Dysfunctional uterine bleeding in adolescence

George Creatsas (GR)

[Creatsas] Uni of Athens

Menstrual disorders is a common problem during adolescence presented in approximately 60% of young girls during the first two gynecological years. Dysfunctional uterine bleeding (DUB) is usually a painless, excessive and irregular endometrial bleeding not attributable to any underlying structural or systemic disease. DUB is usually due to the late maturation of the hypothalamic pituitary ovarian axis and is classified as mild, moderate and severe, depended on the clinical and laboratory findings. The etiology of bleeding arises out of continuing maturation of the hypothalamus. The European Society of Human Reproduction and Embryology (ESHRE) reports DUB as an excessive bleeding of uterine origin, which is not due to any systemic disease or complications of pregnancy. According to ESHRE, DUB can be either ovulatory or anovulatory. Diagnosis is based on the clinical and physical examinations, the pelvic ultrasonography and the laboratory findings. Management depends on the severity of the disease. The use of progestogens, the new generation combined oral contraceptives, the non steroidal anti-iflammatory and anti-fibrinollytic drugs and occasionally the mini-IUDs are recommended. Hospitalization is recommended in severe cases, as well proper consultation provided by experts, to the child and the family, mainly by Pediatric and Adolescent Gynecological Services. The Stuff of the Institution must take care during the discussion with the adolescent or/and the mother to avoid medical terms and exaggeration of the problem to prevent further psychosocial side effects.