Case 1: Keri is a 15-year-old presents with complaints of “irregular cycles.” She reports her periods have never “been regular” and she “never knows when they are coming.” Intervals are every 2–3 months and periods last approximately 1-2 weeks. She denies any heavy bleeding or passing clots. When you speak with her in confidence, she reports she is sexually active and uses condoms regularly, and does not want children for several years.

Case 2: Lucy is a 13 year old female who presents with prolonged periods. She had menarche 1 year ago and has had 4 periods since menarche. Previously, periods have lasted anywhere from 5-14 days and have been painless. However this current period started 35 days ago and now she is having some cramping. The bleeding was initially heavy and then lightened over the last week until 2 days ago when it became much heavier. Lucy now reports having to change her pad every 2 to 3 hours.