Abnormal Uterine Bleeding In Adolescents Research Articles

Expert consensus on issues related to abnormal uterine bleeding in adolescents

Expert consensus on issues related to abnormal uterine bleeding in adolescents

Abnormal uterine bleeding in adolescents: modern views of the problem

Abnormal uterine bleeding in adolescents: modern views of the problem

An Assessment of the Quality of YouTube Videos as a Resource for Adolescents Experiencing Abnormal Uterine Bleeding

Study ObjectiveYouTube, the largest accessible media-sharing platform, has become an important tool for pursuing health-related information. Adolescents may find it challenging to seek counseling or access adolescent-friendly services for menstruation-related problems, so YouTube may be a useful resource. The aim of this study was to examine the reliability, quality, and accuracy of YouTube videos concerning abnormal uterine bleeding in adolescents. MethodsA YouTube search using the key words “adolescent, teens, heavy period, abnormal uterine bleeding, heavy menstrual bleeding” yielded 109 videos. Video features (duration, time since upload, likes, views, comments), sources of upload, and content were recorded. All the videos were reviewed by 2 adolescent medicine specialists and scored using the Journal of the American Medical Association, the 5-point modified DISCERN tool, and the Global Quality Scale. ResultsFifty-eight videos met the inclusion criteria. Most (62.1%) were created by non-professionals, and a significant portion (81%) contained general descriptions. On the basis of the DISCERN classification, 50% exhibited poor quality. Similarly, the Journal of the American Medical Association assessment indicated that only 36.2% satisfied the requirements for good quality. The videos uploaded by professionals exhibited notably superior quality in comparison with those uploaded by non-professionals. Additionally, higher-quality videos were longer (P = .040) and more recent (P = .011). ConclusionMot YouTube videos about adolescent abnormal uterine bleeding provide low-quality information. We believe that increasing the number of videos tailored by health care providers specializing in adolescent gynecology to address the specific physical and psychosocial needs of adolescents with menstrual problems would be beneficial.

Evaluation of Abnormal Uterine Bleeding in Adolescents: Single Center Experience.

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. 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. 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. 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.

HTRS2023.P3.5 Screening for abnormal uterine bleeding in adolescents presenting to primary care clinics

HTRS2023.P3.5 Screening for abnormal uterine bleeding in adolescents presenting to primary care clinics

ИСТОРИЯ И СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ОТЕЧЕСТВЕННОГО ЗДРАВООХРАНЕНИЯ В СФЕРЕ ОХРАНЫ РЕПРОДУКТИВНОГО ЗДОРОВЬЯ ДЕВОЧЕК

The article is devoted to the problems of gynecology of children and adolescents. The historical information about the formation of specialized gynecological medical care for girls in Russia from the first thematic publications at the end of the XIX Century to modern days is given. The achievements of gynecologists in diagnostics and treatment of main diseases of reproductive system that represent major problematics within the medical community are observed as well, such as: the norm and the pathology of vaginal and vulva microbiocenosis; eligibility of establishing of a diagnoses of polycystic ovary syndrome and genital endometriosis in menstruating adolescent girls; relapses of abnormal uterine bleeding in adolescents; the quality of life and the prevention of surgical complications in adolescent girls with defects in the development of uterus and vagina; the possibility of rehabilitation of a follicular reserve in girls with premature ovarian exhaustion.

Abnormal uterine bleeding in adolescents

Abnormal uterine bleeding (AUB) is a common diagnosis in the adolescent female population. In recent years, changes have been made to standardize nomenclature, evaluation and management of AUB in adolescents. The terms "abnormal uterine bleeding" and "heavy menstrual bleeding" have replaced terms including "dysfunctional uterine bleeding," "menorrhagia," "metrorrhagia", and "menometrorrhagia." Due to a high prevalence of these diagnoses in this population and resulting effects on quality of life, clinicians should understand and practice current evidence-based care, yet variability continues to exist. Evaluation should be focused on common etiologies of AUB in adolescents, namely non-structural causes, rather than those etiologies more common in adult females. The aim of this article is to review the existing definition, etiologies, pathophysiology, evaluation and management of AUB in adolescent females, with an emphasis on current universally accepted nomenclature and guidelines for use in clinical care.

