Menstruation in young girls: a clinical perspective
Abstract
The ACOG has recommended that the initial visit to an obstetrician-gynecologist for health guidance, screening, and provision of preventive services should take place around age 13-15. At this visit, clinicians can provide guidance to young girls and their parents on adolescent physical development based on data that define parameters for normal pubertal development, menarche, and menstrual cyclicity, and address menstrual hygiene and emerging adolescent concerns. Adolescent menstrual cycles are initially variable, but this variability does not imply that there are no useful parameters for menstrual cyclicity. Data indicate that cycles typically range from 21 to 45 days, even in the first few gynecologic years. Individuals with cycles that vary widely from this norm may have significant pathology, most commonly hyperandrogenism or polycystic ovary syndrome. Controversy now exists regarding the lower limits for the onset of pubertal development in girls; data suggest that pubertal growth may be occurring earlier than had previously been described. The age of menarche has remained constant. Clinicians can furnish information about menstrual hygiene and menstrual protection and provide parental and teen guidance with printed patient education materials and suggested Web-based sources of information. The provision of anticipatory guidance and information to young girls and their parents can help ease the transition from childhood through puberty and a healthy adolescence.
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In the first postmenarcheal year, 80% of cycles occur within a predictable range of 21 to 45 days.
“Nonetheless, 80% of cycles occur within a predictable range of 21 to 45 days. 65-68”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [67]
By the third postmenarcheal year, 95% of cycles fall into the 21 to 45 day range.
“By the third postmenarcheal year, 95% of cycles fall into this range”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [67]
Cites
Variations in pattern of pubertal changes in girls
Marshall, W. A., & Tanner, J. M. (1969) · Archives of Disease in Childhood · doi:10.1136/adc.44.235.291 · Cited by 5,963 · see citing works
Herman-Giddens, M. E., Slora, E. J., Wasserman, R. C., Bourdony, C. J., Bhapkar, M. V., Koch, G. G., & Hasemeier, C. M. (1997) · PEDIATRICS · doi:10.1542/peds.99.4.505 · Cited by 1,709 · see citing works
TOXIC-SHOCK SYNDROME ASSOCIATED WITH PHAGE-GROUP-I STAPHYLOCOCCI
Todd, J. K., Fishaut, M., Kapral, F. A., et al. (1978) · The Lancet · doi:10.1016/s0140-6736(78)92274-2 · Cited by 1,024 · see citing works
VARIATION OF THE HUMAN MENSTRUAL CYCLE THROUGH REPRODUCTIVE LIFE
TRELOAR, A. E., BOYNTON, R. E., BEHN, B. G., & BROWN, B. W. (1968) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-196801000-00019 · Cited by 1,018 · see citing works
ANGIOTENSIN-CONVERTING ENZYME AND THE COUGH REFLEX
Morice, A., Brown, M., Lowry, R., & Higenbottam, T. (1987) · The Lancet · doi:10.1016/s0140-6736(87)91547-9 · Cited by 746 · see citing works
Kaplowitz, P. B., & Oberfield, S. E. (1999) · PEDIATRICS · doi:10.1542/peds.104.4.936 · Cited by 475 · see citing works
Early Menarche, a Risk Factor for Breast Cancer, Indicates Early Onset of Ovulatory Cycles*
APTER, D., & VIHKO, R. (1983) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-57-1-82 · Cited by 323 · see citing works
Chimbira, T. H. K., Anderson, A. B. M., & Turnbull, A. C. (1980) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1980.tb05013.x · Cited by 251 · see citing works
Endocrine characteristics of adolescent menstrual cycles: impact of early menarche
Vihko, R., & Apter, D. (1984) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(84)90209-7 · Cited by 227 · see citing works
Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961
Hajjeh, R. A., Reingold, A. L., Weil, A., Shutt, K. A., Schuchat, A., & Perkins, B. A. (1999) · Emerging infectious diseases · doi:10.3201/eid0506.990611 · Cited by 204 · see citing works
Toxic Shock Syndrome Surveillance in the United States, 1980 to 1981
Reingold, A. L., HARGRETT, N. T., SHANDS, K. N., et al. (1982) · Annals of Internal Medicine · doi:10.7326/0003-4819-96-6-875 · Cited by 195 · see citing works
INDIVIDUAL DIFFERENCES IN PHYSICAL CHANGES ASSOCIATED WITH ADOLESCENCE IN GIRLS
Reynolds, E. L. (1948) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1948.02030020341006 · Cited by 194 · see citing works
Etiology and Age Incidence of Precocious Puberty in Girls: A Multicentric Study
Cisternino, M., Arrigo, T., Pasquino, A. M., et al. (2000) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2000.13.s1.695 · Cited by 160 · see citing works
WORLDHEALTHORGANIZATIONTASKFO (1986) · Journal of Adolescent Health Care · doi:10.1016/s0197-0070(86)80015-8 · Cited by 151 · see citing works
Menstrual patterns in adolescent Swiss girls: a longitudinal study
Flug, D., Largo, R. H., & Prader, A. (1984) · Annals of Human Biology · doi:10.1080/03014468400007411 · Cited by 140 · see citing works
Current Age of Onset of Puberty
Rosenfield, R. L., Bachrach, L. K., Chernausek, S. D., Gertner, J. M., Gottschalk, M. E., Hardin, D. S., Pescovitz, O. H., & Saenger, P. H. (2000) · PEDIATRICS · doi:10.1542/peds.106.3.622 · Cited by 125 · see citing works
Precocious Puberty: Who Has It? Who Should Be Treated?
