They are experiencing too much bleeding, too frequent bleeding, or irregular bleeding. Some are concerned that they have not had a period. Others may experience painful cramps and back pain with menstruation. Most adolescent patients think they are abnormal but, for their age group, they are not, Anderson added. Initially the teen body is not mature enough to regulate menstruation completely.
Irregularities are common early on.
Many adolescent women have eating disorders, which can affect normal menstruation. Developmental abnormalities or congenital anomalies often surface in this age group because of the normal changes that take place at puberty. If a girl is 16 or older with secondary sexual characteristics, such as breast development and pubic hair growth, and has never had a period, or 14 without any of the above, then she should be evaluated. An examination can be very important to help determine why a young woman is not menstruating. Occasionally, an ultrasound examination or MRI may be helpful.