(10 – 19 YEARS)

Adolescence is the transition from childhood to womanhood, with accompanying physical changes. The first signs of puberty include an increase in height and weight, development of breasts, growth of body hair, acne and menstruation. Gynaecological issues found in adolescent girls are usually caused by hormonal imbalances brought about by puberty.

1. Menstruation (Period)

A regular menstrual cycle occurs every 21 – 35 days and bleeding may last from 2 – 7 days. At the start of your period, you may experience some cramping. Regularity of a period depends on age, body weight, stress or other underlying health conditions. Pre-menstrual syndrome (PMS) may include tiredness or bloatedness and are commonly experienced around a week before a period. Adolescents may also face abnormal menstruation, which are listed below.

Dysmenorrhoea (Painful Periods)

More commonly experienced in adolescents and young women, dysmenorrhoea refers to severe and frequent cramps experienced during menstruation. The release of a substance known as prostaglandin during menstruation causes the uterus muscles to contract as the lining is shed. Severe cramps can also be caused by conditions such as endometriosis, fibroids or cysts. Though the pain can be managed by painkillers, you may wish to consult an O&G specialist to find out the cause if it gets progressively worse.

Irregular Menses (Infrequent Menses / Overly Frequent Menses)

A common occurrence in adolescent girls, an irregular menstrual cycle is one that occurs less than 21 days (polymenorrhoea) or more than 35 days apart (oligomenorrhoea). Girls may not develop a regular cycle for several years after puberty and the menstrual cycle could either gradually regulate or stay irregular even in adulthood. Lifestyle changes including diet and adequate rest can help address the issue. However, if these self-care practices are not working well for you, request for further examination.

Menorrhagia (Excessive Bleeding)

Indications of menorrhagia 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. Causes of menorrhagia include hormonal imbalances, which are common during the initial occurrences of menstruation. However, it could also be an indication of uterine fibroids, uterine polyps, endometriosis, or a bleeding disorder. Many women with menorrhagia suffer from anemia – tell-tale signs include the tiredness experienced by an individual or the pallor of their skin – due to excessive bleeding.

Amenorrhoea (Absence of Periods)

An adolescent may not experience any menstrual period by the age of 16 or may experience the absence of a period for 6 consecutive months without pregnancy. A delay in puberty, hormonal imbalances, or polycystic ovary syndrome (PCOS) could also result in amenorrhoea. The absence may also be caused by weight fluctuations, stress or excessive exercising.

2. Sexual Health

Adolescents who are sexually active must take care of their sexual health through the practice of safe and responsible sex. A greater risk of contracting sexually transmitted infections (STI) including HIV, chlamydia, genital warts, genital herpes or gonorrhoea may arise due to a lack of understanding about sexual health. Though some STIs caused by bacteria (gonorrhoea, syphilis, chlamydia) can be treated with antibiotics, those caused by viruses (genital warts, genital herpes, HIV) may not be eradicated even if treated. STIs may also lead to more health problems if left untreated.

How Can I Protect Myself Against STIs?

  • Practice safe sex if you are sexually active; use condoms and other contraceptives
  • Get vaccinated against some strains of the human papillomavirus (HPV), which can cause genital warts or cervical cancer in women
  • Keep your number of sexual partners to a minimum – a high number of sexual partners increases your risk of contracting an STI
  • Find out about your partner’s sexual health and history
  • Practice abstinence, the most effective method that prevents contracting an STI
Get Vaccinated Against HPV

Human papillomavirus (HPV) infections could lead to cervical cancer but a vaccination could help prevent certain strains from infecting you. Before engaging in sexual activity, get a HPV vaccination. Girls and women aged 9 to 26 are eligible and advised to get vaccinated against HPV. In Singapore, the Gardasil and Cervarix vaccines are currently approved for use. Consult your doctor to understand more about a HPV vaccination. Even if you have received a HPV vaccination, sexually active individuals are advised to go for a regular pap smear once every 3 years.

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