Heavy menstrual bleeding in adolescence: who to investigate and how to manage it
Corresponding Author
S L Walter MBChB(hons) MRCOG
Speciality Registrar in Obstetrics and Gynaecology, Severn Deanery, UK
Correspondence: S L Walter. Email: [email protected]
Search for more papers by this authorS Channing MBBS MA(Cantab) MRCOG PGCertMedEd
Consultant Gynaecologist with a special interest in Paediatric & Adolescent Gynaecology, University Hospitals Bristol and Weston NHS Foundation Trust, St Michaels Hospital, Southwell Street, Bristol, BS2 8EG UK
Search for more papers by this authorN S Crouch MD MRCOG
Consultant Gynaecologist with a special interest in Paediatric & Adolescent Gynaecology, University Hospitals Bristol and Weston NHS Foundation Trust, St Michaels Hospital, Southwell Street, Bristol, BS2 8EG UK
Search for more papers by this authorCorresponding Author
S L Walter MBChB(hons) MRCOG
Speciality Registrar in Obstetrics and Gynaecology, Severn Deanery, UK
Correspondence: S L Walter. Email: [email protected]
Search for more papers by this authorS Channing MBBS MA(Cantab) MRCOG PGCertMedEd
Consultant Gynaecologist with a special interest in Paediatric & Adolescent Gynaecology, University Hospitals Bristol and Weston NHS Foundation Trust, St Michaels Hospital, Southwell Street, Bristol, BS2 8EG UK
Search for more papers by this authorN S Crouch MD MRCOG
Consultant Gynaecologist with a special interest in Paediatric & Adolescent Gynaecology, University Hospitals Bristol and Weston NHS Foundation Trust, St Michaels Hospital, Southwell Street, Bristol, BS2 8EG UK
Search for more papers by this authorAbstract
Key content
- Adolescent heavy menstrual bleeding (HMB) is commonly related to hypothalamic pituitary ovarian axis immaturity, which improves with age. This article outlines when and how to investigate for underlying pathological causes.
- Medical treatment for adolescent HMB consists predominantly of hormonal contraceptives. Preparation choice depends upon patient preference, comorbidities and co-existing conditions.
- Acute adolescent HMB is rare; a suggested framework for assessing and managing such cases is provided within this article.
Learning objectives
- To understand how to clinically evaluate adolescent HMB.
- To understand when and how to investigate adolescent HMB.
- To understand the different medical treatment options for HMB, their efficacy, risks and alternatives.
- To understand the management of acute adolescent HMB.
Ethical issues
- Duties of confidentiality must be balanced against safeguarding concerns.
References
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