Category: Children’s Health

Menstrual Disorders in Adolescent Girls

Adolescence is the time when there is sudden transformation in the body and many questions arises in the minds of the adolescents. Firstly they are not able to cope with the changes and secondly the changes bring along problems with them. The most challenging problems are related to menses, in girls. Menstrual conditions are many that may require physicians attention or any other healthcare professionals attention. The most common of the menstrual disorders are premenstrual syndrome, dysmenorrheal and amenorrhea.

Before the onset of the menses, females face many uncomfortable symptoms which last for a short period, stretching from few hours to few days. But some of them can be very intense and can disturb the normal functioning of the person. These symptoms are grouped as premenstrual syndrome. In usual cases, the symptoms come to a halt when the menses begin, but for some they may last even after the menstrual periods are over. Eighty five percent of the females experience some of the symptoms of premenstrual syndrome at one time or the other. Nearly forty percent experience the symptoms so intensely that their daily chores are affected by it and ten percent are disabled by it.

There are many premenstrual syndrome symptoms which can be broadly classified as neurologic & vascular symptoms, psychological symptoms, gastrointestinal symptoms, fluid retention, eye problems and respiratory problems. The cause of premenstrual syndrome are fluctuations in the levels of progesterone & estrogen, hypoglycemia, hyperprolactinemia, psychogenic factors, changes in carbohydrate metabolism, excessive aldosterone, progesterone allergy and water retention by kidneys. The good thing is that premenstrual syndrome can be prevented by exercising regularly, eating balanced diet and sleeping adequately.

Dysmenorrhea is feeling intense menstrual pain and cramps. Depending on the severity, dysmenorrhea is stated as primary dysmenorrhea or secondary dysmenorrhea. Primary dysmenorrhea symptoms are felt from the onset of the menstrual periods and are felt life-long. Because of abnormal uterine contractions due to chemical imbalance, severe menstrual cramping is experienced. Secondary dysmenorrhea starts in the later stages. The causes are different for primary and secondary dysmenorrhea. Secondary dysmenorrhea can be blamed on medical conditions such as endometriosis, uterine fibroids, pelvic inflammatory disease, tumors, infections, and abnormal pregnancy.

Dysmenorrhea symptoms are lower abdomen cramping & pain, lower back pain, nausea, diarrhea, vomiting, fatigue, fainting, weakness and headaches. Females who are overweight, smoke, and have started to menstruate before turning eleven are at a higher risk of developing dysmenorrheal. Females who drink alcohol during menstrual period experience prolonged pain. After studying the health conditions, age, cause of dysmenorrhea, and extent of condition of the individual, corresponding treatment will be recommended. Regular exercise, abdominal massage, hot bath, vitamin supplements, and dietary modifications can help overcome dysmenorrhea.

Amenorrhea is the condition in which the female skips her menses for more than three consecutive menstrual cycles. Amenorrhea is also classified as primary amenorrhea and secondary amenorrhea. Primary amenorrhea develops from the onset of menstrual periods. In this condition, the adolescent might not get periods when she enters puberty. Secondary amenorrhea is a condition where periods become irregular after a period of time and not from the start.

There are many causes of amenorrhea such as ovulation abnormality, eating disorders, birth defects, anatomical abnormalities, malnourishment, anorexia, bulimia, pregnancy, over exercising, thyroid disorder, obesity and other medical conditions. Out of these ovulation abnormalities are a common cause for absent or irregular periods. It is a must that an adolescent start getting menses at least by the age of sixteen. If not, anatomical abnormality, birth defect and other medical conditions are the cause. Adolescents who participate in sports actively and are athletic have a lower body fat content because of which they have absent menses. Even because of malnourishment, the body is incapable of sustaining pregnancy. So in turn the body itself shuts down the reproductive system and menses. Extra fat cells in the body interfere with ovulation and that is the reason why obese female have irregular menses. Amenorrhea is treated by dietary modifications, ovulation inhibitors and hormone treatment.

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Infectious Mononucleosis

Also known as mononucleosis or mono Pfeiffer’s disease or glandular fever, infectious mononucleosis can be identified by inflamed lymph glands and constant fatigue. The disease is named so as the amount of mononuclear leukocytes which belong to white cells increase in number. The cause of the disease is EBV (Epstein – Barr virus) or in some cases cytomegalovirus. Both these viruses belong to the family of herpes simplex. According to statistic majority of the adults in the United States are exposed to the virus Epstein Barr, a very widespread virus. Although the virus does not show any visible affects in children but it does in adolescents which can lead to infectious mononucleosis in nearly fifty percent of cases of exposure to the virus.

