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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Acupuncture and Biorhythm

We all know something about biorhythms. Basically, a biorhythm is an internal clock that regulates our bodies in relation to the daily positions of the sun, and the monthly positions of the moon. This can be seen in the time it takes our bodies to adjust to small changes, such as the changes of daylight savings time, or in large changes, such as jet lag. Our understanding of and interest in biorhythms has been recent, within the last thirty or forty years.

The ancient Chinese observed this connection between our bodies and the planets many centuries ago, and use it in
their practice of acupuncture. They list a number of different biorhythms, from the normal twenty four hour cycle up through longer several day periods. All of these are used to follow and influence fluctuations in body energy.In acupuncture, this energy circulates through each part of the body throughout the day, each organ having a two hour time for maximum energy and a time for minimum energy. For example, the major organs have their maximum energy in the following order: first the liver, then the lungs, large intestine, stomach, spleen, heart, etc., in sequence, for all of the twelve major organs. This order was discovered by years of observing the times of day that the disorders of the various organs displayed their worst symptoms. The acupuncture practitioner can use the times of a patient’s symptoms to help determine which organs and energy channels are affected, and also help select the favorable times to treat the patient. For example, many of the worst asthma attacks take place during the wee hours, which is the maximum energy period of the lungs. The best time to treat these cases is at a time as close to this time as possible.

In the science behind acupuncture, a symptom may be caused by too much energy at an organ, and other symptoms by an insufficient amount of energy. (The determination of which symptoms fall into which category has been catalogued over many centuries, and there are many books on acupuncture detailing these for each of the major organs.) The best time to treat a symptom associated with too much energy is during its maximum energy output, and a symptom with a deficiency in energy is just after the maximum output is over. Of course, it may not be possible to get to your practitioner at those particular times, and there are also other good choices at other times of the day.

In addition to the daily biorhythm, there are also ten day intervals associated with the moon, and so the acupuncture practitioner might strongly suggest that a particular day would be better for treatment than another, based on the particular symptoms reported. Each day of the ten days is associated with one of two aspects of the Qi energy, and also associated with one of five elements. Particular organs are associated with particular elements, and so stimulation of these organs will be more successful on those days associated with the correct element.

It is important for us to take note of the times our symptoms occur as well as what our symptoms are, for that is important information in our acupuncture treatment plan. And know that the time and dates for our treatments are an important part of how well the treatment works.

Depression in Adolescents

Depression in adolescents is a disorder which occurs due to persistent sadness, loss of interest, loss of self worth and discouragement. Depression is normally a temporary reaction towards situations of stress. Depression is a normal part of the maturation process of adolescents. It is even induced due to production of sex hormones. Adolescent females are depressed twice more than adolescent boys according to a study.

Adolescent behavior is normally marked with good and bad moods. The transition from a good mood to bad mood and vice-versa, can take minutes, hours and even days. That is the reason why true depression is very difficult to find out. Depression in adolescents can be caused due to bad school performance, break up with boyfriend or girlfriend, and failing relations with friends and family. These causes can lead to persistent depression. Other serious causes are chronic illness, obesity, child abuse, stressful lifestyle, poor social skills, unstable care giving and depression in family history.

Symptoms of depression in adolescents are eating disorders, weight change, irritable mood, excessive sleeping in daytime, excessive temper, criminal behavior, memory loss, fatigue, self preoccupation, sadness, difficulty in concentrating, worthlessness feelings, loss of interest, self hatred, obsession with death and thought & attempts of suicides. When these symptoms are being noticed for more than two weeks, it is important to get treatment for the adolescent. Depression not only affects interpersonal relationships, but school performance as well. Depressed adolescents are more prone to take onto drugs and alcohol as an attempt to overcome their depression. Such problems require intensive treatment.

