For girls between the ages of 12 to 18, life can be difficult as hormones and other developmental changes begin to occur. While changes take place in a woman’s body during puberty as a part of normal development, there can be serious teenage menstruation problems that require medical attention.
Also known as delayed menstruation, primary amenorrhea can cause significant anxiety in a teen. Menstruation marks the beginning of a stage where hormones are changing and, depending how these changes occur, it could be a straightforward process, or it might be delayed and confusing. The age when menstruation begins is getting younger with each generation. While many girls begin to menstruate between ages 11 and 13, it is not unusual for it to occur later on or much earlier. On average, menstruation can occur at any time between the ages of 10 and 17. When it is delayed beyond the age of 17, it may be possible that primary amenorrhea is responsible.
In general, girls who haven’t started menstruating by 16 years of age, or three years after showing the first signs of puberty, could possibly have primary amenorrhea. The cause might be a failure of maturity in sex organs, and this might result in decreased production of estrogen. The starting age of menstruation for a teen’s mother or grandmother could help doctors determine a specific pattern related to genetics. Although rare, tube blocks are another possibility, along with obesity or other physical factors that can cause menstruation to be delayed. For example, psychological conditions, such as depression, anorexia and schizophrenia, can cause delayed menstruation as well.
Secondary amenorrhea is also a condition related to the absence of a period; however, in this condition, menstruation starts, establishes itself and then suddenly stops. Causes of secondary amenorrhea include severe shock, physical distress, constant travel, usage of drugs, or abrupt cessation of contraceptive pills. In most cases, teens are advised to wait it out and let the condition resolve itself; however, hormone replacement therapy has proven to be an option as well.
Because pregnancy is a common cause of secondary amenorrhea, your doctor will want to rule it out first. There are several other factors that can cause both primary and secondary amenorrhea, aside from hormone imbalances or pregnancy. These include:
- Excessive weight loss or gain
- Thyroid conditions
- Ovarian cysts
- Conditions that can affect hormone levels
- Excessive exercising
- Poor diet
During menstruation, it is normal to experience pain and cramps in your lower stomach, lower back or kidney region. Often this pain begins with bleeding, or a few days prior to when PMS symptoms begin. Your doctor may prescribe painkillers () or anti-prostaglandin to treat the pain, but these do not provide permanent relief. In many cases, adjusting to the pain is the only solution. However, it’s important to note that severe menstrual problems may be the result of a medical condition. These conditions include:
- Sexually transmitted diseases (STDs)
- Ovarian cysts
- Endometriosis (a disorder that affects the lining of the uterus)
- Extreme stress and anxiety
- Pelvic inflammatory disease, which is an infection in the reproductive system
- Using an IUD (intrauterine device)
- Uterine fibroids, which are non-cancerous tumors of the uterus
If self-care measures, such as pain relievers, do not alleviate your pain, you should see your healthcare provider, who may recommend other pain relievers, anti-inflammatories or antibiotics.
It can often take two to three years from the start of menstruation for a teen’s body to develop a regular cycle. Cycles often become 21 days instead of 28, but sometimes a longer cycle of 35 to 40 days is possible. Your period may also be absent for a period of several months. Teens who have irregular periods like this often have no idea when menstruation will occur, and this can add to the frustration of puberty. There are hormone treatments that have been used in the past, but their success rates are low. Often irregular periods are like other menstrual problems and will improve as you get older. Any teen who is sexually active and misses a period should see her doctor to ensure that pregnancy is not a factor.