Itriyeva Khalida
Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 410 Lakeville Road, Suite 108, New Hyde Park, Hempstead, NY 11042, USA.
Curr Probl Pediatr Adolesc Health Care. 2022 May;52(5):101183. doi: 10.1016/j.cppeds.2022.101183. Epub 2022 May 6.
The normal ovulatory menstrual cycle requires the presence of a mature hypothalamic-pituitary-ovarian axis and highly coordinated hormonal feedback loops. Consisting of three phases (follicular, ovulatory, and luteal), the normal menstrual cycle results in the formation of a mature follicle and release of an oocyte during each cycle, with menses occurring in the absence of fertilization. While adolescents may initially experience anovulatory cycles following menarche, the vast majority of cycles will be fairly regular, lasting 21 to 45 days in length with an average of three to seven days of bleeding. Absence of menarche by age 15, absence of menses for three consecutive months, and menses lasting eight days or longer with or without associated heavy bleeding are among the menstrual abnormalities that warrant further evaluation. Obtaining the menstrual history in adolescents with the knowledge of expected menstrual patterns allows the pediatric practitioner to provide appropriate counseling and education to adolescents and their families, and to identify menstrual abnormalities when they arise. Treating the menstrual cycle as a "vital sign" highlights the importance of normal menses as an indicator of an individual's overall health and enables timely identification of any concerning findings.
正常的排卵性月经周期需要成熟的下丘脑 - 垂体 - 卵巢轴以及高度协调的激素反馈回路。正常月经周期包括三个阶段（卵泡期、排卵期和黄体期），每个周期会形成一个成熟卵泡并释放一个卵母细胞，若未受精则会出现月经。虽然青少年在初潮后最初可能经历无排卵周期，但绝大多数周期会相当规律，持续时间为21至45天，平均出血时间为三至七天。15岁仍未初潮、连续三个月无月经、月经持续八天或更长时间（无论有无大量出血）等月经异常情况都需要进一步评估。了解预期月经模式后获取青少年的月经史，有助于儿科医生为青少年及其家庭提供适当的咨询和教育，并在出现月经异常时加以识别。将月经周期视为一项“生命体征”，凸显了正常月经作为个体整体健康指标的重要性，并能及时发现任何相关问题。
