Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach

Area of Science:

• Reproductive Endocrinology
• Adolescent Gynecology
• Pediatric Healthcare

Background:

• Abnormal uterine bleeding (AUB) is a frequent reason for adolescent females seeking medical care.
• AUB significantly affects quality of life, leading to school absenteeism and social limitations.
• Episodes range from mild to life-threatening, necessitating prompt recognition and treatment.

Purpose of the Study:

• To highlight the importance of distinguishing normal from abnormal menstrual patterns in adolescents.
• To emphasize the utility of the PALM-COEIN classification system for AUB evaluation.
• To address the challenges in diagnosing and managing AUB in adolescents due to a lack of age-specific recommendations.

Main Methods:

• Review of current literature and clinical guidelines for AUB in adolescents.
• Application of the PALM-COEIN classification system for diagnostic evaluation.
• Assessment of common causes, particularly anovulation due to hypothalamic-pituitary-ovarian axis immaturity.

Main Results:

• Anovulation is the most frequent cause of AUB in adolescents.
• Careful history and physical examination are vital for differential diagnosis.
• Pharmacological treatment, primarily hormonal therapy, is the first-line approach, with surgery rarely indicated.

Conclusions:

• Management requires a multidisciplinary approach tailored to the underlying cause and bleeding severity.
• There is a notable lack of standardized care and age-specific treatment regimens for adolescents.
• Further research is needed to establish efficacy and safety of treatments specifically for this population.