Dysfunctional uterine bleeding in adolescents

Dysfunctional uterine bleeding (DUB) is a common presenting problem for adolescents. New data have emerged on the frequency of the pathologic causes for menorrhagia and the potential to use new therapies such as gonadotropin-releasing hormone analogues. DUB is defined as abnormal vaginal bleeding without an identifiable pathologic condition. In adolescents, DUB is most often due to the anovulatory cycles that result from an immature hypothalamic-pituitary-ovarian axis. Although most adolescents will develop normal, regular menstrual cycles, a significant number may require gynecologic follow-up for persistent abnormal vaginal bleeding. Thus, optimal management of DUB requires a systematic diagnosis and therapeutic approach. This article reviews the pathophysiology, diagnostic evaluation, treatment options, and outcome of DUB in adolescents.