Menstrual Disorders In Adolescents Research Articles

ABNORMAL UTERINE BLEEDING AT DIFFERENT PERIODS OF A WOMAN'S LIFE

Abnormal uterine bleeding (AUB) is a common gynecological problem affecting women at different stages of life: from adolescence to menopause. This article discusses statistical data and the main causes leading to AUB in different age groups. Attention is drawn to the characteristic features of menstrual disorders in adolescents, women of reproductive age and during menopause, and modern treatment, including both conservative and surgical methods, is presented. Research shows that adequate diagnostics and an individualized approach to treatment can significantly improve the quality of life of patients and prevent serious complications. The article emphasizes the importance of early medical care and regular gynecological examinations to ensure women's health at all stages of their lives.

Potensi Air Kelapa Hijau Dan Kompres Hangat Dalam Mengatasi Dismenore Primer Pada Remaja Putri: Studi Di PMB S Tahun 2023

Based on adolescent report from Pandeglang Regency Health Office, there are 1178 cases of menstrual disorders in adolescents. Based on adolescent program report at UPTD Puskesmas Cikeusik until November 2022, 43.5% of adolescents experience dysmenorrhea or menstrual disorders. The impact of dysmenorrhea causes discomfort, difficulty concentrating in learning and decreased motivation to learn because of the pain felt, can limit women to carry out daily activities so that the need for handling dysmenorrhea in adolescents. The aim is to determine the effectiveness of green coconut water on reducing primary dysmenorrhea pain in adolescent girls in 2023. The sample population in this study were 2 respondents, namely adolescents who experienced primary dysmenorrhea by comparing directly to the response of green coconut water and warm water compresses. The research time was carried out on February 6, 2024 to February 10, 2024 and February 9 to February 11, 2024. Methods Data collection methods by means of assessment, namely interviews to explore the data needed related to the research to be carried out on adolescent girls with primary dysmenorrhea. The results showed a reduction in the pain scale after being given green coconut water. Conclusion In the results of the study, significant results were obtained in reducing primary dysmenorrhea, namely drinking green coconut water 1-3 days of menstruation, because the results obtained reduced pain from scale 4 to scale 2. Suggestions It is expected to apply the green coconut water method and warm water compresses on reducing dysmenorrhea pain.

Hormonal profiles and adjustment disorders in adolescent girls with menstrual abnormalities and comorbid pathology

Background. The reproductive health of girls has acquired great social significance in connection with the problem of quantitative and qualitative reproduction of the population. The purpose of the study was to determine the hormonal status of adolescent females with menstrual disorders and various somatic pathologies and to investigate the state of adaptive-compensatory capacities in these patients. Materials and methods. The hormonal background was studied in 391 girls aged 12–17 years: 175 with abnormal uterine bleeding (AUB) and 216 with oligomenorrhea (OM). All patients were examined by a multidisciplinary team. Results. A comorbid pathology was found in the absolute majority of girls with menstrual abnormalities. Endocrine disorders were noted more often (pϕ < 0.001–0.00001). Indicators of hormone concentration in patients with menstrual disorders had no significant differences depending on the type of comorbidity. Probable changes in the content of some hormones were observed depending on the type of menstrual disorders. A significant increase in the level of luteinizing hormone (pu < 0.02) and a decrease in estradiol (pu < 0.02) were observed in patients with OM compared to those with AUB. The assessment of the adjustment state revealed that in girls with menstrual disorders, the average cortisol content did not differ from that of controls, and insulin was higher than in the comparison group (pu < 0.001). Ho­wever, high cortisol values (above 90 percentile) were noted in 8–13 % of patients with AUB and OM. The stress index (C/In) as a marker of a nonspecific stress response was lower than in the comparison group (pu < 0.0001), and it was probably higher in girls with OM than in adolescents with AUB (pu < 0.004). Conclusions. An interdisciplinary approach is a mo­dern strategy in the treatment of menstrual disorders in adolescence. A decrease in the stress index was found in girls with menstrual disorders, which may indicate a decrease in adaptive capacity. Moreover, adolescents with OM are more adjusted to menstrual disorders than girls with AUB.

Stress-induced menstrual disorders in adolescents during the Ukrainian war: cross-sectional study.

