J Clin Res Pediatr Endocrinol. Ahead of Print: JCRPE-37232 | DOI: 10.4274/jcrpe.galenos.2023.2022-10-7

Evaluation of Abnormal Uterine Bleeding in Adolescents: Single Center Experience

Sirmen Kýzýlcan Çetin¹, Zehra Aycan², Elif Özsu¹, Zeynep Þýklar¹, Ayþegül Ceran¹, Seda Eriþen Karaca¹, Gizem Þenyazar¹, Merih Berberoðlu^1
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 adolescent girls' most common gynecologic complaint. This study aimed to determine the diagnostic and management differences between those with/without heavy menstrual bleeding.
METHODS: We collected retrospective data such as follow-up, final control, and treatment regimen of adolescents aged 10-19 with the diagnosis of AUB. We excluded adolescents with known bleeding disorders at admission. We classified all subjects according to the level of anemia. Group 1 consisted of subjects with heavy bleeding (Hb<10 g/dl), and the rest with moderate and mild bleeding (Hb>10 g/dl) presented in Group 2. Admission and follow-up characteristics between the two groups were compared.
RESULTS: In this study, we included 79 adolescent girls with a mean age was 14.3±1.8 years. 85% of all had a menstrual irregularity in the first two years after menarche. Anovulation was observed in 80%. 95% of group 1 had irregular bleeding in the two years (p<0.01). In all subjects, while 13 girls (16%) were diagnosed with PCOS, two adolescents (2%) had structural anomalies. No adolescents had hypothyroidism or hyperprolactinemia. Three (10.7%) were diagnosed with Factor 7 deficiency. Nineteen girls had MTHFR mutation. None had venous thromboembolism during at least six month-follow-up-period.
DISCUSSION AND CONCLUSION: This study showed that 85% of AUB had occurred in the first two years. We found the frequency of hematological disease (Factor 7 deficiency) 10.7%. The frequency of MTHFR mutation was 50%. We thought this did not increase the risk of bleeding/thrombosis. Its routine evaluation was not necessarily due to the similarity in population frequency.

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

---