What to do if a 16-year-old hasn't started menstruating
Jan 24, 2025
Source: Cainiu Health
Dr. Zhang Lu
Introduction
In general, the absence of menstruation by age 16 refers to primary amenorrhea, which may be caused by individual differences, delayed puberty, polycystic ovary syndrome (PCOS), hyperprolactinemia, or hypothalamic amenorrhea. To help prevent this condition, it is recommended to maintain a balanced diet and ensure adequate nutrition in daily life, especially sufficient intake of minerals such as iron and calcium, to avoid malnutrition.
Generally, if a girl has not started menstruating by the age of 16, it refers to primary amenorrhea. Possible causes include individual differences, delayed puberty, polycystic ovary syndrome (PCOS), hyperprolactinemia, and hypothalamic amenorrhea. Treatment options include general therapy and medication, under a doctor's guidance. Detailed explanations are as follows:
1. Individual Differences
Physiological development varies among females. Some girls may experience a later onset of menarche due to genetic factors, nutritional status, or environmental conditions. Maintain a balanced diet with adequate nutrition, especially minerals such as iron and calcium; follow a regular sleep schedule and avoid staying up late; engage in moderate physical activity to promote healthy development.
2. Delayed Puberty
Delayed puberty refers to the absence of secondary sexual characteristics after age 13 or the absence of menarche after age 15. This may be related to multiple factors such as genetics, nutrition, and psychological influences. Monitor the child's growth and development regularly; conduct routine health check-ups; provide a nutrient-rich diet to prevent malnutrition.
3. Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome is typically caused by endocrine and metabolic abnormalities, leading to multiple small cysts forming in the ovaries and affecting normal ovulation. Ovarian dysfunction can result in oligomenorrhea or amenorrhea. Associated symptoms may include hirsutism, acne, and obesity. Under a doctor's guidance, medications such as ethinyl estradiol/cyproterone acetate tablets, metformin hydrochloride tablets, and spironolactone tablets can be used to regulate endocrine function and improve metabolic status.
4. Hyperprolactinemia
Hyperprolactinemia may be caused by conditions such as pituitary prolactinoma or hypothalamic disorders, leading to abnormally elevated serum prolactin levels. Elevated prolactin levels can suppress the synthesis and secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus, resulting in oligomenorrhea or amenorrhea. Symptoms may also include galactorrhea, infertility, and decreased libido. Under medical guidance, medications such as bromocriptine tablets, cabergoline tablets, and vitamin B6 tablets can be used to lower prolactin levels and restore menstruation.
5. Hypothalamic Amenorrhea
Hypothalamic amenorrhea may be triggered by various factors such as psychological stress, weight loss, and exercise-induced amenorrhea, which affect the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus. Hypothalamic dysfunction leads to reduced GnRH secretion, which subsequently affects ovarian function, resulting in amenorrhea. Symptoms such as anxiety, depression, and weight loss may also occur. Follow medical advice to use medications such as estradiol tablets, progesterone capsules, and dydrogesterone tablets for treatment.
To prevent this condition, it is recommended to maintain a balanced diet in daily life, ensure adequate nutrition, especially minerals such as iron and calcium, and avoid malnutrition. At the same time, ensure sufficient sleep and avoid staying up late to maintain overall health.