A cross-sectional study of 120 Ukrainian girls aged 9-18 asked to complete a survey about their menstrual cycle status 3-6 months after the war began. Other examination methods used included anthropometry, laboratory, and instrumental studies. The frequency of menstrual cycle disorders in the study group was 65.8% (n=79). The following menstrual cycle disorders were most frequently reported; dysmenorrhea 45.6% (n=36), excessive menstruation during puberty 27.8% (n=22), and secondary amenorrhea 26.6% (n=21). The 52.5% (n=63) of those examined had pathological menarche. The 81.7% (n=63) of respondents reported a change in eating habits in the previous few months. The 61.9% (n=39) of these children had dyshormonal disorders or met the criteria for metabolic syndrome. Adolescent females under stress warrant a quick assessment of their psychoemotional and metabolic conditions. The protection from future menstruation and reproductive illnesses depends on this tactic. By diagnosing these conditions promptly and well-managed, adolescent females may maintain good physical and emotional health.

Menstrual disorders in adolescents and young adults with eating disorders

Although amenorrhea is no longer a specific criterion required to make the diagnosis of anorexia nervosa (AN), the relationship between restrictive eating and menstrual status remains important in the diagnosis, treatment, and consequences for patients with eating disorders. Clinicians should understand the relationship between menstrual irregularities and malnutrition due to eating disorders, as it may be possible to intervene sooner if the diagnosis is made earlier. Treatment of AN (in those who are underweight) and atypical AN (in those who are not underweight) is aimed at cessation of restrictive thoughts and behaviors, restoration of appropriate nutrition and weight, and normal functioning of the body. While eating disorder thoughts and behaviors are helped by both therapy and nutrition, regular functioning of the body, including regular menstruation, is linked to both appropriate nutrition and weight. Patients who are not underweight based on their body mass index (BMI) may still have oligo/amenorrhea due to their caloric restriction; thus any patient who has irregular menses should have a detailed dietary evaluation as part of their workup. Timely diagnosis and treatment of patients with eating disorders and amenorrhea is important due to the impact on bone mass accrual for adolescents who have prolonged amenorrhea. Menstrual abnormalities may also be seen in patients with bulimia nervosa (BN).

Audio Visual Media-Based Health Education Increases Knowledge of Menstrual Disorders in Adolescence

Background: students' knowledge about menstrual disorders is still inadequate so that it will have an impact on disrupting learning activities, difficulty concentrating, mood changes, anemia, etc. So it is necessary to increase knowledge about menstrual disorders with interesting health education by using audio-visual media. Purpose: to determine the effect of health education with audio-visual media on knowledge of menstrual disorders in adolescents. Method s : this study used a pre-experimental design with a one-group pretest-posttest design. The sampling technique used proportional random sampling technique as many as 41 respondents, the sample selection used the lottery technique. The research instrument used is a questionnaire. Data analysis used the Wilcoxon test. Results: based on the results p -value = 0.000, it can be concluded that there is an effect of health education with audio-visual media on the level of knowledge about menstrual disorders in adolescent girls. Conclusion: it is needed that teenagers can increase their knowledge about menstrual disorders through reading books, electronics, or other printed media so that they can handle menstrual disorders when they occur.

Studying the factors associated with Premenstrual syndrome prevention among pre-university students in Tehran.

SummaryIntroductionPremenstrual syndrome is one of the common menstrual disorders in adolescents. Considering the destructive effects of this syndrome on adolescents’ activity and performance and the importance of epidemiological studies in designing preventive interventions,AimThis study aimed to determine some of the factors associated with the prevention of premenstrual syndrome among adolescents.Settings and DesignIn a cross-sectional study, 255 female high school students in Tehran were selected using multistage random sampling method.Methods and MaterialThe data were collected using a demographic and background questionnaire and a valid and reliable questionnaire to assess preventive behaviors of premenstrual syndrome.Statistical analysis usedThe collected data were analyzed using SPSS software version 16 and descriptive statistics and logistic regression.ResultsThe mean (SD) score of adoption of preventive behaviors of premenstrual syndrome was 19.25 (0.63) out of 50, and it was low. Also, weekly physical activity, mother education level, and family income were the factors affecting the adoption of preventive behaviors of premenstrual syndrome (P < 0.05).ConclusionDue to the low adoption of preventive behaviors among students with lower income families, students with less physical activity and students with mothers with lower levels of education, it is suggested that more attention be paid to the above students in designing educational programs to promote the prevention of premenstrual syndrome.

