Puberty and Hormones

Notes taken by Iris Lau from the 2014 Australian & NZ Dravet Syndrome Family Conference

Puberty and Hormones

Adolescence is a developmental stage involving

• Cognitive

• Pubertal

• Separation

• Independence

• Peer group

• Risk taking

Puberty Blues – the challenge's of managing periods

Menstrual management – for women with intellectual and/or severe physical disability

AIMS

Optimise quality of life

Ensure no pain, no negative health consequences

Puberty Blues- understanding hormones

Puberty blues – the challenges

Menstrual management – for women with intellectual and/or severe physical disability

Optionssimple measure – reduce pain, reduce heaviness of periods

“the pill” – continuously – “skipping periods”

Depo Provera – need to watch bones

Mirena IUS

iris Note: the speaker explained that “skipping periods” –

Like grandmothers – have ten kids, normally only 55 periods in their life

Like pregnancy – no period, then go to breast feeding with no period.

So no period for few years is not unhealthy, just the way to control the hormones

Continuous Pill

“skipping periods on the pill”

Concern by some regarding “ not natural”

Well….How many periods in a life time is natural?

Continuous Pill continued

Tricks to make it work

…need higher dose with most anticonvulsants

Need continuous dose ( not changing dose pill)

Care with lamotrigine – as may reduce the effectiveness of this

Non Contraceptive benefits of the pill

50-80% reduction in ovarian cancer

50% reduction in endometrial cancer

Reduction in bowel cancer

Less endometriosis

Less Anaemia

Less ovarian cysts

Rules for skipping

Period at the end of the first packet

Can go continuous after that

Go as long as possible…until spotting starts, put up with this for 2 or 3 days

If persists, have a 4 days off the pill and restart

If cyclic 4 week bleed or pain despite continuous pill not suppressed. Need to increase pill dose

Can’t always achieve no periods at all – accepts 4-6 month interval

Mirena IUS 95% less bleeding by 6 months

97% less bleeding by 12 months

Lasts 5+ years

95% satisfaction reported by families of young women with disabilities at RCH

Implanon

Lasts 3 years

Almost 100% effective in preventing pregnancy

Causes irregular bleeding – resulting in removal in 25-30% of young women

Not helpful if aiming for constant hormones