Klein, K. O. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.2.5533 · Cited by 113 · see citing works
The prognosis for adolescents with menstrual abnormalities
Southam, A. L., & Richart, R. M. (1966) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(66)90398-x · Cited by 111 · see citing works
A statistical analysis of the menstrual patterns of 8,000 Finnish girls and their mothers.
Widholm, O., & Kantero, R. L. (1971) · PubMed · Cited by 106 · see citing works
Lee, P. A. (1999) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(05)70108-0 · Cited by 95 · see citing works
Priorities in adolescent health care: the teenager's viewpoint.
Malus, M., LaChance, P. A., Lamy, L., et al. (1987) · PubMed · Cited by 93 · see citing works
Léger, J., Reynaud, R., & Czernichow, P. (2000) · The Journal of Pediatrics · doi:10.1067/mpd.2000.109201 · Cited by 84 · see citing works
The Degree of Normal Menstrual Irregularity
Arey, L. B. (1939) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(16)40957-9 · Cited by 82 · see citing works
Venturoli, S., Porcu, E., Fabbri, R., MAGRINI, O., Paradisi, R., Pallotti, G., Gammi, L., & Flamigni, C. (1987) · Fertility and Sterility · doi:10.1016/s0015-0282(16)59294-2 · Cited by 76 · see citing works
Menstrual Irregularities in Adolescents: Hormonal Pattern and Ovarian Morphology
Venturoli, S., Porcu, E., Fabbri, R., Paradisi, R., Ruggeri, S., Bolelli, G., Orsini, L. F., Gabbi, D., & Flamigni, C. (2008) · Hormone Research · doi:10.1159/000180567 · Cited by 69 · see citing works
Blondell, R. D., Foster, M. B., & Dave, K. C. (1999) · PubMed · Cited by 67 · see citing works
WORLDHEALTHORGANIZATIONTASKFO (1986) · Journal of Adolescent Health Care · doi:10.1016/s0197-0070(86)80014-6 · Cited by 43 · see citing works
Adolescent menstrual irregularity.
Mansfield, M. J., & Emans, S. J. (1984) · PubMed · Cited by 35 · see citing works
Oligomenorrhea in adolescent girls
Emans, S. J., Grace, E., & GOLDSTEIN, D. P. (1980) · The Journal of Pediatrics · doi:10.1016/s0022-3476(80)80278-2 · Cited by 29 · see citing works
Early Puberty: A Cautionary Tale
Herman, M. E., Giddens, P., Bourdony, C. J., Slora, E. J., & Wasserman, R. C. (2001) · PEDIATRICS · doi:10.1542/peds.107.3.609 · Cited by 23 · see citing works
The earlier maturation of children.
Jm, T. (1966) · PubMed · Cited by 3 · see citing works
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Menstruation in girls and adolescents: using the menstrual cycle as a vital sign
American Academy of Pediatrics, Committee on Adolescence, American College of Obstetricians and Gynecologists, & Committee on Adolescent Health Care (2006) · PEDIATRICS · doi:10.1542/peds.2006-2481 · Cited by 651 · see citing works
Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline
Teede, H. J., Misso, M. L., Deeks, A. A., Moran, L. J., Stuckey, B. G. A., Wong, J. L. A., Norman, R. J., Costello, M. F., & Groups, O. B. O. T. G. D. (2011) · Medical Journal of Australia · doi:10.5694/mja11.10915 · Cited by 379 · see citing works
Menstrual disorders in adolescence
Slap*, G. B. (2003) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/ybeog.2002.0342 · Cited by 140 · see citing works
Menstrual patterns in the first gynecological year: a systematic review
Gunn, H. M., Tsai, M.-C., McRae, A., & Steinbeck, K. S. (2018) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2018.07.009 · Cited by 60 · see citing works
Cultural aspects of menstruation and menstrual hygiene in adolescents
Farage, M. A., Miller, K. W., & Davis, A. (2011) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.11.1 · Cited by 42 · see citing works
- Authors
- Adams Hillard, P.
- Venue
- Obstetrics & Gynecology
- Published
- 2002-04
- Volume
- 99
- Issue
- 4
- Pages
- 655-662
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2133886420
- Cited by
- 105
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 3 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 7
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Keywords
- menarche, menstrual cycle variability, pubertal development, age at menarche, precocious puberty, hyperandrogenism, polycystic ovary syndrome, menstrual hygiene, anticipatory guidance, adolescent health education
- MeSH terms
- Adolescent, Child, Female, Health Education, Humans, Hygiene, Menstruation, Puberty, Precocious, Reference Values, Sex Counseling, Shock, Septic
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