Menstrual Patterns and Treatment of Heavy Menstrual Bleeding in Adolescents with Bleeding Disorders

Dowlut‐McElroy, Tazim; Williams, Karen; Carpenter, Shannon L.; Strickland, Julie

doi:10.1016/j.jpag.2015.03.001

Cited by 26 publications

(24 citation statements)

References 17 publications

(11 reference statements)

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“…It is very important to establish the stabilization of ovulation cycles. Therapeutic intervention always takes seriously the young of the age [36,37].…”

Section: Adolescent Functional Disorders Of Uterusmentioning

confidence: 99%

Causes of Visiting Teenagers in the Pediatric and Adolescence Examining Room

Tsikouras¹,

Deftereou²,

AnnaChalkidou³

et al. 2018

Family Planning

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Adolescence is the transitional period between childhood and adulthood. Depending on female gonads' function and on hypothalamic-pituitary-ovarian axis activation, results in teenager's body growth, in secondary sex characteristics' development and finally in their reproductive potential. In adolescence, the negative feedback of gonadal steroids on gonadotropins is disturbed. Teenagers presenting with dysfunctional bleedings are usually suspected of hemorrhagic ovarian cysts or endometriosis and require gynecologic examination, evaluation, and hormone therapy. It is of great importance both for teenagers and their parents to understand that hormone therapy is the first line treatment for bleeding disorders in these ages. A detailed medical history is necessary to determine the appropriate treatment plan. Primary care includes the detection of adolescents with acute or chronic pelvic pain that may be associated with endometriosis or other pathologies like mullerian duct abnormalities, imperforate hymen, ovarian teratomas, ovarian torsion, and vaginal absence or atresia. Mullerian duct abnormalities are associated with increased rates of unexplained infertility, spontaneous abortions, and pathological conditions of pregnancy. Specialists, should help teenagers in getting familiar to their bodies, to their sexuality, inform them about the sexually transmitted diseases, and safety options including vaccination and guide them in contraception issues.

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“…It is very important to establish the stabilization of ovulation cycles. Therapeutic intervention always takes seriously the young of the age [36,37].…”

Section: Adolescent Functional Disorders Of Uterusmentioning

confidence: 99%

Causes of Visiting Teenagers in the Pediatric and Adolescence Examining Room

Tsikouras¹,

Deftereou²,

AnnaChalkidou³

et al. 2018

Family Planning

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“…A study by Dowlut-McElroy et al identified prepubertal girls with known bleeding disorders who do not have a plan of care in the event they had heavy menstrual bleeding after menarche [6]. They conclude a consultation with a pediatric gynecologist or hematologist prior to menarche would be helpful to review abnormal bleeding patterns and discuss possible treatment options should they experience heavy menses.…”

Section: Pediatric Considerationsmentioning

confidence: 99%

“…The second most common cause of AUB in adolescents is coagulopathy [5][6][7]. Patients with heavy menstrual bleeding should be evaluated for both inherited and acquired disorders of coagulation [8].…”

Section: Introductionmentioning

confidence: 99%

Treatment Options for the Adolescent Patient Experiencing Abnormal Uterine Bleeding

Polis

Hertweck

2016

Curr Treat Options Peds

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Opinion statementAbnormal uterine bleeding (AUB) is one of the most common reasons adolescent patients present for gynecologic care. A new classification system has been created to provide a universally accepted system of nomenclature to describe uterine bleeding causes in reproductive-aged women. The acronym PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic and not yet classified) was introduced in 2011. This classification will help to target not only treatment but also future research into treatment options in the AUB population. In order for treatments to be effective, an accurate diagnosis is paramount. Adolescents tend to have anovulatory, infectious, or pregnancy-related causes of AUB. Traditional treatment modalities have been hormonal in nature, the most common being the use of oral contraceptive pills. The latest development has been the recognition of the effective use of the levonorgestrel intrauterine systems (LNG-IUS) in successful treatment of AUB in the adolescent population.

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“…La causa más frecuente del sangrado uterino anormal en el periodo postmenárquico es la inmadurez del eje hipotalámo-hipófisis-ovario, que conduce a ciclos anovulatorios 2,[20][21][22] . La prevalencia de trastornos hereditarios de la coagulación muestra variaciones en los estudios publicados, especialmente en EvW con un intervalo entre un 5% a 36% y la DP entre un 3% a un 68% de las pacientes con SME [23][24][25] .…”

Section: Introductionunclassified

Trastornos hereditarios de la coagulación en adolescentes con sangrado menstrual excesivo, ¿Debemos evaluar la vía fibrinolítica?

et al. 2020

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El Sangrado Menstrual Excesivo (SME) es un problema frecuente en la adolescencia. La prevalencia de trastornos hereditarios de la coagulación (THC) como causa del SME no está bien establecida y la participación de defectos de la vía fibrinolítica ha sido poco explorada.Objetivo: determinar la prevalencia de THC y defectos de la fibrinólisis en adolescentes con SME.Pacientes y Método: Se incluyeron 93 adolescentes, edad 11 a 18 años. Los antecedentes personales y familiares de sangrado se obtuvieron con un cuestionario estandarizado. Se controló exámenes: tiempo de protrombina (TP), tiempo de tromboplastina parcial activada (TTPa), estudio del factor Von Willebrand, recuento y función plaquetaria. Los pacientes que no fueron diagnosticados como THC, se evaluaron adicionalmente con el tiempo de lisis del coágulo.Resultados: 41 pacientes (44%) fueron diagnosticados como THC: Enfermedad de Von Willebrand n=28, defectos de la función plaquetaria n=8, hemofilia leve n=5. Se confirmó disminución del tiempo de lisis del coágulo en 31 pacientes. El 54% de pacientes diagnosticado como THC, tuvo SME como la primera manifestación hemorrágica. Conclusión: Estos resultados apoyan la necesidad de evaluación de la coagulación, incluyendo la vía fibrinolítica, en el estudio de adolescentes con SME.

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Menstrual Patterns and Treatment of Heavy Menstrual Bleeding in Adolescents with Bleeding Disorders

Cited by 26 publications

References 17 publications

Causes of Visiting Teenagers in the Pediatric and Adolescence Examining Room

Causes of Visiting Teenagers in the Pediatric and Adolescence Examining Room

Treatment Options for the Adolescent Patient Experiencing Abnormal Uterine Bleeding

Trastornos hereditarios de la coagulación en adolescentes con sangrado menstrual excesivo, ¿Debemos evaluar la vía fibrinolítica?

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