Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach

Authors

  • Inês Ramalho Serviço de Ginecologia/Obstetrícia. Centro Hospitalar e Universitário de Coimbra. Coimbra. https://orcid.org/0000-0002-8816-4020
  • Helena Leite Serviço de Ginecologia/Obstetrícia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Fernanda Águas Serviço de Ginecologia/Obstetrícia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

DOI:

https://doi.org/10.20344/amp.12829

Keywords:

Adolescent, Blood Coagulation Disorders, Menorrhagia, Metrorrhagia, Uterine Hemorrhage

Abstract

Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed.

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Published

2021-03-31

How to Cite

1.
Ramalho I, Leite H, Águas F. Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach. Acta Med Port [Internet]. 2021 Mar. 31 [cited 2024 Apr. 23];34(4):291-7. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829

Issue

Section

Review Articles