Question: My daughter is 15 but has not started her periods. Is this reason for concern?
In the seventeenth century, it was unusual for girls to start their periods until they were 16 or 17. Today, they may start at 12 or earlier, the change being due to the better diet, health and hygiene in the twentieth century, more rapid growth, and therefore faster maturation of the body. The onset of periods in a girl can be estimated by the experience of her mother, sisters or cousins, but there may still be significant variations. The trend is continuing for periods to start earlier every generation.
By 15, you would expect breast buds to have developed and some early wisps of pubic hair to be present. If this is not the case your daughter should be checked by a doctor. There are some medical conditions that can lead to a delay in the onset of periods. These include any severe illness earlier in life that may have slowed maturation, diseases of the ovaries or other glands, and some rare congenital disorders.

Question: Can you explain endometriosis for me? I have been told that this is the cause of my painful periods.
Your uterus (womb) is lined with special cells, which during the second half of your monthly cycle, are prepared to accept any fertilized egg and allow it to grow into a baby. If no pregnancy occurs, these cells degenerate, break away from the inside of the uterus, and with the resultant bleeding, pass out of the body in a woman’s period.
From the top of the uterus, the two Fallopian tubes lead out to the two ovaries. In a very small number of unlucky women, the cells that normally go out during a period, may go in and through these Fallopian tubes. The cells are then in an abnormal position around the ovary, on the outside of the uterus or in the pelvic cavity, and they can attach to these tissues and start growing and spreading further. They will still respond to the hormonal cycle every month, as these hormones pass through the bloodstream to every cell in the body. As a result, these cells in abnormal positions will bleed every month, releasing blood in places where it can cause pain and other symptoms. The cells may also block the Fallopian tubes causing infertility, or settle on the outside of the intestine to cause irritation and diarrhea.
The condition can only be diagnosed by examining a woman’s pelvis by means of an operation or a laparoscopy. A laparoscopy involves a small tube being put through the belly button into the abdomen, and through this a doctor can see the spots of endometriosis in its abnormal positions.

Question: I have not had a period for 5 months after stopping the pill. Is this normal?
About 10% of women who use the contraceptive pill have a delay in the return of their periods after stopping it. It is nothing to be overly concerned about, and can occur just as easily after one month on the pill as after ten years on it. Unless you are very eager to fall pregnant, doctors will wait for about six months before prescribing hormone tablets to start your cycle again. The vast majority of women will restart their periods within six months.
Some women have a tendency to miss periods for emotional, hormonal and other reasons. These women are the ones most likely to develop this problem. The pill has no effect on the long-term fertility of a couple, but is often blamed for difficulty in falling pregnancy because 15% of all couples have a delay of over a year in conceiving.

Question: I have just had an appendix operation. The doctor examined my ovaries during the operation, and he says they are very small. Is this serious?
Some people have small noses, others big noses. Some people have small feet, others big feet. Some people have small ovaries, others big ovaries. The actual size of the ovary has no effect upon your fertility or femininity, unless their size is due to fibrosis or disease. If this was the case, the surgeon would probably have commented about it, and referred you to a gynecologist for a further opinion and treatment.
The ovaries are responsible for producing an egg every month that has the potential to be fertilized and implant in the womb in pregnancy. The ovaries also produce hormones that give you your appearance as a woman. The breasts, for example, develop in the first place and continue their firm shape because of the hormones produced in the ovary. If you are concerned, you should contact the surgeon again and ask him if the small size of your ovaries was due to disease.