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J Pediatr Adolesc Gynecol. 2015 Dec;28(6):499-501. doi: 10.1016/j.jpag.2015.03.001. Epub 2015 Mar 10.

Menstrual Patterns and Treatment of Heavy Menstrual Bleeding in Adolescents with Bleeding Disorders.

Author information

1
Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri. Electronic address: dowlutmcelroyt@umkc.edu.
2
Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
3
Section of Hematology, Division of Hematology/Oncology/Bone Marrow Transplant, Children's Mercy Hospitals, Kansas City, Missouri.
4
Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Section of Gynecological Surgery, Department of Surgery, Children's Mercy Hospitals, Kansas City, Missouri.

Abstract

STUDY OBJECTIVE:

To characterize menstrual bleeding patterns and treatment of heavy menstrual bleeding in adolescents with bleeding disorders.

DESIGN, SETTING, AND PARTICIPANTS:

We conducted a retrospective review of female patients aged nine to 21 years with known bleeding disorders who attended a pediatric gynecology, hematology, and comprehensive hematology/gynecology clinic at a children's hospital in a metropolitan area.

MAIN OUTCOME MEASURES:

Prevalence of heavy menstrual bleeding at menarche, prolonged menses, and irregular menses among girls with bleeding disorders and patterns of initial and subsequent treatment for heavy menstrual bleeding in girls with bleeding disorders.

RESULTS:

Of 115 participants aged nine to 21 years with known bleeding disorders, 102 were included in the final analysis. Of the 69 postmenarcheal girls, almost half (32/69, 46.4%) noted heavy menstrual bleeding at menarche. Girls with von Willebrand disease were more likely to have menses lasting longer than seven days. Only 28% of girls had discussed a treatment plan for heavy menstrual bleeding before menarche. Hormonal therapy was most commonly used as initial treatment of heavy menstrual bleeding. Half (53%) of the girls failed initial treatment. Combination (hormonal and non-hormonal therapy) was more frequently used for subsequent treatment.

CONCLUSIONS:

Adolescents with bleeding disorders are at risk of heavy bleeding at and after menarche. Consultation with a pediatric gynecologist and/or hematologist prior to menarche may be helpful to outline abnormal patterns of menstrual bleeding and to discuss options of treatment in the event of heavy menstrual bleeding.

KEYWORDS:

Adolescent; Bleeding disorder; Heavy menstrual bleeding; Menstrual patterns

PMID:
26231609
DOI:
10.1016/j.jpag.2015.03.001
[Indexed for MEDLINE]

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