Acute adolescent menorrhagia

Acute menorrhagia in adolescence is a much underestimated clinical problem, often requiring urgent medical intervention. In a 9-year case review between January, 1971, and January, 1980, we looked at all admissions to a children's hospital for acute menorrhagia, where genital tract pathology had been excluded. A primary coagulation disorder was found in almost 20% of these 59 patients. One quarter of those with severe menorrhagia (hemoglobin less than 10 gm/100 ml), one third of those requiring transfusion, and one half of those presenting at menarche had such an underlying disorder. Therefore, proper screening and therapy are essential in all girls with menorrhagia. Conventional methods of hormonal control are only partially effective in these special cases.