ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 16 Issue: 3 Year: 2024
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Turkish Society for Pediatric Endocrinology and Diabetes
Evaluation of Abnormal Uterine Bleeding in Adolescents: Single Center Experience [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2023; 15(3): 230-237 | DOI: 10.4274/jcrpe.galenos.2023.2022-10-7

Evaluation of Abnormal Uterine Bleeding in Adolescents: Single Center Experience

Sirmen Kızılcan Çetin1, Zehra Aycan2, Elif Özsu1, Zeynep Şıklar1, Ayşegül Ceran1, Seda Erişen Karaca1, Gizem Şenyazar1, Merih Berberoğlu1
1Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
2Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey and Ankara University Faculty of Medicine, Department of Adolescent Health, Ankara, Turkey

INTRODUCTION: Abnormal uterine bleeding (AUB) is the most common gynecologic complaint in adolescent girls. The aim of this study was to identify the diagnostic and management differences between those with/without heavy menstrual bleeding.
METHODS: Retrospective data was collected from adolescents aged 10-19 years, diagnosed with AUB. Adolescents with known bleeding disorders at admission were excluded. All girls were classified according to the degree of anemia; group 1 had heavy bleeding [hemoglobin (Hb) <10 g/dL] and group 2 had moderate or mild bleeding (Hb >10 g/dL). Admission and follow-up characteristics were compared between the two groups.
RESULTS: The cohort consisted of 79 girls with a mean age of 14.3±1.8 years and mean age of menarche of 11.9±1.4 years, with 85% experiencing menstrual irregularity in the two years after menarche, rising to 95.3% in group 1 (p<0.01). Anovulation was evident in 80% of the cohort. Of these 79 girls, 13 (16.5%) had polycystic ovary syndrome and two (2.5%) had structural anomalies (uterus didelphys). Three girls (group 1, n=2) had previously undiagnosed clotting factor VII deficiency; no other clotting deficiencies were diagnosed. Nineteen of 34 (56%) with personal (n=2)/family history of thrombosis had MTHFR mutation. None had venous thromboembolism during follow-up of >6 months.
DISCUSSION AND CONCLUSION: The majority of AUB (85%) occurred in the first two years after menarche. A small proportion (3.8%) had undiagnosed clotting factor deficiency. The frequency of MTHFR mutation was 50% in girls with history of thrombosis; however this did not increase the risk of bleeding/thrombosis and so routine evaluation does not appear to be justified.

Keywords: Abnormal uterine bleeding, adolescents, anovulatory bleeding, heavy menstrual bleeding

Corresponding Author: Sirmen Kızılcan Çetin, Türkiye
Manuscript Language: English
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