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Evaluation of oligomenorrhea in adolescence

Jan Paradise, MD
Section Editor
Stephen J Teach, MD, MPH
Deputy Editor
Kathryn A Martin, MD


Oligomenorrhea means infrequent menstruation. A menstrual cycle is defined as the number of days from the first day of one bleeding episode to the first day of the next bleeding episode. For the clinician evaluating an adolescent, oligomenorrhea can be defined as a menstrual cycle of longer than six weeks. The term secondary amenorrhea is applied if menstruation does not resume within three to six months. However, because of the chance that pregnancy could be the cause, clinicians evaluating adolescents must not dismiss brief delays in the onset of an expected menstrual period. Oligomenorrhea should be distinguished from hypomenorrhea, a nonpathologic pattern of light or short, but nonetheless regular menstrual periods.

Some adolescents with anovulatory menstrual cycles have oligomenorrhea punctuated by episodes of excessive bleeding. An approach to the evaluation of excessive vaginal bleeding in adolescents is presented elsewhere.

Primary amenorrhea, that is, failure to menstruate by a specified age, often 15 years, and issues related to secondary amenorrhea or oligomenorrhea in adult women are discussed separately. (See "Evaluation and management of primary amenorrhea" and "Evaluation and management of secondary amenorrhea".)


The following definitions can provide clarity when considering whether or not a patient’s menstrual pattern is abnormal:

Menstrual cycle – The number of days from the first day of one bleeding episode to the first day of the next bleeding episode


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Literature review current through: Jul 2017. | This topic last updated: Apr 15, 2015.
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