Despite variations worldwide and within the U.S. population, median age at menarche has remained relatively stable-between 12 years and 13 years-across well-nourished populations in developed countries. Environmental factors, including socioeconomic conditions, nutrition, and access to preventive health care, may influence the timing and progression of puberty. A number of medical conditions can cause abnormal uterine bleeding, characterized by unpredictable timing and variable amount of flow. Clinicians should educate girls and their caretakers (eg, parents or guardians) about what to expect of a first menstrual period and the range for normal cycle length of subsequent menses. Identification of abnormal menstrual patterns in adolescence may improve early identification of potential health concerns for adulthood. It is important for clinicians to have an understanding of the menstrual patterns of adolescent girls, the ability to differentiate between normal and abnormal menstruation, and the skill to know how to evaluate the adolescent girl patient. By including an evaluation of the menstrual cycle as an additional vital sign, clinicians reinforce its importance in assessing overall health status for patients and caretakers.
PMID 26595586 26595586 DOI 10.1097/AOG.0000000000001215 10.1097/AOG.0000000000001215
Cite this article
ACOG (2015). ACOG Committee Opinion No. 651: Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign. Obstetrics and gynecology, 126(6), e143-e146. https://doi.org/10.1097/AOG.0000000000001215
ACOG. ACOG Committee Opinion No. 651: Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign. Obstet Gynecol. 2015;126(6):e143-e146. doi:10.1097/AOG.0000000000001215
ACOG. "ACOG Committee Opinion No. 651: Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign." Obstetrics and gynecology, vol. 126, no. 6, 2015, pp. e143-e146.
Keywords
Adolescent, Adolescent Health Services, Child, Female, Health Status Indicators, Humans, Menarche/physiology, Menstrual Cycle/physiology, Menstruation/physiology, Menstruation Disturbances/diagnosis/etiology, Patient Education As Topic, Preventive Health Services/methods, Vital Signs
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