Adolescence is a crucial stage in a child's development. The World Health Organization defines adolescence as the period from 10 to 19 years old, spanning from the onset of menarche to the gradual maturation of the reproductive system. Many girls around the ages of 13-14 experience menstrual irregularities during this period. So, what is menstruation? What are the common menstrual problems during adolescence? What should be noted during menstruation? Let's hear from gynecologists.
1. What is a Normal Age to Start Menstruation?
Menstruation is a cyclic shedding of the uterine lining regulated by hormones. The first occurrence of menstruation is called menarche, a significant milestone in a girl's puberty. The typical age for menarche is 13-15 years, but it can be as early as 11-12 years or as late as 15-16 years.
Normal Menstrual Characteristics
- Cycle: 21-35 days, averaging 28 days
- Duration: 2-8 days, averaging 4-6 days
- Volume: 20-60 milliliters
- Color: Dark red, lighter at the start, brighter during heavy flow, and gradually fades without clots.
2. Common Menstrual Problems in Adolescence
- Precocious Puberty
- If a child develops any secondary sexual characteristics before the age of 8 or starts menstruating before the age of 10, it is considered precocious puberty. This can cause early cessation of growth in height and may lead to psychological issues, requiring special attention from parents.
- Primary Amenorrhea
- This refers to a situation where a girl, by the age of 16, has developed secondary sexual characteristics but has not started menstruating, or by the age of 14, has not developed any secondary sexual characteristics.
- Adolescent Menstrual Irregularities
- Due to the immaturity of the hypothalamic-pituitary-ovarian axis during adolescence, combined with significant physiological and psychological changes, academic pressure, and environmental changes, menstrual irregularities are common. It often takes 2-4 years after menarche to establish a regular menstrual cycle. However, if menstruation stops for several months or the cycle varies significantly, it could indicate menstrual disorders.
Specific Manifestations of Menstrual Disorders
- Irregular Cycles: Unpredictable intervals between periods, with cycles shorter than 21 days or longer than 35 days, or no menstruation for more than 6 months.
- Abnormal Bleeding and Duration: Variations in menstrual volume from very light (less than 5 ml) to very heavy (more than 80 ml); menstrual periods lasting less than 3 days or more than 7 days.
- Accompanying Symptoms: Such as dysmenorrhea, which includes lower abdominal pain, a feeling of heaviness, and other discomforts before, during, or after menstruation, potentially severe enough to cause nausea, vomiting, diarrhea, dizziness, and cold sweats.
3. Should Adolescent Menstrual Irregularities Be Treated?
Menstrual irregularities are a broad concept that requires specific analysis based on individual circumstances. Irregular cycles within 2 years after menarche are common. If the menstrual cycle is regular but the volume or color changes, it can be observed. If the cycle is regularly 2-3 months with 5-7 days of bleeding, it can also be observed.
Situations Requiring Attention and Medical Consultation
- Timing of Menarche
- If a child experiences precocious puberty or primary amenorrhea, it requires attention and targeted treatment after various examinations.
- Menstrual Cycle Issues
- If a child's menstruation stops for 3 cycles or more than 6 months after menarche, known as secondary amenorrhea, parents should seek medical attention promptly.
- Duration and Volume Issues
- If the menstrual period lasts for more than 10 days to half a month or if there is excessive bleeding causing secondary anemia or fainting, it requires immediate medical attention.
4. What to Pay Attention to During Menarche?
- Maintain a Positive, Stable Mood
- During menstruation, girls often feel irritable or depressed due to discomforts such as lower back pain and abdominal cramps. Parents should help them prepare mentally and maintain a cheerful mood to alleviate menstrual discomfort and prevent irregularities.
- Balanced Diet
- Encourage light meals, avoiding cold and spicy foods. Include easily digestible fruits and vegetables, protein-rich foods like eggs, lean meat, and seafood. Drink plenty of water and avoid coffee, strong tea, and milk tea.
- Adequate Sleep and Moderate Exercise
- Ensure sufficient rest and sleep to boost immunity. Avoid strenuous physical activities and heavy labor. Opt for light exercises like jogging and walking.
- Keep Warm
- Hormone levels and immunity drop during menstruation, so it's crucial to stay warm and avoid getting cold. In summer, avoid excessive cold drinks, which can cause pelvic vasoconstriction, leading to dysmenorrhea, reduced menstrual flow, or sudden cessation of menstruation.
In summary, parents of adolescent girls should pay close attention to these minor issues during puberty and seek medical advice in a timely manner. Under the guidance of healthcare professionals, appropriate lifestyle or treatment interventions can prevent small problems from becoming significant issues.
Malaysia