Adolescence

Stepping into Womanhood:
10 – 19 years

The Adolescence YearsThis period signifies the transition from childhood to womanhood, with accompanying physical changes. The first signs of puberty in girls may start at around 10 years old, and include an increase in height and weight, development of breasts, growth of body hair, acne and menstruation. Gynaecological issues in adolescence are often caused by hormonal imbalances related to the onset of puberty.

1. Menstruation (Period)

In general, a regular menstrual cycle occurs every 21 – 35 days with bleeding lasting 2 – 7 days. You may experience some cramping during a heavy flow at the start of your period. Regularity of a period can depend on age, body weight, stress or other underlying health conditions. Pre-menstrual syndrome (PMS) such as tiredness and bloatedness are commonly experienced around 1 week before a period. Some adolescents may experience abnormal menstruation, which are listed below.

Dysmenorrhoea (Painful Periods)

Dysmenorrhoea refers to severe and frequent cramps experienced during menstruation. It is more commonly experienced in adolescents and young women due to the release of a substance known as prostaglandin, which causes the uterus muscles to contract as the lining is shed. However, severe menstrual cramps may also be caused by underlying conditions such as endometriosis, fibroids or cysts. The pain is often managed using common painkillers, but if the pain gets worse progressively, it may be prudent to consult an O&G specialist to understand the cause.

Irregular Menses (Infrequent Menses / Overly Frequent Menses)

An irregular menstrual cycle is one that occurs less than 21 days (polymenorrhoea) or more than 35 days apart (oligomenorrhoea). It is a common occurrence in adolescence. Some adolescent girls may not develop a regular cycle for several years after starting their period. Your menstrual cycle may gradually regulate or stay irregular into adulthood. Most menstrual disorders may be managed with lifestyle changes such as diet and adequate rest or pain relief medication. If you feel that self-care practices are not adequately addressing these issues, seek a doctor’s advice for a further examination.

Menorrhagia (Excessive Bleeding)

Menorrhagia occurs when the menstruation lasts longer and is heavier than normal. Indications of excessive bleeding include having to change a pad or tampon every 1 – 2 hours, having huge blood clots, having flooding episodes, having to use double pads to prevent overflow, or having heavy periods lasting for 8 – 10 days or more. Menorrhagia may be caused by a variety of reasons, including hormonal imbalances which are common during the initial occurrences of menstruation. However, they may also be a symptom of uterine fibroids, uterine polyps, endometriosis, or a bleeding disorder. As a result of the excessive bleeding, many women with menorrhagia suffer from anemia. Signs of anemia include feeling tired easily and paleness of the skin.

Amenorrhoea (Absence of Periods)

Amenorrhoea is characterised by the absence of any menstrual period by 16 years of age, or absence of any period for 6 consecutive months without pregnancy. It may be the result of a delay in puberty, hormonal imbalances, or polycystic ovary syndrome (PCOS). Lifestyle factors such as weight changes (gain or loss), stress or excessive exercising may also lead to an absence of periods.

Dysmenorrhoea refers to severe and frequent cramps experienced during menstruation. It is more commonly experienced in adolescents and young women due to the release of a substance known as prostaglandin, which causes the uterus muscles to contract as the lining is shed. However, severe menstrual cramps may also be caused by underlying conditions such as endometriosis, fibroids or cysts. The pain is often managed using common painkillers, but if the pain gets worse progressively, it may be prudent to consult an O&G specialist to understand the cause.

An irregular menstrual cycle is one that occurs less than 21 days (polymenorrhoea) or more than 35 days apart (oligomenorrhoea). It is a common occurrence in adolescence. Some adolescent girls may not develop a regular cycle for several years after starting their period. Your menstrual cycle may gradually regulate or stay irregular into adulthood. Most menstrual disorders may be managed with lifestyle changes such as diet and adequate rest or pain relief medication. If you feel that self-care practices are not adequately addressing these issues, seek a doctor’s advice for a further examination.

Menorrhagia occurs when the menstruation lasts longer and is heavier than normal. Indications of excessive bleeding include having to change a pad or tampon every 1 – 2 hours, having huge blood clots, having flooding episodes, having to use double pads to prevent overflow, or having heavy periods lasting for 8 – 10 days or more. Menorrhagia may be caused by a variety of reasons, including hormonal imbalances which are common during the initial occurrences of menstruation. However, they may also be a symptom of uterine fibroids, uterine polyps, endometriosis, or a bleeding disorder. As a result of the excessive bleeding, many women with menorrhagia suffer from anemia. Signs of anemia include feeling tired easily and paleness of the skin.

Amenorrhoea is characterised by the absence of any menstrual period by 16 years of age, or absence of any period for 6 consecutive months without pregnancy. It may be the result of a delay in puberty, hormonal imbalances, or polycystic ovary syndrome (PCOS). Lifestyle factors such as weight changes (gain or loss), stress or excessive exercising may also lead to an absence of periods.

Are period problems affecting you?

2. Sexual Health

Sexual HealthIt is important for adolescents who are sexually active to take care of their sexual health and practice safe and responsible sex. Lack of information on one’s sexual health can lead to a greater risk of contracting sexually transmitted infections (STI) such as HIV, chlamydia, genital warts, genital herpes or gonorrhoea. STIs caused by bacteria (gonorrhoea, syphilis, chlamydia) can be treated with antibiotics. Those caused by viruses (genital warts, genital herpes, HIV) can be treated, but the viruses may not be eradicated. If left untreated, some of these STIs may lead to serious health problems in later life.

How Can I Protect Myself Against STIs?

  • Practice safe sex if you are sexually active; condoms offer an effective protection against STIs
  • A vaccination can protect against some strains of the human papillomavirus (HPV) which may cause genital warts or cervical cancer in women
  • Reduce your number of sexual partners- a higher number of sexual partners increases the risk of contracting an STI
  • Learn about your partner’s sexual health and history
  • Abstinence is the most effective method to preventing an STI

Get Vaccinated Against HPV

Get Vaccinated Against HPVA vaccination against human papillomavirus (HPV) can help prevent certain strains of HPV infections that could lead to cervical cancer. A HPV vaccination is most effective when provided before the start of sexual activity, before potential exposure to HPV. In Singapore, there are a couple of HPV vaccines, which are currently approved for use against specific strains of HPV. There is the 4-valent vaccine which covers 4 HPV types i.e. 6, 11, 16, 18, as well as the 9-valent vaccine which covers 9 HPV types i.e. 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Depending on the specific vaccines, girls and women aged 9 to 26 are eligible and advised to get vaccinated against HPV. For Singaporean women, some HPV vaccines are Medisave-claimable (up to $400), as long as you are between the age of 9- 26 years old. If you are unsure of your suitability, consult your doctor to understand more about a HPV vaccination. If you are sexually active, it is important to continue to go for a regular pap smear every 3 years even if you have received a HPV vaccination.

About

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At SMG Women’s Health (SMGWH), we are dedicated to seeing you through your health and wellness…

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Wellness & Gynaecology Centre by Dr Julinda Lee

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