Pediatria pre prax 1/2010

Menstrual cycle disorders in adolescent girls and their treatment

Menstrual cycle is controlled by non-matured axis hypothalamus-hypophysis-ovary. More than 50 % of cycles tends to be anovulatory and therefore irregular. Dysmenorea is term for heavy menstrual pain, it starts usually some months after menarche and is characteristic for biphasic, ovulatory cycles. Oligomenorrhoea is the most common disturbance in adolescence and we shall tolerate it, except 3× „too“: Too heavy, too long and too frequent. Dysfunctional uterine bleeding (DUB) in adolescence, called juvenile metrorrhagia must be treated using small dosis of estrogens (arrests bleeding), of gestagens (secretory transformation of dysfunctional endomeetrium) and by prevention of relapses by cyclic administration of gestagen minimally 3 months. Primary amenorrhoea is last of menstruation after the age of 15 years. Is classified according development of secondary sex characters. Hormonal treatment of cycle disturbancies in adolescence should be done on „tailor-made“ basis, we refuse comon therapy by hormonal contraception.

Keywords: adolescent girl, menstrual cycle, dysmenorrhoea, metrorrhagia juvenilis, amenorea primaria.