Abnormal Uterine Bleeding in Adolescents

Area of Science:

• Gynecology
• Adolescent Medicine
• Hematology

Background:

• Abnormal uterine bleeding (AUB) is a common gynecologic issue in hospitalized adolescents.
• Heavy menstrual bleeding (HMB) is the most frequent manifestation of AUB.
• Anovulatory cycles due to immature hypothalamic-pituitary-ovarian axis are the primary cause of HMB.

Purpose of the Study:

• To review the epidemiology, clinical presentation, diagnostic approach, and treatment of HMB in adolescents.
• To highlight the importance of excluding bleeding disorders, such as von Willebrand disease.
• To present clinical experience in managing HMB.

Main Methods:

• Review of literature on HMB in adolescents.
• Discussion of diagnostic criteria and differential diagnoses for AUB.
• Outline of management strategies based on etiology and severity.

Main Results:

• Anovulatory cycles account for the majority of HMB cases.
• Approximately 20% of HMB patients have an underlying bleeding disorder.
• Endocrine disorders like hypothyroidism and PCOS can also cause AUB.

Conclusions:

• Early diagnosis and exclusion of bleeding disorders are crucial for effective HMB management.
• Anovulatory HMB can be successfully treated with combined oral contraceptives and iron supplementation.
• Management should be tailored to the individual patient's clinical findings and anemia level.