Evaluation and management of acute abnormal uterine bleeding in adolescents: oral contraceptive pill taper versus single-dose therapy, a pilot study

Background: Hormonal management is first-line therapy for acute abnormal uterine bleeding (AUB) in adolescents. Studies have demonstrated efficacy of oral contraceptive pill (OCP) and progestin tapers and single dose therapy for acute AUB, but comparative studies, side effects and patient satisfaction rates are lacking. Our objective was to implement QI measures to standardize evaluation of acute AUB and prospectively assess time to amenorrhea, patient satisfaction and side effects in teens treated with OCP taper versus single-dose OCP and progestin.

165 Abnormal uterine bleeding in adolescents as a common medical problem of demographic situation in ukraine

Relevance: Abnormal uterine bleeding is a common medical problem that directly affects the quality of life of girls. In Ukraine, the number of adolescents with abnormal uterine bleeding is growing every year. Aim: The aim is to study the causes, frequency and treatment of AUB and the relationship with somatic and psychological pathology in adolescents. Materials and methods: We analyzed 62 cases of AUB. Patients were adolescents 11-17 years old. They were examined and treated at the clinical bases of Department of Obstetrics, Gynecology and Pediatric Gynecology of Kharkiv National Medical University.

Abnormal Uterine Bleeding in Adolescent

Abnormal uterine bleeding (AUB) is defined as the abnormal bleeding from the uterine corpus in term of duration, volume, frequency and/or regularity. This condition occurs in 37% of adolescents and may affect the quality of life and increased hospitalization. Etiology is divided into structural and non-structural causes, known as PALM-COEIN. The most common etiology in adolescents is anovulatory menstruation due to immature hypothalamus-hypophysis axis. Diagnostic evaluation should include investigation in the etiology of AUB, anemia signs, and hemodynamic status. Treatment of AUB consists of hormonal and non-hormonal therapy. Therapy in adolescent is given based on the severity of bleeding, grading of anemia, and hemodynamic stability. Follow-up is required after therapy. Understanding AUB in adolescents can help clinicians deliver appropriate and comprehensive treatment. This review was aimed to explain about definition, epidemiology, etiology, pathophysiology, diagnosis, and treatment of abnormal uterine bleeding in adolescent.

70. Improvements in Management of Abnormal Uterine Bleeding in Adolescents after Implementation of a Clinical Decision Guideline within the Emergency Room Setting

<h3>Background</h3> Abnormal uterine bleeding (AUB) is a common gynecologic problem among adolescents, and is broadly described as menstrual bleeding that is abnormal in timing, duration, or quantity. While there are abundant guidelines for assessment and management of this condition in adults, there is no current standard of practice for the adolescent population. This lack of standardized recommendations, combined with provider knowledge gaps, often leads to disorderly workup and management. Dell Children's Medical Center (DCMC) created an AUB clinical guidelines pathway, published in May 2015, for use in the emergency department to standardize clinical decision-making. The utilization rate by emergency department practitioners, as well as the impact of standardizing practice with this pathway, has yet to be studied. <h3>Methods</h3> A 14-question survey was designed to assess if DCMC providers have awareness of the protocol, if they use it to assist with management, and their general knowledge of broad concepts reinforced within the protocol. The survey was emailed to attending physicians, associate providers, fellows, and pediatrics and emergency medicine resident physicians who have worked in the ER at Dell Children's for at least 6 months. <h3>Results</h3> A response rate of 40% was achieved. Half of respondents were residents. 72% reported that they do refer to the above-mentioned protocol for guidance on management and treatment of adolescent patients, and over 90% access the protocol through the DCMC intranet. Of those who don't use the protocol, 30% stated they use their own personal practice guidelines. All answered correctly that "A sterile speculum exam is not indicated for every patient", and 86% appropriately answered "false" to the statement "A pelvic ultrasound is always the first step in work-up for abnormal uterine bleeding in adolescents". However, despite most providers stating that they used the protocol, over half (53%) answered "false" to the statement "All patients presenting with AUB should be screened for a bleeding disorder". Additionally, 22% of respondents answered incorrectly when asked about absolute contraindications to estrogen therapies. <h3>Conclusions</h3> Overall, the response rate and respondent make-up of this survey provided an accurate representation of the providers that work in the DCMC emergency department. While most providers have knowledge of the clinical guidelines protocol and state they use it, the responses reveal significant knowledge gaps in the appropriate diagnosis and management of this condition from both resident and attending providers. Further education of physicians regarding AUB in adolescents, as well as easier access to the protocol may be helpful in improving provider compliance.

