Attaining age is a major milestone for a girl and many are the parents who celebrate with a party when their daughter steps into “womanhood”. When will a girl attain age is a question on the minds of parents as their daughters become fuller in body.
The age of menarche or the first menstrual period is determined by general health, genetic, socio-economic and nutritional factors. There appears to be a relationship between body weight and the onset of menarche, supported by earlier menarche seen in obese girls, and increasing percentage of body fat.
If, however, a girl has not started sexual physical development and periods by the age of 14 or she has not started her periods by the age of 16 but has normal sexual physical characteristics for her age, it is considered abnormal.
What is precocious puberty?
Any secondary sexual characteristic (development of breast, axillary and pubic hair) appearing in a girl before the age of eight years or the onset of menstruation prior to 10 years of age is called precocious puberty. Isolated menstruation can occur, without development of secondary sexual characteristics or breast development. In girls, the great majority of cases are constitutional, secondary to premature release of hormones with no organic lesion which does not need treatment. The remaining cases are secondary to an intracranial lesion causing premature release of hormones and need further investigations.
While most conditions that cause abnormal uterine bleeding can occur at any age, it is more common in adolescents.
Why?
Many girls have episodes of irregular bleeding during the first few years after their first menstrual period. This usually resolves without treatment when the girl's hormonal cycle and ovulation normalize. If bleeding persists beyond this time, or if the bleeding is heavy, further evaluation is needed
Embarrassment about discussing menstruation, fear of disease and ignorance about available services are likely reasons why many problems are not discussed.
What is the reason for subsequent absence of periods or Secondary Amenorrhoea?
Although some do not mind missing their menstrual period, these changes should always be discussed with a healthcare provider because they can signal underlying medical conditions and potentially have long-term health consequences. In the absence of menstruation for six months or more in a girl who has been menstruating regularly, it is important to first exclude pregnancy. In those with an increased body mass index, it may be appropriate to address the issue of diet, weight and regular exercise as the obesity associated with a condition called polycystic ovarian disease (PCOS) affects egg maturation, and thus irregular cycles which may become regular with weight reduction.
Why some have severe
pain during periods?
A majority experience some form of period pain during their lifetime. The medical term for period pain is dysmenorrhoea. The pain caused by menstruation can be felt in the lower abdominal area, but can also spread to the back and thighs.
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| A traditional 'attaining age' ceremony. Pic by M.A. Pushpa Kumara |
About 75% of young women and 25-50% of adult women experience pain and discomfort during their period. For up to 20% of women this pain is so severe that it stops them from carrying out their daily activities.
Most cases of period pain are a side effect of the body's natural menstruation process. However, in some cases, it can be caused by an underlying medical condition.The main symptom of period pain is painful muscle cramps in the lower abdomen. Sometimes the pain comes in intense spasms, while at other times the pain may be dull, but more constant.
Period pain can sometimes spread to the lower back and thighs. The pain may also vary with each period. Some periods may cause little or no discomfort, while others may be far more painful.
What are the other associated
symptoms?
As well as experiencing pain in the abdomen, there may also be a number of other symptoms, such as headache, nausea, tiredness, feeling faint, dizziness and diarrhoea.
How long will the pain last?
Usually the period pain starts when bleeding begins, although some may also experience pain several days before their period starts.
Period pain will normally last for 12-24 hours, although in more severe cases it may last for several days. The pain is usually worst when the bleeding is heaviest.
The symptoms of painful periods normally tend to improve the older you get.
What is the cause for
period pain?
Most period pain is not the result of any underlying medical condition. It is only a side-effect of the body's natural menstrual process.
Simple measures like exercise, applying heat to the abdomen, a warm bath or shower, light circular massage around the lower abdomen and relaxation techniques may help to ease or reduce it. If the pain is very severe and not responding to simple pain killers further investigations are necessary. |
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