Is your teen experiencing irregular menstrual cycles?
Irregular menstrual cycles in teens are often dismissed as a normal part of development.
Here’s The Facts:
It is normal for there to be some irregularity in the menstrual cycle in the first 1-3 years after the first menstrual period. However, within the first year, 90% of cycles should be between 21-45 days. And by the third year, 60-80% of cycles will be 21-34 days.
As such, any adolescent who goes 3 months between cycles should be evaluated, as should anyone who does not fit 80-90% of the time in the 21-45 day cycle time frame after the first year of menstruation.
LET’S START WITH THE BASICS
Why Are Regular Cycles Important?
Ovulatory menstrual cycles are an important way for the body to produce estrogen and progesterone - key hormones for things like:
Sleep
Mood
Bone health
Heart health
If we’re not having regular cycles, ovulation likely isn’t occurring regularly enough to support the health of these systems. Furthermore, the reason one might not be having regular menstrual cycles might have other health repercussions, so we want to assess to make sure we aren’t missing anything.
Here’s The Most Common Reasons a Teen May Have Menstrual Irregularities:
Polycystic ovary syndrome (PCOS)
Thyroid concerns
Hyperprolactinemia (abnormally high levels of the hormone prolactin in the blood)
Hyothalamic amenorrhea (a result of under fueling often combined with high stress and/or exercise)
While these show up similarly in terms of SYMPTOMS, they are treated very differently!
So, how do we know what’s what?
Bloodwork is really important to differentiate between these.
! can order most of the required testing as an ND (not OHIP-covered), as can your MD or pediatrician, but a pelvic ultrasound may also be indicated which is outside my scope.
How Does the Oral Contraceptive Pill (OCP) Regulate Cycles?
Many times, the pill is seen as a solution to help regulate hormones. But the truth is, it doesn’t! It actually shuts down ovulation by inducing a pregnancy-like hormonal state. While this will lead to regular bleeding (assuming you’re taking the placebo pills), this is not ‘regulating’ your cycle, but shutting it down.
That Being Said…
There’s definitely a time and place where this can be beneficial and can be a great option in terms of symptom management and pregnancy prevention, but it doesn’t tell us what’s happening to cause the irregularities and what else we need to address. This can be a treatment option but the investigation needs to happen first or we might be missing important underlying health concerns.
If you’re looking for help with regulation your teen’s menstrual cycle, reach out to me and book an initial visit. And make sure you’re signed up for my weekly e-mail list where I send out free information like this every week!
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