Menstrual cycle abnormalities: diagnosis and management.

In summary, the diagnosis and management of menstrual disorders in adolescent girls is a particular challenge. The clinician must keep an open mind and consider physical conditions as well as psychosocial factors that may play a role in the menstrual dysfunction. Knowledge of congenital and genetic conditions, chronic biomedical as well as psychosomatic disorders, lifestyle choices, and complications of sexual behavior are essential to properly diagnose and treat menstrual disorders in young women. A detailed and confidential medical and psychosocial history and a thorough physical examination, including external genital examination, rectoabdominal or vaginal bimanual examination, and speculum examination (if indicated) are necessary.