Hi,

Thank you for posting your query.

I understand your concern as a father thinking about not attaining menarche (periods have not started). Let me explain it to you in detail:

-Menarche is the first menstrual cycle, or first menstrual bleeding, in female human beings. From both social and medical perspectives it is often considered the central event of female puberty, as it signals the possibility of fertility.

-Girls experience menarche at different ages. The timing of menarche is influenced by female biology, as well as genetic and environmental factors, especially nutritional factors. The average age at which menarche occurs is 13 years (range is between 13 to 15 years).If secondary sexual characters (example: development of breasts) have appeared there is nothing to worry. Hence i would advice you to wait for another year during which definitely your daughter will get her periods.

-According to scientific guidelines, Primary amenorrhea ( Never had a period in life) is the failure of menses to occur by age 16 years, in the presence of normal growth and secondary sexual characteristics. If by age 13 menses has not occurred and the onset of puberty, such as breast development, is absent, a workup for primary amenorrhea should start.

- If you are still concerned, you can visit a gynecologist who can check for development of secondary sexual chracteristics and confirm the normal devlopment of genital organs.

- Urine test report of 2-3 RBC per high power field is normal & not to be worried much. Few RBC & epithelial cells are shed and are harmless.

Let me know if you have further queries. I will be glad to answer. If you have no queries, please accept my answer.

Wishing your daughter good health.

Regards,
Dr.Mahesh Koregol

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Hi,

Thank you for writing back and clarifications.

Red blood cells (RBC) are reported semi-quantitatively as number seen per high power field (HPF):

The report might read anything like mentioned below;
none seen; <5, 5-20, 20-100, or >100/HPF.

Interpretation: Up to 5 RBC/HPF generally are considered acceptable for "normal" urine.

RBC can appear in urine due to various rasons:

•Blood in the urine can come from any condition that results in infection, inflammation, or injury to the urinary system.
•Typically, microscopic hematuria indicates damage to the upper urinary tract (kidneys), while visible blood indicates damage to the lower tract (ureters, bladder, or urethra). But this is not always the case.
•The most common causes in people younger than 40 years of age are kidney stones or urinary tract infections.

Since now the RBC are less than 5, it is normal. Earlier it could have been some minor urethral trauma. Hence I reassure you that there is nothing to worry.

If you have no further queries, please accept my answer.

Wishing your daughter good health.

Regards,
Dr.Mahesh Koregol

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Hi,

Thank you for reverting back.

At present, there is nothing to worry. The RBC counts noticed currently in the reports do not seem to be anything serious. So I would not prefer to do any further tests on it. - No need of ultrasound or any other tests. She will be fine.

Hope this answers your query. Please accept my answer if you have no further queries.

Regards
Dr.Mahesh koregol

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Hi and thanks again,

Depending on the person's acid-base status, the pH of urine may range from 4.5 to 8. The urine pH of your daughter is absolutely normal.

I wish you and your good health. If you like my answers and wish me to answer in future, bring it to my attention, “Dr. Mahesh Koregol”.

Please accept my answer if no further queries

Regards,

Dr. Mahesh Koregol

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