Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach

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.

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

“…1 Most cases of anovulatory bleeding can be treated by hormonal and non-hormonal medicines, thus avoiding surgeries. 5 Treating thyroid function has shown to improve the menstrual abnormalities. 6,7 This study aims to find the prevalence of thyroid dysfunction in women of reproductive age with abnormal uterine bleeding in a tertiary hospital of eastern Nepal.…”

Abnormal Uterine Bleeding in Adolescent

“…Heavy menstrual bleeding (HMB), previously known as dysfunctional uterine bleeding, is defined as excessive menstrual bleeding that affects the quality of life physically, socially, emotionally and/or materially. 2 This is not caused by structural abnormalities. 1 Abnormal uterine bleeding occurs in 3-20% of women of reproductive age.…”

“…The incidence in adolescents is higher than in adults (37% versus 10-20%). 2 Heavy menstrual bleeding is the most common symptom. 8 A Swedish study involving 1,000 adolescents found that eISSN (Online): 2598-0580…”

“…1 The prevalence of AUB in adolescents is higher than in adults (37% vs 10%-20%). 2,3 This condition causes fatigue or even might need hospitalization that can interfere with quality of life, absence from school, and limited social life. 3,4 According to International Federation of Gynecology and Obstetrics (FIGO), the etiology of AUB is divided into structural and nonstructural which have different treatments.…”

“…3,4 According to International Federation of Gynecology and Obstetrics (FIGO), the etiology of AUB is divided into structural and nonstructural which have different treatments. 2 The understanding about the cause, diagnosis and management of AUB in adolescence could help clinician administering the best course of action. 5-7…”