically occurs about two to three years after breast development begins, according to the report. A normal menstrual cycle interval is 21 to 45 days, and flow lasts up to seven days necessitating about three to six pads or tampons per day.
A number of medical conditions can cause abnormal timing or flow, including pregnancy, thyroid disease, primary pituitary disease, sexually transmitted infections and uterine lesions.
Recommendations for clinicians
- Be able to identify normal and abnormal menstrual patterns in adolescent girls.
- Educate girls and their caretakers about the menstrual cycle.
- Ask about the first day of a girl’s last menstrual period and the pattern of menses at each preventive care or comprehensive visit.
- Watch for abnormal menstrual patterns that may improve early identification of health concerns.