Study of puberty menorrhagia - Causes and management

Ashraf, Samina; Afzal, Asima; Nigeen, Waseeqa; Nabi, Nighat

doi:10.5455/ijmsph.2017.0823318092017

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…Around 20% of them with less than 4 gm. Similar results had been shown in the study conducted by Sameena et al 8 They needed packed cell transfusion with parenteral iron therapy for management of anaemia.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of cases of puberty menorrhagia requiring in-patient care

Varadarajan

Yoganarasimha

2022

Int J Reprod Contracept Obstet Gynecol

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Background: Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman’s physical, social, emotional or material quality of life. Puberty menorrhagia is excessive bleeding occurring between menarche and 19 years. Abnormal bleeding amounts to 50% of gynaecological visits in adolescent girls. The leading cause of puberty menorrhagia is hypothalamic pituitary, ovarian axis immaturity followed by bleeding disorders, endocrine disorders. Excessive blood loss leading to anaemia has a negative impact over the development and quality of life of the adolescent, requiring immediate attention to these cases. The objective was to evaluate the incidence, etiology and management of puberty menorrhagia requiring in-patient care.Methods: A retrospective observational study was done on adolescents admitted for management of puberty menorrhagia in Kempegowda Institute of Medical Sciences over a period lasting from January 2017 to October 2021 from hospital records.Results: Amongst the 35 admitted, 42% belonged to the age group 10-14 years. 62.8% presented with symptoms lasting less than 6 months. 20% presented with haemoglobin less than 4 gm, 51.4% with haemoglobin between 4 gm to 6 gm, 28.6% with 6 gm to 8 gm. 57.2% patients had anovulatory cycles, 25.7% were PCOS, 11.4% had hypothyroidism and 5.7% had fibroid uterus. 42% ultrasonographies showed PCOS, 5.7% had fibroid uterus. The approach to managing these patients were with a combination of hormone therapy, hematinics, blood transfusion and anti fibrinolytics like tranexemic acid. 20% received tranexemic acid and hematinics. 31.42% received blood, hematinics and tranexemic acid, 11.42% received hematinics, tranexemic acid and thyroxine, 17.14% received blood, hematinics, tranexemic acid and progesterone, 8.57% received hematinics, tranexemic acid and COCs, 11.42% received hematinics, tranexemic acid and progesterone.Conclusions: In conclusion, the leading cause of puberty menorrhagia was anovulatory cycles, followed by PCOS and then by endocrine dysfunction. Medical management was successful in all cases.

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Section: Discussionsupporting

confidence: 87%

Evaluation of cases of puberty menorrhagia requiring in-patient care

Varadarajan

Yoganarasimha

2022

Int J Reprod Contracept Obstet Gynecol

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“…Irregular shedding occurs due to endometrial growth due to unopposed estrogen action. The ratio of prostaglandin F2 alpha: PGE2 is 2:1, Where in anovulatory cycles the ratio is decreased due to lack of progesterone resulting in painless (4) anovulatoty cycles.…”

Section: Resultsmentioning

confidence: 99%

“…Many adolescents come late to gynecologists making them more vulnerable to complications such as severe anemia and hypoproteinemia. In all cases of puberty menorrhagia, it is important to exclude pregnancy, especially incomplete (4) abortion and ectopic pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Etiology of Puberty Menorrhagia - A Prospective Study

Jananii

Anuradha²,

Aandal

2019

PIJR

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OBJECTIVES: To determine the etiology of puberty menorrhagia. MATERIALS AND METHOD:A total of 35 cases who attended OBG OPD at Shri SathyaSai Medical college from January 2019 – June 2019 who presented with chief complaints of irregular heavy menstrual bleeding since menarche were included in this study.After taking detailed history taking,physical examination,lab investigations,ultrasound etiology of puberty menorrhagia is ruled out. RESULTS: Most common age group in our study are between 12 – 14 years (60%).34.2 % attained menarche between 12 – 13yrs.Around 27 patient had duration of symptoms for less than 6 months, 6 had symptoms for about 6 – 12 months, 2 had for more than 1 year. Most common etiolgy in our study is PCOD (25.7%), anovulatory without PCOD (20 %), bleeding diathesis and thyroid disorder (17.1 %), pregnancy complication (8.5%), tuberculosis (5.7 %), fibroid and endometriosis (2.8 %). CONCLUSION: Puberty menorrhagia needs to be evaluated in early stage rather than at later stage so that consequences of abnormal uterine bleeding can prevented.

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“…6 A similar study from North India found same causes and reported that 61.5% required blood transfusion. 7 A review on abnormal uterine bleeding in adolescents proposed to do minimal investigations which include hCG, CBC, Peripheral smear, serum ferritin, PT, aPTT, and fibrinogen and to investigate for bleeding disorders in adolescents with severe anaemia. 8 In 9 pre-menarchal girls with cyclical vaginal bleeding no cause could be found inspite of extensive investigations including vaginoscopy.…”

Section: Discussionmentioning

confidence: 99%

Catastrophe at menarche

Dasari

Garg²

2021

IJOGR

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Menarche, the beginning of menstrual function occurs as a result of complex interaction between the hypothalamus, pituitary and ovarian hormones and is an important event in any girl’s life as it signifies the beginning of fertility. Rarely some diseases like migraine, epilepsy, inherited bleeding disorders can manifest at menarche and cause significant anxiety to the parents and the adolescent girl. A 13-year-old girl presented with convulsions following 8 days of excessive bleeding at the time of menarche. She had altered sensorium, severe anaemia with Respiratory alkalosis and needed ICU Care. She needed multiple transfusions of blood and blood products. She showed features of sepsis on haemogram at admission later manifested respiratory findings. Her bleeding per vaginum did not respond to antifibrinolytics and progesterones and stopped only after evacuation of contents on day 5 under GA. No organism could be isolated and she recovered on Day 6 of higher broad spectrum antibiotics. Her parents were counselled to watch for occurrence of seizures in later life as this catastrophe may signify onset of epilepsy in later life.

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Study of puberty menorrhagia - Causes and management

Cited by 3 publications

References 7 publications

Evaluation of cases of puberty menorrhagia requiring in-patient care

Evaluation of cases of puberty menorrhagia requiring in-patient care

Etiology of Puberty Menorrhagia - A Prospective Study

Catastrophe at menarche

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