Dear Readers,

S. H. write's Lifeline from a Golden Spring address in St Andrew. She is worried about her 13-year-old daughter who started seeing her period (menses) about a year ago. S. H. says that her daughters' period is quite irregular and has been really heavy on several occasions making it necessary for the young lady to stay home from school. Her daughter is very upset when these episodes occur and this tends to upset the entire family while it lasts.

Her daughter has been seen and examined by their family doctor who told them not to worry and indicated that the problem should soon settle down as it is due to a hormone imbalance as the menstrual cycle is not yet properly established. S. H. asks LIFELINE what more can be done to assist her daughter as they just cannot continue with this stress.

Puberty tends to occur in young girls sometime between 10 to 15 years old. Often at this time, the menstrual cycles are irregular for several months, even up to a few years. This tendency varies from family to family and there seems to be a genetic association.

When menstruation first begins the cycles are often anovulatory as the girl's body continues to mature. Anovulatory refers to the bleeding in the absence of ovulation. Because there is ovulatory cycle, a random shedding of the lining of the uterus occurs, leading to the anovulatory menstrual periods which occur randomly and vary both in the duration of the blood and the volume of blood lost. The problem is usually due to the immaturity of the hormonal hypothalamic-Pituitary-Ovarian axis. This can result in infrequent or even absent periods associated with occasional episodes of heavy and/or prolonged bleeding.

Significant disorders

Other significant disorders can present in this manner in young females, so if the menstrual irregularities associated with heavy bleeding are prolonged, the young lady should be examined by a doctor. Conditions such as Polycystic Ovarian Syndrome (PCOS), Leukaemia, Von Willebrands disease and Thrombocytopeni (which can cause clotting disorders), can occur in this way in young females and should be tested for.

Once the physician is certain that the bleeding problem being experienced by a young lady is related to an immaturity of her female reproductive hormones then some intervention can take place.

The hormonal axis can be temporarily bypassed with the use of oestrogen/progesterone preparations. These preparations will include the oral contraceptive pills and the drug PROGYLUTON. When these pills are taken CYCLICALLY they provide the user with a regular monthly menstruation, often of shorter duration and smaller volume of flow than what was previously being experienced.

The use of non steroidal-anti-inflammatory drugs (NSAIDS), during the time of heavy flow can also in some instances lessen the bleeding. NSAIDS would include PONSATN, BRUFEN, CATAFLAM, VOLTAREN, FELDENE, etc.

When the bleeding is recurring frequently and is heavy, anaemia may occur through blood loss and there may be a need for Iron, Vitamin B12 and Folic Acid supplements.

Also of importance in the young, sexually active female is that chronic pelvic inflammation and infection due to CHLAMYDIA can also result in prolonged episodes of menstrual bleeding.

This condition would need to be treated by a physician.

Write to:Lifeline

PO Box 1731

Kingston 8

AJM