Puberty and adolescencemenarche to age

A. Irregularity is normal during the first few months of menstruation; however, soaking more than 25 pads or 30 tampons during a menstrual period is abnormal.

B. Absence of premenstrual symptoms (breast tenderness, bloating, cramping) is associated with anovulatory cycles.

C. Fever, particularly in association with pelvic or abdominal pain may, indicate pelvic inflammatory disease. A history of easy bruising suggests a coagulation defect. Headaches and visual changes suggest a pituitary tumor.

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