13. Contraceptive Implant-associated Abnormal Uterine Bleeding in Adolescents and Young Adults: Predictors, Management, and Rates of Continuation

<h3>Background</h3> Abnormal uterine bleeding (AUB) is commonly experienced by adolescents and young adults (AYA) following contraceptive implant placement. We assessed for predictors of AUB, factors contributing to AUB management, and differences in implant continuation rates by AUB management approach. <h3>Methods</h3> We analyzed data from a long-acting reversible contraception database from 3 AYA sites in tertiary care institutions. We included patients with the contraceptive implant placed from 7/1/2014-12/31/2018 and follow-up data through 12/31/2019. We excluded patients with ≥3 years since insertion without follow-up. Variables included age at insertion, comorbid conditions, menstrual history, prior contraceptive use, patient-reported AUB after implant placement, AUB evaluation and management, and implant discontinuation. We included data from insertion, follow-up, and removal visits. We assessed AUB predictors with logistic regression. Descriptive statistics, chi-square, and t-tests compared patient demographic and clinical variables by AUB status. Survival analysis examined predictors of time to discontinuation. This study was IRB approved. <h3>Results</h3> Our sample included 609 patients, average age was 19 years (SD=2.5). Prior to implant placement 37% reported irregular menses, and after insertion 25% reported AUB. In those with AUB, 67% had evaluation and management including laboratory studies (32%), pelvic ultrasound (4%), or medication therapy (86%). Medication initiation occurred at first AUB report for the majority of patients. Of those prescribed a medication, 60% received a combined oral contraceptive or progestin-only pill. AUB was associated with polycystic ovary syndrome (PCOS) in bivariate analysis (p-value=0.006), 57% of patients with PCOS (n=14) reported AUB after implant insertion. This association persisted after adjusting for age, medical comorbidities, menstrual history, and prior contraceptive use. Bivariate analyses did not identify any predictors for AUB evaluation and management. Implant discontinuation was low: 16% at 1 year, 27% at 2 years, and 35% at 3 years. Early discontinuation was significantly different between patients with and without AUB: 21% vs. 14% at 1 year (p-value=0.047), 38% vs. 23% at 2 years (p-value=0.000), 44% vs. 31% at 3 years (p-value=0.007). Medication for AUB management did not impact rates of or time to early discontinuation. <h3>Conclusions</h3> In this large cohort of AYA, PCOS was the only significant predictor of implant-associated AUB. There were no relationships between AUB and comorbid medical conditions or prior contraceptive use. There were no significant predictors of AUB evaluation and management following implant insertion, and such evaluation and management did not impact rates of early discontinuation.

62. Contraceptive Implant-Associated Abnormal Uterine Bleeding in Adolescents and Young Adults: Predictors, Management, and Rates of Continuation

62. Contraceptive Implant-Associated Abnormal Uterine Bleeding in Adolescents and Young Adults: Predictors, Management, and Rates of Continuation

Recommendations of the Group of Experts of the Polish Society of Gynecologists and Obstetricians regarding abnormal uterine bleeding in adolescents.

The recommendations present the current knowledge and procedures, which can be modified and changed in some cases, after careful analysis of a given clinical situation, which in the future may become the basis for their modification and updating.

Approach to Abnormal Uterine Bleeding in Adolescents

This article reviews the current understanding and management of abnormal uterine bleeding (AUB) in adolescents. It is hoped that this review will provide readers with an approach to the evaluation and treatment of mild to severe uterine bleeding. AUB is a common problem which has significantly adverse effects on an affected adolescent’s quality of life. The most common underlying condition in AUB in adolescence is anovulation. During the evaluation, pregnancy, trauma and sexually transmitted diseases must be ruled out, regardless of history. It should be kept in mind that AUB during this period may be the first sign of underlying bleeding disorders. Although observation is sufficient in the mild form of AUB, at the other end of the spectrum life-threatening bleeding may necessitate the use of high doses of combined oral contraceptives, intravenous estrogen and/or interventional procedures.

