Late age of menarche due to constitutional delay requires reassurance, not hormonal therapy
Late age of menarche due to constitutional delay requires reassurance, not hormonal therapy.
The first occurrence of menstruation averages around 12 to 13 years, with differences between ethnic groups.
âWe would be worried if a woman started developing secondary sexual characteristics before the age of eight years,â says Dr Yasmin Tan, a gynaecologist and laparoscopic surgeon at the Royal Hospital for Women in Sydney.
âIt doesnât necessarily mean something sinister is occurring but we would just want to have a look at that person.â
Dr Tan says she would like to see any patient who is 14 years who had not had her period with no secondary sexual development.
âIf theyâve got breast development then we can wait till 16 years before we start to investigate them for lack of periods,â she says.
However, there is no cause for alarm in most cases, as lack of periods is usually just caused by constitutional delay.
âFor hypothalamic hypogonadism, which is probably constitutional delay, reassurance â thatâs the most important thing,â says Dr Tan.
Parents may insist on treatment but GPs should âsit on your hands, reassure and monitor the patientâ, continues Dr Tan.
âIt is sometimes really hard to get the mothers of the girls to accept this,â she says.
âThey all want you to make them have their period, which in most cases you could. You could just give them the pill but itâs not the right treatment. The pill is very suppressive.
“If itâs their hypothalamic pituitary system thatâs not mature yet, giving the pill is actually going to make it worse.â
In this video, Dr Tan discusses:
- What is delayed puberty?
- What is the normal pattern of puberty development in women?
- Are there any variants to the normal patterns?
- What is the average age of menarche?
- What are the causes of delayed puberty?
