Arch Dis Child 97:554-560 doi:10.1136/adc.2009.160853
  • Reviews

Period problems: disorders of menstruation in adolescents

  1. T Mushtaq
  1. Department of Paediatric Endocrinology, Leeds General Infirmary, Leeds, UK
  1. Correspondence to Dr Talat Mushtaq, Department of Paediatric Endocrinology, Leeds Children's Hospital, Leeds LS1 3EX, UK; talat.mushtaq{at}
  • Accepted 17 March 2010
  • Published Online First 24 June 2010


Adolescence is a time of great psychological and physical change. In the UK, girls enter puberty around the age of 10 years with a median age of menarche of 12.9 years; thereafter, it may be several years before regular menstrual cycles are established. Variations in the type and the frequency of periods may create anxiety regarding ill health or serious underlying disorders. With the increase in childhood obesity and subsequent polycystic ovary syndrome, there is a greater awareness and presentation of girls with disorders of menstruation.

This review focuses on normal variations of menses and common pathological causes of menstrual problems, including amenorrhoea, dysmenorrhoea and menorrhagia. Further consideration is given to the variations of presentation of polycystic ovary syndrome. It provides a guide to evaluate the various symptoms, investigations and management options.


  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.