Periods.. the fifth "vital sign"

When a patient comes in to see a doctor, we often check their temperature,respiratory rate, blood pressure and pulse . For women, we should always include their last menstual period as the fifth vital sign. This is true for all females but is particularly important for teen girls. Many teen girls are private about their periods, and event their moms don't know whats really going on. Other times, teens and their moms think it is just "normal adolescence" to have irregular periods, heavy periods, infrequent periods, or mood swings with their periods. In the first two years after menarche ( when a girl gets her first period), it is normal to have SOME irregularity. After 1 year, 50% of adolescent girls will establish a regular menstrual pattern anywhere from 21- 46 day cycles. After another year, half of those who did not have regular periods in the first year will develop a pattern. ANY period problems that disrupt a teen girls quality of life deserves to be investigated. Our teen girls are trying to navigate and deal with so many intense pressures in every life- all in this ever changing new world of social media. When you add period problems - from pain and heavy bleeding, to mood issues and PMDD ( that will be my next post!) to infrequent or absent periods (often associated with disordered eating or PCOS) it is a lot for  a girl to handle! I advise moms to talk to their daughters about their period as a fifth vital sign and encourage them to track their periods. Some apps that are good are "Eve", "Flo", "Clue" , and "Magic Girl". If you suspect an issue, talk to your pediatrician and ask for a consult with a gyn who deals with adolescents. The good news is that it is often very easy to diagnose and treat the underlying causes of period problems. We just have to ask   our girls whats going on and educate them that it it NOT normal to suffer with you periods. I have spoken to countless adult women who report that they suffered for years with irregular, heavy, painful or infrequent periods, all because they thought it was just normal and nobody asked them about it . Some very common and treatable conditions the we see with period problems are : Polycystic Ovarian Syndrome , endometriosis, female athlete triad, disordered eating, hypothyroid Disorder, Von Willenbrand's Disease and other bleeding disorders, dysmenorrhea, PMS, PMD, menstrual migraines, just to name a few. Bottom line is ask your daughter, speak up if there is even a question of a problem and understand that teen girls quality of life and happiness can be greatly affected by her periods- AND she doesn't have to suffer! 

Be well!
​Dr. Menn

For more information check out this article :
www.contemporaryobgyn.net/article/menses-“vital-sign”-teenaged-girls

For period tracker apps, check out :
FLO, EVE, MAGIC GIRL or CLUE.


​

---