The other virus called cytomegalovirus which also belongs to the family of herpes simplex causes the cells to become enlarged. According to statistics, about eighty percent of adolescents infected with this virus generally dont see any further symptoms. Although EBV has potential to develop infectious mononucleosis in adolescents the virus could make throat and blood cells its home for the lifetime. The virus has the capability to bounce back and reactive from time to time but the consolation is that it would reactivate without symptoms.

The condition usually lasts for 1-2 months. The symptoms may vary from one adolescent to other but may include inflamed lymph glands in areas such as groin, neck and armpits, fever, continuous fatigue, enlarged spleen, sore throat as a result of tonsillitis that can make things difficult to swallow and last but not the least minor liver damage that can lead to short-term jaundice. Some adolescents may also experience symptoms such as abdominal pain, petechial hemorrhage, muscle ache, headache, depression, loss of appetite, skin rash, weakness, dizziness, enlarged prostrate, dry cough, swelled genitals and puffy and swollen eyes. Some parents are puzzled by the symptoms of mononucleosis as it may be similar to other medical conditions. It is safe to consult a doctor in such cases.

The viruses are usually transmitted to other people through saliva (the reason why it is also called kissing disease), blood, sharing drinks and sharing utensils. The symptoms usually lasts for 4-6 weeks and do not cross 4 months. The disease is diagnosable but requires a though medical history of the adolescent. The diagnosis also involves physical examination of the adolescent and is based on symptoms reported to the physician. The diagnosis is further supported by laboratory test like blood test, antibody test and test to count white blood cells.

A rest of about a month is generally advised and normal activities can be resumed after acute symptoms disappear. Also care should be taken to avoid physical activities which are heavy in nature and also activities or sports involving physical contacts should also be avoided. Care must also be taken to avoid eating sweet things in excess for few months.

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High Blood Pressure in Adolescents

High blood pressure is a condition where the blood pressure is more than normal. It is also known as hypertension. Heart pumps out blood, so that oxygen can reach to different parts of the body via blood. The pressure with which heart pumps blood is known as blood pressure. The blood pressure comprises of two measures, the systolic pressure and diastolic pressure. Systolic pressure is the larger figure and represents the pressure within the artery of the heart, when contractions take place which pump blood to different parts of the body. Diastolic pressure is the pressure within the artery of the heart, when the blood is filling in the heart and it is at rest. Both the pressures are measured in millimeters of mercury or mmHg. High blood pressure is abnormal increase in systolic pressure or diastole pressure.

Blood pressure is measured by putting a blood pressure cuff on the arm and placing a stethoscope on the chest. There can be very little variation in blood pressure depending upon the time, emotional moods, age, gender, weight, height, physical activity, stress and other illness such as heart disease and kidney disease. Children and adolescents become anxious when they visit the doctor. This is also an important factor which affects the blood pressure and the readings taken get tampered because of it. That is the reason why many blood pressure readings are taken in order to determine whether the adolescent has high blood pressure or not. The nurse may even ask the adolescent to calm down while taken the readings. Time gap is given between each reading, so as to give time to the adolescent to calm down. Emotions can also affect the blood pressure reading.

An infant will have a normal blood pressure reading of 80/45, where as an adolescent will have a normal blood pressure reading of 110/70. Therefore, age, gender, and height are important factor when determining the normal blood pressure level. Adults will have a higher blood pressure than the infants and teenagers. Also, boys have a higher blood pressure when compared to girls and tall people have a higher blood pressure than short people. An adolescent is said to have high blood pressure when the blood pressure is more than the blood pressure of ninety percent people of his/her age, gender and height.

There are many risks associated with hypertension or high blood pressure. The risk of developing coronary heart disease increases proportionally. The arteries will develop greater resistance towards the blood flow, because of which the heart will pump blood harder. Stroke is also another risk. Adolescents who have had high blood pressure as a child, develop harmful effects on the blood vessels and heart till the time they turn twenty.

