Bleeding Disorders in Adolescents with Heavy Menstrual Bleeding: The Queensland Statewide Paediatric and Adolescent Gynaecology Service

Abstract

Study Objective: Heavy menstrual bleeding (HMB) is a common gynaecological complaint among young females with up to 40% having experienced HMB. Bleeding disorders are

Metrorrhagia iuvenilis and Premenstrual Syndrome as frequent problems of adolescent gynecology with aspects of diet therapy

“…When the cycles are anovulatory, bleeding is not cyclical, and there are no typical premenstrual symptoms associated with premenstrual syndrome, such as fluid retention, breast tenderness, abdominal distension. Juvenile bleedings usually have a sudden onset without any symptoms which predict them [1,3,6,10,15].…”

“…In the etiology of profuse bleeding is involved the abnormal process in the endometrium, which controls the supply of arachidonic acid for the production of prostaglandins too. In women and girls with profuse bleeding, endometrium occurs on a much larger scale than in women with normal menstruation, and causes the formation of prostaglandins series 2, which affect the functions of the blood vessels and affects the sensation of pain [5,11,15].…”

“…In the case of abrupt juvenile hemorrhage, early diagnosis is important to avoid complications that threaten health and life [2,4,9,15]. A gynecologist decides whether the patient's condition is acute and requires immediate hospitalization, or whether it will be possible to monitor it in as an outpatient.…”

“…It is important to establish whether the patient takes drugs or dietary supplements, and if so, what kind. Of particularly importance is information that excludes or confirms hematological problems, whether the patient is suffering from hemorrhagic diathesis or whether there are bleeds from other places [8,10,15].…”

“…An ultrasound examination is performed via the rectum or ultrasound examination is carried out through the abdominal walls, and in the case of patients who have had a sexual relationship, an ultrasound examination is performed. Laboratory tests are recommended: complete blood count, coagulation system, FSH, LH, estradiol, prolactin, thyroid hormones and TSH [1,5,9,10,15]. On the basis of these, the doctor is able to assess the condition of the patient (exclude anemia, thrombocytopenia, plasma defects) and the hormonal causes of acyclic bleeding.…”