title: Menstrual disorders in a Paediatric and Adolescent Gynaecology Clinic: patient presentations and longitudinal outcomes.
abstract: OBJECTIVE. To study the presentations, diagnoses, and outcomes in adolescents with menstrual disorders. DESIGN. Prospective cohort study. SETTING. Paediatric and Adolescent Gynaecology Clinic, Hong Kong. PARTICIPANTS. A total of 577 adolescents aged 14 to 19 years. MAIN OUTCOME MEASURES. The presentations and diagnoses of adolescents with menstrual disorders were reviewed and their menstrual outcomes determined by a telephone survey. RESULTS. In all, 47% presented with menorrhagia, prolonged menstruation, and short menstrual cycles; 27% had secondary amenorrhoea, 12% had dysmenorrhoea, 11% had oligomenorrhoea, and 3% had primary amenorrhoea. Significant diagnoses included congenital genital tract anomalies, premature ovarian failure, anorexia nervosa, and polycystic ovarian syndrome. Polycystic ovarian syndrome was diagnosed in 16% of the cohort. In all, 24% of these 577 patients had abnormal menstrual cycles 4 years later. Direct logistic regression analysis indicated a cycle length of more than 35 days at presentation (adjusted odds ratio=2.8; 95% confidence interval, 1.8-4.5), previous diagnosis of polycystic ovarian syndrome (adjusted odds ratio=2.0; 95% confidence interval, 1.1-3.4), and current body mass index of 23 kg/m(2) or higher (adjusted odds ratio=1.8; 95% confidence interval, 1.0-3.0) were risk factors for persistently long menstrual cycle exceeding 35 days. Adolescents who were screened out with a definitive diagnosis after initial assessment were at low risk of persistently long menstrual cycles at follow-up (adjusted odds ratio=0.3; 95% confidence interval, 0.1-0.8). CONCLUSIONS. Adolescent menstrual disorders should not be ignored. Long cycle, diagnosis of polycystic ovarian syndrome at first consultation, and a current body mass index of 23 kg/m(2) or higher were statistically associated with persistent problems.
authors: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors: P W
authors: PW
authors: Chung
authors: Symphorosa S C
authors: SS
authors: Chan
authors: K W
authors: KW
authors: Yiu
authors: Terence T H
authors: TT
authors: Lao
authors: Tony K H
authors: TK
authors: Chung
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000150:complications; D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications; D015992:Body Mass Index; D000013:Congenital Abnormalities; D015444:Exercise; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D016015:Logistic Models; D008137:Longitudinal Studies; D008597:Menstrual Cycle; D008599:Menstruation Disturbances / Q000175:diagnosis* / Q000209:etiology*; D009095:Mullerian Ducts / Q000002:abnormalities; D011085:Polycystic Ovary Syndrome / Q000150:complications; D016649:Primary Ovarian Insufficiency / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors; D019170:Somites / Q000002:abnormalities; D013131:Spine / Q000002:abnormalities; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires; D013997:Time Factors; D014599:Uterus / Q000002:abnormalities; D014621:Vagina / Q000002:abnormalities; D015431:Weight Loss; D055815:Young Adult