Irregular Menstruation in Teenagers May be a Warning Sign

MAY 23, 2011
A recent study indicates that irregular periods in teenage girls are linked to obesity, and girls suffering from irregular periods may also present early warning symptoms of diabetes, reproductive issues, and heart disease.

"There may be a misconception in adolescent medicine...that it 'takes a couple of years after menarche to get the engine running' and hence one might not want to be concerned about irregular adolescent menstrual cycles until much later," said Charles Glueck, one of the study's authors, from the Cholesterol and Metabolism Center at the Jewish Hospital of Cincinnati.

"That's clearly wrong," he stated, adding that even in younger teenage girls, exceedingly irregular menstruation is not typical and should not be disregarded.

The research performed by Glueck and his colleagues was a part of a larger study initiated by the National Heart, Lung and Blood Institute, and is published in Fertility and Sterility.

The researchers studied 370 teenage females, starting at age fourteen, who all had begun menstruating prior to the commencement of the study.  Once per year, the girls were interviewed and asked how long it had been since their last period.

Researchers also measured the girls’ levels of sex hormones, glucose and insulin, and blood pressure at different points in the study, as well as collected data concerning the girls' height, weight, and waist circumference.

The authors classified irregular menstrual cycles as enduring for more than forty-two days, which, according to Glueck, is a criterion that's meant to catch the 2% of girls with the least regular periods.

Between age fourteen and nineteen, 269 of the girls reported regular periods at every annual visit. Another seventy-four of them had only one report of an irregular period, while nineteen girls had two reports and eight said it had been at least forty-two days since their last period at three or more visits.

The girls with the most reports of irregular periods were already heavier than the other participants at the start of the study, age fourteen, and gained more weight and inches on their waist during the study. They also possessed increased levels of testosterone.

Irregular menstruation was also linked to higher levels of blood sugar and insulin at age twenty-five.

There are some factors to be noted in this study, however. 

The authors did not research in depth what was occurring with the menstrual cycles of their participants during the rest of the year. Also, the findings do not prove that irregular periods cause girls to gain weight or are responsible for the increases in glucose and insulin levels.

But there is no denying that the irregularity of menstruation in adolescent girls could signal other problems.  The link between irregular periods and heart disease, as well as diabetes, is well-established in older women, but these findings strongly indicate that doctors could identify this risk much earlier, which could enable physicians to act preemptively.

According to Alice Chang, an endocrinologist at UT Southwestern Medical center who was not involved in the latest study, one possible cause of irregular menstruation in teenage girls is that their ovaries are responding to changes in metabolism, such as increased insulin levels.

This, she said, may suggest that some of their diabetes-related risks arose prior to troubles with ovulation.

Irregular periods might also be a sign of polycystic ovary syndrome (PCOS), which carries the potential to cause fertility problems. But catching it in adolescence, said Glueck, means it can be "very successfully treated."

Chang agreed that the implications for PCOS are an important message to take from the study.

"When I see women diagnosed with PCOS, they often have symptoms all through adolescence, but it's not put together for them. We need to be more aggressive in adolescents about treating PCOS and treating obesity," she said.
 
 

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