Ovarian function after the menarche and hormonal contraception
- PMID: 2903093
- DOI: 10.1016/0020-7292(88)90016-1
Ovarian function after the menarche and hormonal contraception
Abstract
The aim of the study was to determine the date of regular ovulation after the menarche to better understand the physiology of female adolescence, especially as it pertains to the use of hormonal contraception. Early morning urine samples were collected from 51 girls in the perimenarche for 9 weeks semi-annually during 2 years. Estrone- and pregnanediol-3-glucuronide values were determined. Cycles lasting 35-40 days at the onset of menses shortened to 28 days after the 23rd-25th cycle. Menses reached a 5.0-5.5 day average length at about the same time. After the 20th cycle, ovulation could be demonstrated in more than 50% of the study patients. Using a scoring system, regular ovulation could be expected on the basis of somatic data with scores of greater than 16. Hormonal contraception may be prescribed 2 years after the menarche, based on scores of greater than 16 and ovulation proven be hormonal cytology and basal body temperature.
PIP: The increasing number of pregnancies among young teenagers has drawn attention to the timing of the onset of ovulation after menarche. As part of a broader study of menstrual and ovulatory patterns at puberty, estrone and pregnanediol-3-glucuronide levels were analyzed in urine samples collected from 51 girls in the perimenarche for 9 weeks semiannually over a 2-year period. Data pertaining to changes in the menstrual cycles of these 51 girls were analyzed in the course of 30 cycles and study participants kept menstrual calendars. Cycles lasting 35-40 days at the onset of menses shortened to 28 days after the 23rd-25th cycle. Menses reached a 5.0-5.5-day average length at about the same time. The frequency of ovulatory cycles was 10-13% after the 1st 7-10 menstrual cycles; it approached 50% after the 20th cycle. The pattern of normalization of menstrual cycles in young girls is important to defining the earliest date for the need of hormonal contraception without undue risk in order to prevent early pregnancy. The findings of this study suggest that hormonal contraception can be started 2 years after the onset of menses. However, attention should also be given to somatic development. The authors have developed a scoring system which considers the state of the breasts, pubic and axillary hair, and the uterus, as well as the results of hormonal cytological analysis and basal body temperature to more accurately detect the onset of regular ovulation.
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