Discovery learning via a deep dive with “Riddle me this!”


I recommend trying “Riddle me this! – as pediatric providers we tend to enjoy playing and many of us enjoy the challenges of active engagement in online learning that is also informative.

Have you participated in Contemporary Pediatrics online discovery learning called “Riddle Me This!” yet?  It is an exciting way to reaffirm what you already know and to discover what you need to learn about a particular topic through responding to online questions with immediate comparative results and additional online information available on professional websites. In this issue, the Riddle me this! is entitled: “Irregular menses in adolescents”?  I recommend trying “Riddle me this! – as pediatric providers we tend to enjoy playing and many of us enjoy the challenges of active engagement in online learning that is also informative. Riddle me this! offers the joy of playing and learning all rolled into a single adventure.

Riddle yourself first

Have you asked yourself these 2 questions recently? ‘How much do I know about teenagers and the menstrual cycle’ and ‘Do I implement the principles cited in the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) opinion paper (Committee on Adolescent Health, 2015) entitled, “Menstruation in girls and adolescents: Using the menstrual cycle as a vital sign” in clinical practice?’ 

Based on your responses to these questions, there are 2 options to refresh your knowledge on teenage menstruation in this issue of Contemporary Pediatrics: 1.) Read the article entitled, Menses: A “vital sign” for teenaged girls” written by Ms Nierengarten or 2.) Participate in the online discovery learning module entitled, Riddle me this! Irregular menses in adolescentsin which you have the opportunity to take a ‘deep dive’ into the current body of evidence on the menstrual cycle and potential problems.  Either option will enable you to update your personal knowledge on teenage menstruation and early identification of potential abnormalities that may require further evaluation and/or a referral. Your choice for learning by reading or via online interactions may simply be a matter of which learning style is most attractive to you at this moment in time. If you have not tried ‘Riddle Me This!’, I encourage you to try it….and have some fun discovering, and to determine whether you indeed took a ‘deep (rewarding) dive’ into the evidence.

There’s an app for that

I did find the apps for tracking periods that are included in the article by Ms. Nierengarten entitled, “Menses: A ‘vital sign’ for teenaged girls” interesting to review. The app called Magic Girl was the most appropriate for teenage girl and could be a source of information for pediatricians and nurse practitioners when speaking with teenagers about their menstrual cycle, as teenagers can record the cycle, as well as information about their mood, behaviors, and other concerns. The nurse practitioner may want to ask teenagers if they are using an app and if they want to share information that they recorded over the past few months about their menstrual cycle, moods, emotions for further discussion.

Apps called Flo, Clue, and Eve provide ways to record the menstrual cycle but also focus on ovulation and other items that may not be appropriate for teenagers. It is important for providers to be aware of apps that are available and which ones should and should not be recommended for use by teenagers. Part of our routine questions to all patients and parents should include questions about social media, apps, and sites they frequent.


The importance of using the menstrual cycle as a vital sign is discussed in both the article and in the online learning. Nurse practitioners need to consider whether their current practices are meeting the recommended guidance in the AAP and ACOG Committee’s opinion statement and whether quality improvement measures regarding menstrual health are needed and/or would benefit their patients and practices.  

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