Teens: Menstrual Cycle : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 3)

Several OTC products, such as Midol and Pamprin, are specifically formulated for menstrual symptoms. Read the labels of these medicines before you buy them, because different formulations often contain different ingredients or strengths of ingredients. For example, Teen Formula Midol contains acetaminophen for pain and pamabrom (a mild diuretic) for fluid retention. Pamprin contains acetaminophen, pamabrom and pyrilamine maleate (an antihistamine) for tension and irritability. Cramp Relief Formula Midol IB contains as its sole ingredient ibuprofen. Manufacturers may change their products' ingredients from time to time, so it's a good idea to check the label each time you buy the product.

Plain acetaminophen products like Tylenol, Datril, and Aspirin-Free Anacin also may help menstrual pain. It takes time for pain relievers to work, so it's best to take them before the pain gets bad and continue for one or two days, as needed.

Some 20 to 40 percent of menstruating women have PMS, or premenstrual syndrome. Starting anywhere from mid-cycle to a few days before menstruation begins, women with PMS may have one or all of a virtual laundry list of physical and emotional symptoms. They include breast swelling and tenderness, fluid retention, increased thirst or appetite, craving for sweets and salty foods, headaches, anxiety, restlessness, irritability, depression, hostility, and loss of self confidence. Experts say PMS doesn't usually affect teenagers, though. It increases with age and is more prevalent in the 30s and 40s.

From Menarche to Menopause

In the United States, the average age of menarche — a girl's first period-is 12 years, although it's normal to start as early as 10 or as late as 16. Menopause — when periods stop-usually occurs around age 50, although that, too, can vary by several years. Except perhaps for the first two years of menstruation-and barring pregnancy, nursing, and certain illnesses or other problems-the reproductive cycle repeats with predictable regularity every month.

Exercise, diet and stress can delay the onset of menstruation, Rarick says, or alter cycles once they've been established.

"Gymnasts, ballerinas and others who exercise strenuously can sometimes delay the onset of their periods, so you might not be surprised to find a 16- or 17-year-old in that group who hasn't started menstruating," she says. "Some experts believe the connection between exercise and amenorrhea [the absence of menstrual periods] is related to body fat content, because fat affects estrogen. Young women who are very thin from malnourishment may not start menstruating until they gain weight, with a certain portion of that weight being fat. So, girls who exercise a lot-who are all bone and muscle with no fat-may delay their periods."

Similarly, young women with severe eating disorders such as anorexia or bulimia often do not menstruate. (See "On the Teen Scene: Eating Disorders Require Medical Attention" in the March 1992 FDA Consumer.)

The American College of Obstetricians and Gynecologists recommends that a girl see her doctor if she hasn't started menstruating by age 16, or if by age 13 or 14 she hasn't begun to develop breasts or pubic and underarm hair.

Just Like Clockwork?

Many young women have very irregular periods the first couple years of menstruating — even skipping some months, until, as Rarick says, "the system is well-tuned."

In addition, she says, young women don't always ovulate every month when they first get their periods. She adds that there's no sure way for a young woman to know which month she is ovulating and which she is not. So, from the time her periods begin, a young woman should assume she can get pregnant each and every month, even if her periods are irregular.

Eventually, periods become regular, but even when they do, a missed or late period once a year — especially at a stressful time — is considered normal, according to Rarick.

Also, just as strenuous exercise and eating disorders can delay the onset of menstruation, they can also cause previously regular menstrual cycles to become irregular or stop completely.

Technical Talk

• amenorrhea: the absence of menstrual periods
• dysmenorrhea: pain or discomfort during menstruation
• fallopian tubes: two slender tubes-one on either side of the uterus — that carry the egg (ovum) from the ovary to the uterus
• menarche: a young woman's first period
• mittelschmerz: pain or discomfort during ovulation
• ovaries: two female reproductive organs — one on either side of the uterus — that contain the eggs, or ova, and make hormones
• ovulation: release of an egg from the ovaryv
• prostaglandin: a chemical made by the body that causes the muscle of the uterus to contract, often causing cramps
• uterus (womb): the female organ in which a fertilized egg grows and develops into a baby

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.