Menstrual Disorders and Main Indicators of Hormonal and Metabolic Homeostasis in Teenage Girls Against the Background of Endemic Goiter

Along with the widespread prevalence of goiter endemics, the medical and social significance of this problem is determined by the multifaceted spectrum of pathological abnormalities associated with asymptomatic course or hypothyroxinemia, causing numerous disorders at almost all stages of menstrual and reproductive function development.&#x0D; The objective of the research was to substantiate and conduct a comprehensive analysis of the prevalence, structure and leading factors of dishormonal disorders of menstrual function in adolescent girls with diffuse endemic goiter, and to develop a diagnostic algorithm based on the risk of the formation of this pathology.&#x0D; Materials and Methods. Two study groups were formed and a clinical laboratory examination was performed in 210 patients: 120 of them were diagnosed with menstrual dysfunction against the background of thyroid dysfunction (the main group); 60 girls were diagnosed with menstrual dysfunction and healthy thyroid gland (the comparison group); 30 apparently healthy girls made up the control group. Experimental and psychological methods, hormonal investigation of the level of thyroid, gonadotropic and steroid hormones, lipid and carbohydrate metabolism and vitamin D content in blood plasma were used.&#x0D; Results and Discussion. Hypomenstrual syndrome, secondary amenorrhea, dysmenorrhea, manifestations of premenstrual syndrome and anovulatory conditions are the main menstrual disorders in adolescents suffering from endemic goiter. One third of the girls in the main group had an increase in the proportion of delayed sexual development, while in the control group, physiological rates of sexual development occurred in 96.7% of observations. The presented hormonal studies made it possible to identify differentiated changes taking into account different clinical forms of menstrual disorders in this category of patients. The transition to the “mature” type of reproductive system functioning in girls with endemic goiter is associated with changes in prolactin secretion from low levels to the indicators that exceed the reference values, which is characterized by increased functional hyperprolactinemia. Generalization of the frequencies of the main psycho-emotional characteristics and indicators of the personal profile in the girls of the studied cohort allowed revealing the constant dominance of psycho-emotional manifestations of moderate degree, as well as high levels of psycho-emotional stress and depressive disorders against the background of dishormonal disorders and thyroid gland dysfunction. Obtained deviations of 25-hydroxyvitamin D level were noticed at the initial stages of thyroid disorder, and low 25-hydroxyvitamin D levels contributed to the manifestation of thyroid pathology.&#x0D; Conclusions. Dissociation of the thyroid system and the hypothalamic-pituitary-ovarian axis initiates menstrual disorders, development of functional cysts and multifollicular structure of the ovarian tissue, and, in case of hypothyroidism, is considered as a factor of metabolic disorders and polycystic ovary syndrome.

Risk factors in adolescence for the development of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common gynaecological endocrinopathy in women of fertile age and represents a major health issue among women affecting not only reproductive function, but also emergence of the most frequent causes of morbidity and mortality in women of postmenopausal age – type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). The current epidemic of obesity suggests that the prevalence of PCOS and its adverse health effects may rise even further in the future. The ability to predict development of PCOS early in life would be essential to decrease and prevent late morbidity linked to PCOS, although, on the other hand, over-diagnosis should be avoided as it can lead to unnecessary labelling and can impact on an adolescent’s quality of life. Systematic search in the Medline literature database through PubMed using the search terms “Polycystic ovary syndrome”, “PCOS”, “Adolescents”, “Polycystic ovary morphology”, “PCOM”, “Menstrual disorders in adolescence”, “Hirsutism”, “Hyperandrogenaemia”, “Anti-Mullerian hormone”, “Obesity and adolescents” and “Prediction of PCOS”. Follow-up and re-evaluation are warranted in all adolescents with features suggestive of PCOS, such as menstrual irregularities two or more years after menarche, or a menstrual interval >90 days, moderate to severe hirsutism and moderate to severe inflammatory acne vulgaris unresponsive to topical medication. Because of the strong association between obesity, weight gain through life, hyperandrogenism and development of PCOS, screening for PCOS and overweight/obesity as early as in adolescence is important in order to tailor treatment and intervention protocols and reduce future risks of infertility, CVDs and T2DM.

