While girls vary in the ages that they are when they start their periods and when the other signs of puberty occur, the order is fairly consistent. The two things that are most closely tied to the age when a girl starts her periods, that she can readily assess herself are: first real bra and armpit hair. A "real" bra means one with a cup size attached to it, as opposed to small, medium, large distinctions. Armpit hair is self-explanatory. Any amount will do. At this point, a girl will probably start her periods within 3-6 months, if she hasn't already. It also occurs right after the growth spurt of adolescence. So, if a girl grew, grew, grew, last year and has slowed down (no more than 2.5 inches a year) then periods are right around the corner. Another way to estimate is to remember when it all started. The very first sign is called breast budding. Budding simply means the nipple elevates a bit. It does not mean the girl has development that resembles a breast. This is later. To remember when this is, a girl should think of when the very, very first time was that she noticed anything different about her chest. In some girls, pubic hair is first, or at least the first thing she remembers. Again, any amount will do. It will take an average of 4 1/2 years from this point, with a range of 1 1/2 to 6 years). Take this as the starting point or adolescence. Here is the sequence and time frame of events for an average girl. The girl will also begin her growth spurt about this time. She will notice pubic hair about 6 months later. About 6 months after that (a total of one year after budding) she will be in her peak growth spurt, growing faster that she ever has. She will probably get her first training bra at this time. About a year after all this (a total of two years after budding), she will get a real bra and armpit hair. First period will come about 4 months before or after these events. Your actual mileage may vary. So, the chart below gives the events and their ranges. The average age for periods in the U.S. is 12.16 for black girls and 12.88 for whites. By age 11, 28% of black girls and 13.5% of whites menstruate. By age 12, 62% of blacks, and 35% of whites. A girl's first menstruation is called menarche. This is pronounced MEN-arc or MEN-arc-y. When a girl passes certain milestones in her development, but does not start having periods, this is called Primary Amenorrhea. This is pronounced A-men-or-rea or Ah-men-or-rea. The word primary is the part that means the girl has never had a period. The amenorrhea part means lack (a is Latin for none) of periods (menorrhea is Latin for "monthly flow"). This is to distinguish it from Secondary Amenorrhea, which is when a woman has had periods and then stops. These standards were developed long ago. Meanwhile the average age of puberty and menarche has dropped. So, Estronaut's opinion is that checking with a doctor a year or so earlier is not a bad idea. Also, girls of African descent mature sooner than Europeans, by about a year. So, these girls should substract another year. (We have not been able to find averages for other races.) On age alone: Age 15 1/2 to 16 1/2 for whites, age 14 1/2 to 15 1/2 for blacks. If no breast or hair development: Age 13 to 14 for whites, age 12 to 13 for blacks. If there is breast development or hair (pubic or armpit)two years after either of these started.Physical Signs That Precede First Menstruation
Average Ages And Average Time Between Stages
When To Go To The Doctor
Some Medical Terms
The Standards For Going To The Doctor
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MedicaForums
Medica Forums -
5/23/13
Hello,
Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it. Thanks !
Medica Forums -
5/19/13
Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?
Medica Forums -
5/12/13
Welcome to the new ObGyn.net Forum!
To all the members of OB-GYN-L… Thank you for coming! I’m thrilled that you’ve decided to check out the new Forum site, and look forward to reading about what’s on your mind. If you’re new to the ObGyn.net community... welcome aboard! You’ve just joined an outstanding group of physicians and health care professionals who have been sharing information, answering questions, and building professional relationships via the site’s listserv for nearly 20 years. Feel free to poke around on the site to get a feel for things, or take a look at the Help Topics page for instructions on how to use the different features of the site. A few quick tips: For those of you who like getting new Forum messages delivered directly to your inbox, the first thing you’ll want to do is click on the ‘Follow this forum’ button on the main page. You’ll have the option of getting notifications immediately, as a daily digest, a weekly digest, or only when you’re not online (which is to say, if you’re on the site when someone posts a message, you won’t be notified of it). You won’t be able to post on the site just by replying to the email, but the message will contain a link that takes you directly to the message you’d like to reply to. You can also follow individual conversations without following the whole list by going into the topic and clicking the ‘Follow this topic’ button next to the title. Also, in ‘My Profile’ you can:
Happy posting!
Medica Forums -
5/11/13
I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.
Ronald E. Ainsworth, MD, FACOG
Medica Forums -
4/15/13
Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.
She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery. Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery. Medical staff bylaws call for a daily progress note; this bylaw was easily met. In reviewing the case, it did not "feel good" that no one came to the bedside. My questions: 1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines. 2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?" Garry EducationalTutorialsPostmenopausal Breast Cancer Survivors at Greater Risk for Metabolic Syndrome
May 22, 2013 Metabolic syndrome is more likely to develop in postmenopausal survivors of breast cancer than in postmenopausal women who never had the disease. Daily Dx: Dysmenorrhea and Pelvic Discomfort
May 21, 2013 This middle-aged woman has severe dysmenorrhea and pelvic discomfort. Ultrasound images of the uterus are shown. What is your diagnosis? History of Cesarean Delivery Does Not Preclude LESS-H
May 20, 2013 Laparoendoscopic single-site surgery with hysterectomy (LESS-H) for benign disease with either a lateral or vaginal approach is a feasible procedure regardless of cesarean section history. Which Contraceptive Is Best for Women With Diabetes Mellitus?
May 15, 2013 There is insufficient evidence to determine that hormonal contraceptives do not influence glucose and lipid metabolism in women with diabetes mellitus, concluded a systematic review conducted by the Cochrane Fertility Regulation Group. Daily Dx: Polymenorrhea and Pelvic Pain
May 14, 2013 there is a clearly defined rounded mass just below the endometrial stripe of the uterus. The endometrium itself appears normal in thickness ruling out hyperplasia. The mass is within the uterine fundus and body ruling out a cervical mass. CaseStudiesFetal Abdomen with Gallbladder Calculi
Dr. Muktachand and Dr. Trupti , September 27, 2011
Sacrococcygeal Teratoma?
Dr. Jaydeep , September 14, 2011
Fetal Cardiac Anomalies
Joshua Abbott Copel, MD OBGYN.net Advisory Board Member , July 19, 2011
Single Umbilical Artery Color Doppler
Abana Cerekja , June 15, 2011
FromPhysiciansPracticeFive Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office. Growing HIPAA Threat – Ignore Windows XP at Your Own Peril Marion K. Jenkins, May 21, 2013 Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003. Finding Physician Work-Life Balance in the Small Moments Jennifer Frank, MD, May 21, 2013 At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs. Three Areas to Reduce Costs at Your Medical Practice Greg Mertz, May 19, 2013 By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation. Dos and Don’ts for Starting a Physician Blog Michael Woo-Ming, MD, May 18, 2013 Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
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