The doctor will take blood test and perform physical examination to determine the cause of depression. The adolescent can also be tested for substance abuse such as smoking, heavy alcohol consumption, marijuana smoking, and usage of other drugs. After the physical examination, psychiatric evaluation is also done to understand the cause of sadness, loss of interest and irritability. Depression can also lead to the development of other psychiatric disorders such as schizophrenia, mania and anxiety. It is also important to determine whether the adolescent poses a risk for himself/herself and others. Family and school personnel can provide valuable information about the adolescent to the doctor.

Treatment for depression for adolescent is similar to the treatment of depression for adults. Along with the treatment, the adolescent are given antidepressant medication and psychotherapy. Antidepressant medications include tricyclics, Prozac, selective serotonin reuptake inhibitors or SSRI. Some of the medicines increase the risk, so it is a good idea that parents discuss the possible risks with the doctor. Only some of the antidepressant medications are meant for children and adolescents. Adolescents with severe depression need to be hospitalized as they are more prone to kill themselves.

Family and school support is necessary to tackle the depression of the adolescent. Parents can get their children admitted in emotional growth schools, boot camps or wilderness programs, to solve the behavioral problems. These programs consist of non medical staff and confrontational therapies. But care must be taken as some of the programs can in turn harm children who are depressed and sensitive. Adolescents, who get caught due to criminal offense, should be taken special care of by their parents. It is best that the child face the consequences and learn a lesson from it. Depressed adolescents respond well to treatment if they are treated comprehensively and early. More than half of the adults are known to have depression when they were in their teens.

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Anemia in Adolescents

To understand what is anemia one should begin with breathing. The oxygen that is inhaled simply doesnt stop in lungs. It circulates though out the body and fuels the brains also. Oxygen travels to all parts of the body though bloodstream and to be precise in the RBCs I.e. red blood cells. Now, these RBCs are produced in the bone marrow of the body and they serve as boats carrying oxygen in the bloodstream. RBCs have something called hemoglobin, a protein which holds oxygen. To make adequate hemoglobin body requires iron in plenty. The iron is supplied by the foods that we take along with other nutrients. When these RBCs are fewer in number than what is needed anemia occurs in the body. There can be 3 primary reasons: RBCs are lost due to some reason, the production of RBCs is slower than what is needed and lastly the body is destroying the RBCs. Different types of anemia are linked to at least one of these causes.

The bone marrow replaces small amounts of blood is lost due to some reason without making a person anemic. But in cases where considerable amount of blood flows in small amount of time as a result of an injury due to a serious example for instance, it may not be possible for bone marrow to replace RBCs so quickly resulting in anemia. Also, losing small amounts of blood over long periods of time may also lead to anemia. Example of this situation can be seen in girls who get heavy periods attributed mainly to deficiency of iron in the diet.

Anemia due to iron deficiency is the most common kind of anemia in the United States. It occurs mainly due to lack of iron in a persons diet. A teen with iron deficiency would have lower hemoglobin production and consequently lower RBCs. When the production of RBCs is low the person is regarded as anemic. The signs of anemia are paleness and tiredness. There can be other reasons as to why enough RBCs are not produced in the body. Folic acid and Vitamin B-12 are also essential to produce RBCs. Getting these in adequate quantities is this important too. There can be a problem with bone marrows working too resulting in anemia.

Hemolytic anemia occurs when a person has RBCs whose lifespan is shorter. The bone marrow may not be able to produce new blood cells if the blood cells die too early. This can result due to many reasons including person having disorders like sphenocytosis or sickle cell anemia. In some cases the immune system of the body may itself destroy the RBCs. In some cases certain antibodies can form in the blood as a result of reaction to certain drugs or infections and may attack the RBCs.

Teens get anemia as they grow rapidly the amount of iron intake may not be enough to keep up with the pace of the growth as it needs more nutrients in this process. In the case of girls they need more iron after puberty and are at risk due to heavy blood loss during menstrual periods. In some cases pregnancies also leads to anemia. Also, teens who diet excessively to lose weight may also be at risk of having iron deficiency. Meat eaters especially red meat eaters are at less risk compared to vegetarians as meat has rich iron in it.

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