Keterhubungan antara Faktor Gangguan Menstruasi Mahasiswi STKIP Pasundan Cimahi

Menstrual disorders are a problem that is often found with the highest prevalence in late teens. If not treated, menstrual disorders can affect the quality of life and daily activities. Research on menstrual disorders in adolescents has not been done much in Indonesia. The purpose of this study was to determine how much the relationship between menstrual disorders in the Department of Sport and related factors. A cross sectional study was conducted on 57 STKIP Pasundan female students from the PJKR Department, using a questionnaire filled with guidance from researchers. Obtained respondents aged 18-22 years who are mostly Level I students (43.9%). Almost all (98.2%) of respondents experienced their first menstruation in the age range of 11-14 years. Most (66.7%) respondents have normal nutritional status. More than half (54.4%) of respondents were physically active. There were 63.2% of respondents who experienced menstrual disorders with the most types of disorders (91.7%) were other disorders related to menstruation, followed by menstrual disorders (25.0%), and menstrual cycle disorders (5.0%). There were no respondents who experienced menstrual volume disorders. Among respondents with other disorders related to menstruation, premenstrual syndrome was the most experienced (75.8%). There is a significant relationship between age, class, and physical activity with menstrual disorders. There is no significant relationship between the age of first menstruation and nutritional status with menstrual disorders

Adolescent abnormal uterine bleeding – The PALM COEIN approach

Background/Aims: Menstrual disorders and abnormal uterine bleeding (AUB) are among the most frequent gynecological complaints of adolescents. AUB has been defined in the past by a variety of terms and there have been inconsistencies and lack of categorization of various potential causes of AUB. To have standard nomenclature internationally, PALM COEIN Classification of AUB was introduced in 2011 by FIGO Menstrual disorder group for non-pregnant, reproductive age women. In the present study we aimed to classify adolescent AUB by PALM COEIN approach. MethodThe study was conducted prospectively on all adolescent girls attending OPD at Sir Ganga Ram Hospital. Menstrual complaints were classified according to PALM COEIN approach after a thorough history taking, examination and investigations. ResultsPrevalence of menstrual disorders in adolescents was 68.5%, of which 86.9% were attributed to AUB. PALM COEIN approach was applied to AUB cases. Ovulatory disorders (AUB-O) formed a major chunk of adolescent AUB (93.7%), of which 60% were due to immaturity of Hypothalamic Pitutary Ovarian axis, 32% due to Polycystic ovarian syndrome and 8% due to Thyroid disorders. Contribution of coagulopathy to AUB was 3.75%. Polyps and leiomyoma were seen in 1.2% and 0.6% of cases respectively. No case remained unclassified when PALM COEIN was applied. ConclusionAUB in adolescents can also be classified by PALM COEIN to standardize nomenclature and abandonment of terms like menorrhagia, metrorrhagia and dysfunctional uterine bleeding.

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/Aims: Menstrual disorders and abnormal uterine bleeding (AUB) are among the most frequent gynecological complaints of adolescents. AUB has been defined in the past by a variety of terms and there have been inconsistencies and lack of categorization of various potential causes of AUB. To have standard nomenclature internationally, PALM COEIN Classification of AUB was introduced in 2011 by FIGO Menstrual disorder group for non-pregnant, reproductive age women. In the present study we aimed to classify adolescent AUB by PALM COEIN approach.The study was conducted prospectively on all adolescent girls attending OPD at Sir Ganga Ram Hospital. Menstrual complaints were classified according to PALM COEIN approach after a thorough history taking, examination and investigations.Prevalence of menstrual disorders in adolescents was 68.5%, of which 86.9% were attributed to AUB. PALM COEIN approach was applied to AUB cases. Ovulatory disorders (AUB-O) formed a major chunk of adolescent AUB (93.7%), of which 60% were due to immaturity of Hypothalamic Pitutary Ovarian axis, 32% due to Polycystic ovarian syndrome and 8% due to Thyroid disorders. Contribution of coagulopathy to AUB was 3.75%. Polyps and leiomyoma were seen in 1.2% and 0.6% of cases respectively. No case remained unclassified when PALM COEIN was applied.AUB in adolescents can also be classified by PALM COEIN to standardize nomenclature and abandonment of terms like menorrhagia, metrorrhagia and dysfunctional uterine bleeding.

