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Abnormal Uterine Bleeding in Adolescent Women

  • Adolescent Medicine (M Goldstein and L Johnson, Section Editors)
  • Published:
Current Pediatrics Reports Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Division of Hematology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA

    Eric S. Mullins

  2. University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870, 3230 Eden Avenue, Cincinnati, OH, 45267, USA

    Eric S. Mullins & Tanya L. Kowalczyk Mullins

  3. Pediatric and Adolescent Gynecology, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA

    Rachel J. Miller

  4. Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, MN, 55455, USA

    Rachel J. Miller

  5. Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 4000, Cincinnati, OH, 45229, USA

    Tanya L. Kowalczyk Mullins

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  1. Eric S. Mullins
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  2. Rachel J. Miller
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  3. Tanya L. Kowalczyk Mullins
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Correspondence to Tanya L. Kowalczyk Mullins.

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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.

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This article is part of the Topical Collection on Adolescent Medicine

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Mullins, E.S., Miller, R.J. & Mullins, T.L.K. Abnormal Uterine Bleeding in Adolescent Women. Curr Pediatr Rep 6, 123–131 (2018). https://doi.org/10.1007/s40124-018-0164-9

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  • DOI: https://doi.org/10.1007/s40124-018-0164-9

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