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32 Issues L. & Med. 277 (2017)
The Menstrual Cycle as a Vital Sign: The Use of Naprotechnology in the Evaluation and Management of Abnormal Vaginal Bleeding and PCOS in the Adolescent

handle is hein.journals/ilmed32 and id is 283 raw text is: 










          The Menstrual Cycle as

          a Vital Sign: The Use of

          Naprotechnology®i n the

 Evaluation and Management of

 Abnormal Vaginal Bleeding and

          PCOS in the Adolescent
                         Shirley Gonzalez, M.D.

     The topic of how the menstrual cycle is a vital sign which could signal patho-
physiologic process has received considerable attention in the past decade. The current
recommendations of various academic groups will be discussed as well as the FertilityTM
Care method of charting and the Naprotechnology approach to evaluating abnormalities
of the menstrual cycle. Two clinical scenarios seen in adolescent medicine, PCOS and
AUB, will be analyzed looking at the pathophysiology of these clinical scenarios and their
management. The approach will be one that conducts an evaluation to try to find the
underlying problem and aims to restore the normal physiology of the menstrual cycle.
     The American Academy of Pediatrics, the American College of Obstetrics and Gy-
necology and the New York Academy of Sciences have published academic statements
during the past ten years emphasizing the need for providers to teach patients how to
chart and the important clinical ramifications of using this charting as a vital sign. In
2006 the American Academy of Pediatrics published in the Pediatrics Journal a recom-
mendation titled: Menstruation in Girls and Adolescents: Using the Menstrual Sign as
a Vital Sign.' In 2015, the American College of Obstetrics and Gynecology published a
Committee Opinion emphasizing the need to teach women the charting of their menses
and the important pathophysiologic process that could be detected with the charting.2
In 2008, the New York Academy of Sciences published a book on the menstrual cycle

   1 American Academy of Pediatrics, Committee on Adolescence, American College of Obstetricians and
Connittee on Adolescent Healthcare. Menstruation in Girls and Adolescents: Using the Menstrual Cycle
as a Vital Sign. Pediatrics. 2006; 118(5):2245-2250.
   2 Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion
No. 651. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2015;126:e 143-6.

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