The causes of high blood pressure can be classified as primary and secondary. If the causes are definite, they are primary and if the cause is linked to some illness, it is secondary. Primary causes are high blood cholesterol levels, smoking, stagnant lifestyle and overweight. Secondary causes are obesity, immobility due to chronic illness, prescription drugs, intense pain due to burns or cancer and illegal drugs. High blood pressure can develop due to hereditary reasons.

Hypertension is diagnosed by blood test and urinalysis. The kidney function will also be checked, along with blood cholesterol levels. Family history check is another important factor. Adolescents eating habits, exercise levels, activities in school and home will also be studied thoroughly. High blood pressure is dealt with by weight reduction, healthy diet, and increase in physical activity. If hypertension is due to illness, the illness is treated first. These treatment measures will decrease the systolic blood pressure and diastolic blood pressure. It will also strengthen the heart and decrease the level of cholesterol in blood. This also helps to keep heart diseases at bay. The good thing is that only one percent of the adolescents, who have high blood pressure, need medication to bring back the blood pressure to normal.

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Heat-Related Illnesses in Teens

Heat related illnesses are caused due to prolonged exposure to heat and also humidity without any reprieve and due to inadequate intake of fluids. Kids and teens adjust to the variations in heat compared to adults who adapt more quickly. However the heat production is high in them when compared to adults but sweat relatively less. Sweating is the natural action of the body and cooling mechanism to counter heat. Kids and teens often ignore these facts and do not hydrate themselves enough while playing, participating in sports and exercises.

Kids and teens with health problems that are chronic or those who are on certain prescription could be more susceptible to heat related problems. Overweight adolescents or those who wear heavy clothing in times of exertion also suffer heat related illnesses. Heat related illnesses are basically classified into three types. They are: Heat cramps, heat stroke and heat exhaustion.

Heat cramps are the mildest of all heat related injuries and constitute aching muscle cramps and also spasms that occur during intense exercising and also after intense exercising and also sweating in high heat. The symptoms of heat cramps include cramps that are painful in the legs. Flushed and moist skin is also symptoms of heat cramps. The symptoms could also include mild fever generally below 102 degree Fahrenheit. Teens suffering from heat cramps should move to a cool place and take adequate rest. Remove any excessive clothing and wear or put cool clothing on skin or cool skin using air conditioner or fan. Sports drinks which are cool and which contains sugars and salts can also be taken. Stretching out cramped muscles slowly and steadily also helps reduce heat cramps.

On the other hand hear exhaustion is more serious and severe compared to heat cramps and occur due to heavy loss of salt and water from the body. Extreme heat conditions, inadequate fluid intake and excessive sweating results in this conditions. Also, heat exhaustion occurs as a result of inability of the body to maintain the body temperature below the normal which can deteriorate further and also result in a heat stroke which is even worse. The symptoms of heat exhaustion are: muscle cramps, moist skin, pale skin, nausea, fever above 102 degree Fahrenheit, diarrhea, vomiting, fatigue, headache, weakness, anxiety and faint feeling. Teens suffering from heat exhaustion should stay in cool surrounding and take enough rest. Removing excessive clothing, putting on cool clothes and sitting in fan or air conditioning also helps the situation. Intake of cold sports drinks which contains salts and sugars are also advisable. If a teen doesnt show any signs of improvement even after taking all these measures a physician should be consulted immediately.

Heat stroke is the severest condition of all heat related illnesses. In this condition the body gets overwhelmed with excessive heat and the efficiency of the system that regulates body heat goes down considerably which can result in a serious emergency requiring immediate medical care. The symptoms of heat stroke include dry and warm skin, very high fever generally above 104 degree Fahrenheit, increased heart rate, appetite loss, nausea, headache, vomiting, fatigue, agitation, confusion, stupor, seizures, coma and possible death. A teenager experiencing symptoms of heat stroke should stay in a cool place and have adequate rest. Heat stroke is a serious condition and emergency attention should be sought by calling 911. In the meanwhile the affected teenager should be made free of excessive clothing and should be worn with cool clothes and also put cool water on the skin to lower the temperature. Placing ice bags in armpits also helps. Make the teenager drink cool drinks if the teenager is alert.

Heat strokes are very much preventable if certain precautions are taken like drinking adequate water during hot days, avoiding alcoholic and caffeine drinks, wearing light clothes, exercising in cooler time of the day, wearing sunglasses and hat, using umbrella on a hot day, applying sun cream with a spf of at least 15 etc.

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