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Menorrhagia at menarche: a case report.
Nuray O Kanbur1, Orhan Derman, Tarik Aksu
1Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey. meatabek@mynet.com
International Journal of Adolescent Medicine and Health
|September 6, 2003
Summary
Dysfunctional uterine bleeding in adolescents, often due to an immature reproductive system, can cause severe menorrhagia. High-dose oral contraceptives and blood transfusions effectively manage acute bleeding episodes in this population.
Area of Science:
- Pediatrics
- Adolescent Medicine
- Gynecology
Background:
- Dysfunctional uterine bleeding (DUB) is abnormal uterine bleeding without an underlying pathology.
- It commonly affects adolescents due to an immature hypothalamic-pituitary-ovarian axis.
- DUB can range from minor cycle alterations to severe, hospitalizing hemorrhage.
Observation:
- A 12-year-old girl presented with 16 days of heavy menorrhagia at menarche.
- Her hemoglobin level dropped to 5.5 gr/dl, necessitating hospitalization.
- Initial treatment included blood transfusion followed by high-dose combination oral contraceptives for hemostasis.
Findings:
- Acute, heavy anovulatory bleeding in an adolescent was successfully managed.
- High-dose oral contraceptives rapidly achieved hemostasis post-transfusion.
- Exclusion of underlying hematologic disease is crucial for menorrhagia at menarche.
Implications:
- This case highlights effective management strategies for severe DUB in adolescents.
- Prompt intervention can prevent complications associated with significant blood loss.
- Reevaluation for coagulopathy is indicated if hormonal therapy fails within 48 hours.