Waiting For First Flow

A woman's first menstrual period is known as the menarche and comes from the Greek words for moon and beginning. Most women think of the first menstrual period as the central event that signals a girl's coming of age.

The purpose of the various changes that come with the menstrual cycle is to prepare a woman's body for a possible pregnancy. Most girls will begin having their periods between 11 and 15 years of age.

Primary Amenorrhea

If a young girl turns 15 without having had her first menstrual period, she is said to have primary amenorrhea. This is as opposed to having light or infrequent periods which are common occurrences in teenagers and quite normal. It may take a few years for a young girl's periods to settle into a more usual pattern with a more typical menstrual flow. Primary amenorrhea also differs from the situation in which a girl begins having her periods and then her periods stop for 3 or more cycles. Here are some common causes of primary amenorrhea:

*Structural issues such as an imperforate hymen in which the skin that covers the opening of the vagina has no aperture

*The absence or abnormality of reproductive organs such as ovaries or a uterus

*Being very under or very overweight

*Crash dieting or eating disorders including bulimia and anorexia.

*Intensive exercise



*Chronic disease, for instance, anemia, diabetes, or thyroid problems

*Inherited conditions such as Turner Syndrome

*Polycystic ovarian syndrome (PCOS)

*Pediatric medical treatments such as chemotherapy or radiation for childhood cancer that may affect the ovaries.

Physical Signs

Girls who show no overt physical signs of puberty by the age of 14 have a higher risk for primary amenorrhea. Such signs include early breast development (breast buds) and pubic hair growth. If the menstrual period doesn't begin by the age of 15, it's important to be seen by a physician for evaluation.

If the doctor can't spot the reason for the lack of menstrual periods, he may offer birth control pills to help start the cycle. This type of treatment can also help to preserve bone health, and can reduce the risk for brittle bone disease (osteoporosis). The doctor may also prescribe calcium supplements to maintain healthy bones.

It is possible to ovulate without experiencing menstruation. For this reason, it's important to educate young girls who don't yet have their periods about birth control and safe sex since they may be sexually active.

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