Editorial

Editorial

Menstrual disorders in adolescence: a marker for hyperandrogenaemia and increased metabolic risks in later life? Finnish general population-based birth cohort study

Are self-reported menstrual disorders associated with hyperandrogenaemia and metabolic disturbances as early as in adolescence? Menstrual disorders at the age 16 are a good marker of hyperandrogenaemia, and an adverse lipid profile was associated with higher androgen levels. Hyperandrogenism per se has been suggested to be a significant metabolic risk factor in women and a cause of physical and psychological morbidity in adolescent girls. A weak positive correlation has been described between hyperandrogenaemia and obesity in adolescent girls, but the clinical consequences are still poorly understood. Hyperandrogenism and insulin resistance are also key features of polycystic ovary syndrome (PCOS), and women with PCOS are consequently at an increased risk of developing type 2 diabetes mellitus and/or metabolic syndrome, and may have increased cardiovascular morbidity. Our findings confirm that the association between menstrual disorders, hyperandrogenism, obesity and metabolic risks is already evident in adolescence. This population-based, cross-sectional study used postal questionnaires to targeting 15-16-year-old girls in the Northern Finland Birth Cohort 1986 (n= 4567). There were 3669 girls who answered the postal questionnaire and out of 3373 girls who also underwent clinical examinations and blood tests, 2448 were included in the analyses. The questionnaire included one question about the regularity and length of the menstrual cycle: 'Is your menstrual cycle (the interval from the beginning of one menstrual period to the beginning of the next period) often (more than twice a year) longer than 35 days?' The girls who answered 'yes' to this question were considered to be suffering from menstrual disorders and were classified as 'symptomatic'. The girls who answered 'no' were defined as 'non-symptomatic'. There were 709 (29%) girls who reported menstrual disorders (symptomatic girls) and 1739 who had regular periods (non-symptomatic girls). In the whole population and in both study groups, there were significant correlations between body mass index (BMI) (and waist-to-hip ratio), hyperandrogenaemia and metabolic parameters. Symptomatic girls exhibited significantly higher serum concentrations of testosterone (P= 0.010), lower levels of sex hormone-binding globulin (P =0.042) and higher free androgen indices [FAIs; geometric mean 3.38 (interquartile range (IQR): 2.27, 5.18) versus 3.08 (IQR: 2.15, 4.74), P= 0.002]. The two groups had comparable BMI and insulin sensitivity, and serum levels of glucose, insulin and lipids. There was a significant linear trend towards higher FAI values in the higher BMI quartiles in both symptomatic and non-symptomatic girls. In the whole population, there was a statistically significant linear decrease in high-density lipoprotein concentrations (P < 0.001) and higher triglyceride concentrations (P =0.004) in the upper FAI quartile. Information regarding menstrual disorders in adolescence is a good marker of hyperandrogenaemia and may be an early risk factor for the development of PCOS in adulthood. The association between obesity, hyperandrogenism and metabolic risks is already evident in adolescence, which strengthens the importance of noting menstrual disorders at an early stage. BIAS, LIMITATIONS, GENERALIZABILITY: The cross-sectional nature of the study does not allow us to draw conclusions concerning the metabolic risks of this population in later life. The diagnosis of menstrual disorders was based on a questionnaire, suggesting a risk of information bias in reporting the symptoms. This study was not designed to diagnose PCOS, as ultrasonography was not available and there was no clinical evaluation of hyperandrogenism (i.e. hirsutism). However, we were able to take into account potential confounding factors in the analyses. This work was supported by grants from the Finnish Medical Society Duodecim, the North Ostrobothnia Regional Fund, the Academy of Finland (project grants 104781, 120315, 129269, 1114194, SALVE), University Hospital Oulu, Biocenter, University of Oulu, Finland (75617), the European Commission (EURO-BLCS, Framework 5 award QLG1-CT-2000-01643) and the Medical Research Council, UK (PrevMetSyn/SALVE). None of the authors have any conflict of interest to declare.

Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence

To evaluate the long-term effects on bone mineral density (BMD) in women diagnosed with menstrual disorders in their adolescence. Prospective follow-up study six years after the initial investigation. A youth clinic that is part of the school health system in Stockholm. Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence. Subjects underwent gynecological examination, evaluation of eating behavior and physical activity. Whole body Dual Energy X-ray Absorptiometry was used for measurement of BMD. BMD. The overall frequency of osteopenia/osteoporosis was 52%, and three girls had osteoporosis. Women with previous secondary amenorrhea had significantly lower BMD in the pelvis and lumbar spine than those with previous oligomenorrhea. The strongest predictor of low BMD was a restrictive eating disorder in adolescence and the most important counteraction was high physical activity at follow-up and a body mass index (BMI) > or = 22. Persistent menstrual dysfunction at follow-up was associated with polycystic ovary syndrome and lower frequency of osteopenia. This clinical follow-up study has demonstrated a high frequency of osteopenia in women diagnosed with menstrual disorders in adolescence. Previous anorectic behavior was the strongest negative predictor of BMD. It is important to pay attention to an underlying eating disorder in young women with menstrual dysfunction in order to promote bone health.

