A 15-year-old female reports menarche at 13 with five periods in the last year. Which action is correct?

A 15-year-old female reports menarche at 13 with five periods in the last year. Which action is correct?

• A. Prescribe oral contraceptives pills to regulate her periods
• B. Reassure her that this is perfectly normal at her age
• C. Perform biometric screening to determine lean body mass
• D. Refer her to an endocrinologist for hormonal evaluation

Answer: (C)

The main idea here is that menstrual irregularity is common in the years soon after menarche. After puberty, the hypothalamic-pituitary-ovarian axis is maturing, and many teens have cycles that are irregular and spaced by several weeks to months. Five periods in a year means cycles roughly every 2–3 months, which falls within the expected variability for a 15-year-old who had menarche at 13. In this scenario, the appropriate step is reassurance and simple education: explain that cycling often takes a few years to regularize, and encourage tracking of cycles and awareness of warning signs (such as very heavy bleeding, menstrual cycles that are very irregular or absent for several months, severe pain, or symptoms suggesting a medical issue). Encourage healthy lifestyle habits and discuss safety if she is sexually active, including pregnancy testing if pregnancy is possible. Biometric screening to determine lean body mass isn’t indicated for evaluating normal menstrual variation in adolescence; it doesn’t address the issue of cycle regularity and isn’t part of routine management in this context.

The main idea here is that menstrual irregularity is common in the years soon after menarche. After puberty, the hypothalamic-pituitary-ovarian axis is maturing, and many teens have cycles that are irregular and spaced by several weeks to months. Five periods in a year means cycles roughly every 2–3 months, which falls within the expected variability for a 15-year-old who had menarche at 13. In this scenario, the appropriate step is reassurance and simple education: explain that cycling often takes a few years to regularize, and encourage tracking of cycles and awareness of warning signs (such as very heavy bleeding, menstrual cycles that are very irregular or absent for several months, severe pain, or symptoms suggesting a medical issue). Encourage healthy lifestyle habits and discuss safety if she is sexually active, including pregnancy testing if pregnancy is possible.

Biometric screening to determine lean body mass isn’t indicated for evaluating normal menstrual variation in adolescence; it doesn’t address the issue of cycle regularity and isn’t part of routine management in this context.