Menorrhagia at menarche: a case report

Dysfunctional uterine bleeding is defined as abnormal endometrial bleeding without any underlying disease. It is particularly a common problem for adolescents and a majority are caused by immature hypothalamic-pituitary-ovarian axis. Usually, it presents as minor alterations of the cycle flow length, but occasionally can be severe enough to require hospitalization. A 12 year-old girl with menorrhagia at menarche was admitted to our Adolescent Unit. She had heavy bleeding for 16 days causing a hemoglobin level of 5.5 gr/dl. She was first treated with blood transfusion and hemostasis was achieved rapidly through high doses of combination oral contraceptives. Whenever menorrhagia occurs at menarche, it is important to exclude an underlying hematologic disease. If there is no response to hormonal therapy in 48 hours there is a need for reevaluation of coagulopathy. In this report, we show how an acute and heavy anovulatory bleeding episode can be controlled and followed-up in an adolescent girl.