Abnormal uterine bleeding in adolescent girls

Abstract

Abnormal menstrual bleeding is one of the most common reasons of gynecologic consultation in adolescent girls. During the first two years after menarche. Most of cycles are anovulatory. Despite this, they are somewhat regular with a range of approximately 21-40 days. Cycles longer than 42 days or shorter than 21 days and bleeding that lasts longer than 7 days particularly 2 years after menarche are considered abnormal. Since the variability in cycle length is greater in adolescence than in adulthood, in the absence of anemia and severe hemorrhage, greater irregularities are accepted. The major cause of abnormal menstrual bleeding in adolescence is anovulation that is caused by unstable growth and incomplete shedding of endometrium in response to continuous secretion of estrogen. The clinical result in irregular, prolonged and heavy bleeding. Treatment is hormonal and is dependent on severity of bleeding. It is necessary to continue treatment for 3-6 cycles. Eventual maturation of the hypothalamus-pituitary-ovarian axis usually will establish regular menses