III Menstrual patterns of adolescent girls according to chronological and gynecological ages

The menstrual pattern of 5,485 menstruating adolescent girls aged 10‐20 years was studied by analysing the questionnaires they had completed. The information accured was compared with corresponding information supplied by the mothers of these girls. The material was classified on the basis of both the chronological and gynecological age. The objective was to obtain the incidence figures for various aspects of menstruation per age group and to compare the oldest age group of girls with adult women. Cycle . The incidence of short cycles of 14‐21 days in the first gynecological year was 11 per cent and long cycles exceeding 31 days 11 per cent. After 5 years of menstruation the frequency of both types was about 8 per cent. In the mothers the incidence of short cycles was 12 and long cycles 3 per cent. Duration . 92 per cent of the girls had menstrual flows lasting 4‐7 days. Changes in duration with advancing age were small. The incidence of a duration of 2‐3 days in the 1st gynecological year was 8.8 and after the 5th 3.7 per cent. Long durations exceeding 7 days occurred 2.2 per cent of the girls in the first and in 1.5 per cent after the 5th year. For mothers, the incidence of short durations was 12.2 and long durations 2.4 per cent. Regularity . The incidence of irregular menstrual periods in the first year was 43 per cent and in the 6th 20 per cent, against only 9.4 per cent among the mothers. Dysmenorrhoea . Pain accompanied menstrual periods regularly in only about 8 per cent of the girls under 14 and in 7.2 per cent in the first gynecological year. Subsequently the incidence rose steadily until, after the 5th year, it was 26 per cent. Of the girls with dysmenorrhoea, 75 per cent reported an onset during the first year, and 90 per cent of these during the first menstrual flows. There was no correlation between the girls' social groups and dysmenorrhoea, but the mothers of Social Group III reported an incidence 3 per cent higher than the others. Premenstrual tension . The incidence in girls was 68 per cent and in mothers 73 per cent. In the very first gynecological year the incidence of fatigue and nervous symptoms was 58 per cent, and after 5 year of menstruation 59 per cent. Syndromes with oedema, on the other hand, increased during this time from 3 to 16 per cent. Premenstrual tension combined with dysmenorrhoea occurred in 42 per cent of the girls and 62 per cent of the mothers. The constitutional type was correlated with the menstrual pattern. The pyknic type had an increased incidence of continuous dysmenorrhoea and short cycles, the asthenics one of oligomenorrhoea and menorrhagia. The incidence of durations exceeding 6 days was 45 per cent for the asthenics against 31 per cent for the pyknic subjects. For a comparison of changes between age groups distribution by gynecological age proved to give clear‐cut results, especially as regards the duration, regularity and dysmenorrhoea of the menstrual periods. A girl who has menstruated for 5 years cannot generally be considered to have reached her full endocrine maturity, a fact to be borne in mind when oral contraceptives are prescribed. Effect of parity on the menstrual pattern of mothers . The mean number of children per mother in the total series was 3.12, and there was no correlation between the menarcheal age of the mother and her fertility. Nor was any correlation noted between cycle, duration and parity. The frequency of dysmenorrhoea was highly significantly smaller in the multiparous group.