ABNORMAL UTERINE BLEEDING IN ADOLESCENTS: CURRENT STATE OF THE PROBLEM

The aim: To summarize the literature data on abnormal uterine bleeding in adolescents. Materials and methods: This article presents an assessment of 32 literary sources from 2003 to 2018, which raise the issues of etiology and pathogenesis of abnormal uterine bleeding in adolescents. Abnormal uterine bleeding in adolescents (AUBA) is a risk factor for disorders of menstrual and generative function, hormone-related abnormalities in the reproductive age. Despite the progress made in the development of methods for the diagnosis and treatment of AUBA, the criteria for selecting a particular method of diagnosis and therapy have not yet been made sufficiently clear. Conclusions: AUBA is a complex polyetiological disease affecting all parts of the hypothalamic-pituitary-adrenal-ovarian system. It has a negative impact on the girl's health and quality of life. Abnormal uterine bleeding is a "signal" to the body of an organic or functional disorder. If this feature is ignored, the pathology can progress and lead to severe consequences. The urgency of the problem of AUBA is further explained by the fact that this disease indicates the presence of serious disorder of the reproductive system, which in the future may be transformed into impaired reproductive function.

Is polycystic ovarian syndrome and insulin resistance associated with abnormal uterine bleeding in adolescents?

The aim of the study was to determine if adolescents with juvenile bleeding had polycystic ovarian syndrome (PCOS) and insulin resistance. The study was conducted in a group of 43 females aged 12-18 years, diagnosed with juvenile menorrhagia, and 37 healthy female adolescents aged 12-18 years. The study was conducted during the early follicular phase of the menstrual cycle. Menstrual cycle disturbances, acne and hirsutism were recorded. Ultrasound scan determining the condition of the ovaries was conducted. Laboratory tests of the glucose level, cholesterol, LDL and HDL cholesterol and triglycerides fraction, DHEAS, FSH, LH, insulin, SHGB, total testosterone, androstenedione, and free testosterone have been established. The occurrence of regular menstrual cycles (30.23%, p = 0.006) was significantly lower in the juvenile bleeding group. Also, secondary amenorrhea was significantly more likely to be recognized in this group of females (p = 0.03). The concentration of FSH was considerably lower (p = 0.0002) in the group of adolescents with AUB. Adolescents with abnormal uterine bleeding (AUB) are often diagnosed with secondary amenorrhea, and PCOS. The group with a diagnosis of juvenile bleeding was also diagnosed with higher rates of insulin resistance.

Adolescent Contraception in the Emergency Department: Abnormal Uterine Bleeding and Beyond

The emergency department (ED) is a frequent and important site for gynecologic care, and many women present to the ED for reproductive health concerns such as abnormal menses. Due to early menstrual age and increased incidence of sexually transmitted infections, adolescents are particularly prone to abnormal menses, but are also disproportionately affected by unintended pregnancy. While EDs have long been used for the evaluation and initial management of abnormal uterine bleeding, general contraceptive provision in the ED is a novel approach to addressing unmet contraceptive needs among adolescent women. We review normal menstruation and the evaluation and management of abnormal uterine bleeding in adolescents, including the use of combined oral contraceptives. Expanding on this established indication for contraceptive use in the ED, we present attitudes, barriers, and approaches to ED provision of contraceptives for adolescent pregnancy prevention.

Abnormal uterine bleeding in adolescents: ultrasound evaluation of uterine volume

Objective: To evaluate ultrasonographic measurements of internal genitalia in girls suffering from abnormal uterine bleeding (AUB) and to compare the appearances with those of healthy girls. DESIGN Prospective case – control study.Methods: One hundred and five not sexually active adolescent girls were enrolled – 67 patients were suffering from AUB and there were 38 healthy peers. The groups did not differ in chronological age, or in postmenarcheal age. All girls underwent assessment of their history, clinical data and transabdominal pelvic ultrasound to evaluate their uterus and ovaries. In order to avoid the impact of endometrium cycle fluctuations, the uterine volume was calculated including and excluding its thickness.Results: The uterine volume among the girls suffering from AUB was significantly larger than in the control group. The mean uterine volume including endometrium in the study and control groups was 63.2 ± 24.8 and 47.8 ± 17.5 cm3, respectively (p=.001), and excluding the endometrium was 34.7 ± 13.1 and 29.1 ± 13.8 cm3 (p=.043). We did not find any significant difference in ovarian volume between the groups.Conclusions: The girls in the AUB group have significantly larger uterine volume than healthy girls. This finding does not depend on endometrial thickness.

Abnormal uterine bleeding in adolescents: experience of a single center

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)