Abstract
Objectives: To evaluate the causes of puberty menorrhagia and effect of hormonal (Progestogens, estrogens and Combined Oral Contraceptive pills) and non-hormonal methods in the management of puberty menorrhagia.Methods: This prospective study included 51 subjects, who presented with puberty menorrhagia to Department of Obstetrics and Gynaecology, King George Medical University, Lucknow from August 2014 to August 2015. Assessment of each case with thorough history, physical examination and laboratory investigations was done. The underlying cause was diagnosed and the relevant treatment started and subjects kept under regular follow up.Results: In 26 (50.98%) subjects, immaturity of hypothalamic pituitary ovarian axis was the main cause of pubertymenorrhagia, 6 (11.76%) subjects had hypothroidism,5 (9.80%) subjects had polycystic ovarian syndrome, 4 (7.8%) subjects had idiopathic thrombocytopenic purpura, 2 (3.9%) subjects had disseminated intravascular coagulopathy, 3 (5.88%) subjects had hyperprolactinemia, 3 (5.88%) subjects had both hypothyroidism and hyperprolactinemia, 2(3.92%) subjects had fibroid uterus. All patients responded to medical management.Conclusion: Puberty menorrhagia is a distressing condition both for the subject as well as her parents. Most of thecases are due to anovulatory cycles which is a self-limiting condition at perimenarchal age group. Counseling and reassurance ofthe subjects is an important part of management. Long term medical treatment is successful in the majority of cases and rarely surgical intervention is required. Blood transfusion is required in a few cases.
Highlights
Puberty is defined as a period during which secondary sexual characters begin to develop and the capability of sexual reproduction is attained
In this Prospective study total 51 young girls from age of menarche to 19 years recruited after taking informed consent with history of excessive bleeding pervaginum, attending outpatient department (OPD) or admitted to the Department of Obstetrics and Gynaecology, King George’s Medical University, Lucknow were included in the study
Phillip et al [23] reported that 3 al [14] 58.3% cases of puberty menorrhagia due to patients (8.6%) had idiopathic thrombocytopenic purpura immature hypothalamo-pituitary-ovarian axis
Summary
Puberty is defined as a period during which secondary sexual characters begin to develop and the capability of sexual reproduction is attained. It is the process of biological, cognitive and psychosocial maturation [1,2] Puberty menorrhagia is a very common gynaecological problem in adolescents, incidence being 10% in Indian population. A normal menstrual cycle lasts from 21 days to 35 days with 2-6 days of flow and an average blood loss of 20 – 60 ml. In per cycle 35 ml average blood is loss, and the major component of menstrual discharge is endometrial tissue [4]. The transition of an ovulatory to ovulatory cycles during adolescence takes place during the www.ssjournals.com
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