INCIDENCE, TYPE, AND ETIOLOGY OF MENSTRUAL DISORDERS IN THE AGE GROUP 12-19 YEARS

In a random sample of 1,533 girls aged 8-18 years, all except three menstruated by the age of 15. The frequency of menstrual disorders at each age ranged from 10 to 17%, had no tendency to decrease with age, and was independent of the color of hair. Among 1,702 patients aged 12-39 years presenting with menstrual disorders at the Endocrine Clinic, 503 (29.6%) were 12-19 years old (group A) and the remaining 1,199 were 20-39 years of age (group B). However, the first clinical manifestation of the abnormalities in their cycle appeared before the age of 20 in 68% of this entire group. Menstrual disorders occurred immediately after menarche in 59.6% of the patients in group A, primary oligomenorrhea being the most common complaint (35-39%). Hypothalamic derangement was the most common etiology to occur with the same frequency in the two groups (group A: 63.4%, group B: 61.4%). One in 63 young girls (vs. one in 27 in group B) had a pituitary tumor (six prolactinomas, one growth hormone-secreting adenoma, one craniopharyngioma). We concluded that 1) the failure of menses to appear by the age of 15 is extremely rare, 2) the vulnerability of ovarian cyclicity does not change during the maturation of its controlling mechanism after menarche, 3) two of three females up to the age of 39 years with menstrual disorders manifest their anomaly in the cycle before 20 years of age, 4) the sensitivity of hypothalamic centers is the same in the young and the older subjects and is responsible for the greater part of menstrual disorders, 5) the occurrence of a pituitary tumor in young girls with menstrual disorders is not a remote possibility.