Menstrual abnormalities during adolescence.

A thorough understanding of the events and hormonal changes which accompany puberty can be successfully utilized to diagnose adolescent menstrual disorders. Knowledge regarding the maturational events within the hypothalamic-pituitary-ovarian axis and the expected times at which positive feedback leading to ovulation occurs is helpful in the design of optimal therapeutic regimens. It should be emphasized that the immature hypothalamic-pituitary-ovarian axis is extremely sensitive to low doses of estrogen and suppression may hinder maturation to normal cyclic activity. Therefore, forms of therapy other than oral contraceptives should be sought and prescribed for adolescents with menstrual disorders.