Menstruation in girls and adolescents: using the menstrual cycle as a vital sign

American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care; Angela Diaz; Marc R Laufer; Lesley L Breech

doi:10.1542/peds.2006-2481

Menstrual Cycle · Cycle Across the Lifespan

Menstruation in girls and adolescents: using the menstrual cycle as a vital sign

American Academy of Pediatrics Committee on Adolescence, American College of Obstetricians and Gynecologists Committee on Adolescent Health Care, Diaz A, Laufer MR, Breech LL

Published November 3, 2006 Pediatrics, 118(5), 2245-2250

DOI 10.1542/peds.2006-2481 PMID 17079600

RRM Academy Synopsis

Teen menstrual cycles typically run 21 to 45 days, AAP and ACOG report

A 2006 report from pediatric and gynecology committees says girls and teens typically have menstrual cycles of 21 to 45 days, even in year one. The report sums up older studies. It proposes using the cycle as an added vital sign.

Key Findings

A World Health Organization study of 3073 girls found the first cycle after menarche had a median length of 34 days, and 38% of first cycles ran longer than 40 days.
In US national survey data, girls reach menarche at a median age of 12.43 years, and 98% have had a first period by age 15.
In the first gynecologic year, cycle length has a fifth percentile of 23 days and a 95th percentile of 90 days.
By the seventh gynecologic year, cycle length has a fifth percentile of 27 days and a 95th percentile of 38 days.
The committees advise evaluation after 90 days without menses, no period by age 15, or no period within 3 years of thelarche (breast budding).

Interpretation

The report is a 2006 clinical report from two physician committees and contains no new study data. Its cycle ranges come from earlier studies. The paper places the point where a person's own normal cycle length settles at about the sixth gynecologic year. The authors offer no outcome data on whether treating the cycle as a vital sign improves health. The committees describe abnormal cycles as possible signs of hormone conditions, bleeding disorders and eating disorders. The guidance expires after 5 years unless reaffirmed.

RRM Context

The AAP and ACOG wrote a report that calls the menstrual cycle a vital sign. Restorative reproductive medicine shares that starting point: the cycle reflects overall health from the first period onward. The report says charting menses may be beneficial when the bleeding history is vague, and describes early menstrual life as marked by cycles without ovulation.

Our editorial summary of this paper, not the article's abstract.

Abstract

Young patients and their parents often are unsure about what represents normal menstrual patterns, and clinicians also may be unsure about normal ranges for menstrual cycle length and amount and duration of flow through adolescence. It is important to be able to educate young patients and their parents regarding what to expect of a first period and about the range for normal cycle length of subsequent menses. It is equally important for clinicians to have an understanding of bleeding patterns in girls and adolescents, the ability to differentiate between normal and abnormal menstruation, and the skill to know how to evaluate young patients' conditions appropriately. Using the menstrual cycle as an additional vital sign adds a powerful tool to the assessment of normal development and the exclusion of pathological conditions.

Topics

Menstrual Cycle Cycle Across the Lifespan Cycle and General Health

Menstrual Cycle › Cycle Across the Lifespan › Cycle and General Health

Angela Diaz, Marc R Laufer, Lesley L Breech

A Diaz, M Laufer, L Breech

PMID 17079600 17079600 DOI 10.1542/peds.2006-2481 10.1542/peds.2006-2481 American Academy of Pediatrics Committee on Adolescence et al. 2006, American Academy of Pediatrics Committee on Adolescence 2006

Keywords

Adolescent, Child, Female, Humans, Menstrual Cycle/physiology, Menstruation/physiology, Menstruation Disturbances/diagnosis, Time Factors

Menstruation in girls and adolescents: using the menstrual cycle as a vital sign

Teen menstrual cycles typically run 21 to 45 days, AAP and ACOG report

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords