Abnormal Uterine Bleeding in Adolescent Women

  • Eric S. Mullins
  • Rachel J. Miller
  • Tanya L. Kowalczyk Mullins
Adolescent Medicine (M Goldstein and L Johnson, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Adolescent Medicine

Abstract

Purpose of Review

To review the current state of terminology, evaluation, and management of abnormal uterine bleeding (AUB) in adolescents.

Recent Findings

The current terminology classifies the causes of AUB under the mnemonic “PALM-COEIN”: Polyps, Adenomyosis, Leiomyoma, Malignancy/hyperplasia; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified. Heavy menstrual bleeding (HMB) is one manifestation of AUB. Complete menstrual, gynecologic, medical, and family histories, together with a thorough physical exam, are critical to the determination of the underlying cause of AUB. Initial laboratory testing should be guided by the findings of history and physical. Hormonal therapy is the mainstay of acute and chronic management of AUB. Hemostatic treatments could be considered.

Summary

The primary management for AUB is with hormonal medications. Further studies of combining estrogen-containing hormonal management and hemostatic therapies (such as tranexamic acid) are needed given the theoretical concerns about increased risk of thromboembolism in women with difficult to manage AUB.

Keywords

Abnormal uterine bleeding Heavy menstrual bleeding Adolescent Bleeding disorder evaluation 

Notes

Compliance with Ethical Standards

Conflict of Interest

Rachel J. Miller and Tanya L. Kowalczyk Mullins declare no conflicts of interest.

Eric Mullins reports personal fees from Shire, personal fees from Bayer, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Eric S. Mullins
    • 1
    • 2
  • Rachel J. Miller
    • 3
    • 4
  • Tanya L. Kowalczyk Mullins
    • 2
    • 5
  1. 1.Division of Hematology, Cancer and Blood Diseases InstituteCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.University of Cincinnati College of MedicineCincinnatiUSA
  3. 3.Pediatric and Adolescent GynecologyChildren’s Hospitals and Clinics of MinnesotaMinneapolisUSA
  4. 4.Department of Obstetrics, Gynecology and Women’s HealthUniversity of MinnesotaMinneapolisUSA
  5. 5.Division of Adolescent and Transition MedicineCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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