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Review
. 2024 Dec 16;13(24):7668.
doi: 10.3390/jcm13247668.

Menstrual Disorders in Adolescence: Diagnostic and Therapeutic Challenges

Christiane Anthon  1 , Marcel Steinmann  2 , Angela Vidal  3 , Carolin Dhakal  4
Affiliations
Review

Menstrual Disorders in Adolescence: Diagnostic and Therapeutic Challenges

Christiane Anthon et al. J Clin Med. .

Abstract

Background: Adolescence is the period of life between the ages of 10 and 19. This period is essentially dominated by puberty. The first menstruation, called menarche, occurs, on average, at the age of 12-13. The period after menarche, especially the first 2 years, is characterized by anovulatory cycles, which can be accompanied by menstrual irregularities. This review aims to describe the current status of the diagnostic and therapeutic challenges of the physiological and pathological causes of menstrual irregularities in adolescence and evaluates the benefits from interdisciplinary collaboration to ensure optimal care. Methods: A systematic literature search was conducted in the PubMed database in April 2024 using the following term: "menstrual disorder adolescence". A total of 1724 abstracts were screened, and relevant articles from the last 10 years were included. In addition, a supplementary topic-relevant literature search of the guidelines of the European Society of Human Reproduction and Embryology (ESHRE) and the guidelines of the Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaft (awmf) was carried out. Results: In addition to cycle irregularities that occur physiologically as a result of anovulatory cycles in the context of the immaturity of the hypothalamic-pituitary-gonadal axis, there are other cycle abnormalities that can be classified as pathological and need to be recognized and treated. Conclusions: Increasing awareness of the various specialist disciplines of physiological and pathological cycle abnormalities in adolescence and interdisciplinary cooperation between them can have a positive influence on the quality of life of adolescent women with cycle abnormalities.

Keywords: adolescence; amenorrhea; endometriosis; genital malformations; high risk for polycystic ovary syndrome (PCOS); hypogonadotropic hypogonadism; juvenile hypermenorrhea; menstrual disorders; premature ovarian insufficiency.

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Conflict of interest statement

The authors confirm that they have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Hormonal control of the hypothalamic–pituitary–ovary axis. GABA: gamma–aminobutyric acid.
Figure 3
Figure 3
Abdominal sonography of an right (re) ovary in an adolescent girl (photo by the authors).
Figure 4
Figure 4
Abdominal sonography of the messurement of the tissue of the uterus in an adolescent girl (photo by the authors).
Figure 5
Figure 5
Abdominal sonography: Messurement of Excessively thickened endometrium in a 12-year-old girl with juvenile hypermenorrhea (photo by the authors).
Figure 6
Figure 6
A 16-year-old girl with pronounced hirsutism and at high risk for PCOS (photo by the authors).
Figure 7
Figure 7
Differential diagnoses of hyperandrogenemia.
See this image and copyright information in PMC

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