Prospective follow‐up of menstrual disorders in adolescence and prognostic factors

Clinical follow-up of menstrual status and eating behavior in grown-up women diagnosed with menstrual disturbance in adolescence. Prospective follow-up study six years after the initial study. A youth clinic that is part of the school health system in Stockholm. Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence. Subjects underwent gynecological examination, evaluation of eating behavior and endocrine status. Menstrual status and eating behavior changes. Menstrual disturbances were still present in 62% of the subjects not using hormonal contraception, 59% of which fulfilled the criteria for polycystic ovary syndrome (PCOS). The frequency of persistent menstrual disturbance was significantly more common in women with previous oligomenorrhea than secondary amenorrhea. The occurrence of eating disorders was decreased by half to 31% in women diagnosed with secondary amenorrhea at the initial study, whereas it was unchanged (40%) in women with previous oligomenorrhea. Recovery from anorectic behavior, primarily in the group of secondary amenorrhea, significantly predicted resumption with menses. Menstrual disturbances and eating disorders were still frequent after six years in a follow-up of women who had menstrual disturbance in adolescence. PCOS was the main cause explaining persistent menstrual disorder, whereas recovery of anorectic eating disorders predicted resumption of menses. The findings call for a continued follow-up of women diagnosed with menstrual disturbance in their teens.

Common menstrual disorders in adolescence: nursing interventions.

Menstrual disorders such as amenorrhea, excessive uterine bleeding, dysmenorrhea, and premenstrual syndrome are common reasons for visits to healthcare providers by adolescent girls. Although menstrual irregularity can be normal during the first few years after menarche, other menstrual signs and symptoms may indicate a pathological condition that requires prompt attention and referral. This article discusses four common menstrual disorders seen in adolescent girls and focuses on specific nursing interventions aimed at eliciting an accurate menstrual history, providing confidentiality and communicating therapeutically, administering culturally sensitive care, and promoting independence and self-care.

Menstrual disorders in adolescence: investigation and management.

Menstrual disorders in adolescence may present diagnostic and management challenges for the gynaecologist. This review will describe the common and uncommon menstrual disorders that may arise in early reproductive life, together with guidance on their investigation and management.

Menstrual disorders in adolescence

Problems associated with menstruation affect 75% of adolescent females and are a leading reason for visits to physicians. This chapter begins with a review of the timing and characteristics of normal menstruation during adolescence. It then discusses the evaluation and management of adolescents with amenorrhoea, dysmenorrhoea and abnormal uterine bleeding. An approach to adolescent amenorrhoea is presented that utilizes primary versus secondary amenorrhoea, delayed versus normal pubertal development, and the presence or absence of hyperandrogenism as nodal points for decision making. The differential diagnosis of dysmenorrhoea and the management of primary dysmenorrhoea and endometriosis are reviewed. The section on abnormal uterine bleeding contrasts anovulatory dysfunctional uterine bleeding (DUB) with bleeding secondary to problems of pregnancy, uterine pathology, exogenous hormone use and systemic bleeding disorders.

Les troubles du cycle menstruel de l'adolescente

Long cycles and excessive uterine bleeding are the most common menstrual disorders in adolescents. Long cycles usually result from a benign transitory functional disorder which spontaneously resolves within two to three years after menarche; however, this diagnosis can only be retained in the absence of hirsutism or galactorrhea as revealing symptoms of functional ovarian hyperandrogenism, polycystic ovary syndrome, late form of congenital adrenal hyperplasia or hyperprolactinemia; ovarian failure will be considered in case of isolated long cycles persisting more than two years after menarche. Excessive uterine bleeding usually occurs early after menarche. Although the main cause is functional, resulting from anovulation and the related absence of progesterone, coagulation disorders must always be excluded. Management of these disorders are described.