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Children's Health

Periods that last too long

11/17/2008

Question:

My 11y/o daughter has been bleeding off and on for an entire month. She started menustrating this summer, and has been very regular. But this last month, she`ll have bleeding for 3 or 4 days, stop for 2 or 3 days and then start bleeding again. I can`t find any info re: why this would be happening and she doesn`t want to see a doctor for fear that he/she will "look down there".

Answer:

When a young woman first starts to have her period, the initial periods are not the same as later ones when the menstrual cycle fully matures.  Some of the markers of these early periods, called anovulatory cycles, include bleeding that can be either regular or irregular but without cramps or breast tenderness.  After a sufficient amount of time, the periods become ovulatory, or in ordinary terms, associated with the release of an egg, which tend to be more regular, more often associated with cramping and breast tenderness.

What you are describing is a situation in which your daughter has started her periods and had some periods that appeared regular, but were most likely anovulatory.  Now she has had increased and irregular bleeding which may be a sign that she has a problem such as a bleeding disorder or perhaps her cycle is just immature and will need time to become regular.  What is important about the diagnosis is really the amount of blood she is losing and how anemic she may become and what the cause of that is.

In order to figure that out, she will need to be seen by a qualified medical provider. That person, either male or female will need to examine her, in the same way she would typically be examined in a normal yearly physical examination.  They will look at breast development, pubic hair development and examine the vaginal area for any abnormalities.  It is important that you discuss these types of examinations with her, to help her understand the importance of her health and the correct names for her body parts so that she can move beyond her initial fear and participate actively in her health care, and the more calmly and rationally you act with her, both before and during the visit, the better she will do and the faster the answer to your question will be answered.

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Response by:

Michael Spigarelli, MD, PhD
Formerly, Associate Professor of Pediatrics and Internal Medicine
College of Medicine
University of Cincinnati