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Study of puberty menorrhagia - Causes and management

Samina Ashraf, Asima Afzal, Waseeqa Nigeen, Nighat Nabi.

Abstract
Background: Puberty menorrhagia accounts for 50% of gynecological visits in adolescent girls. Some adolescents present late with serious complications such as anemia and hypoproteinemia. Early diagnosis and treatment are the keystones in the management of puberty menorrhagia. Reassurance, counseling, and correction of anemia play an important role in the management of such cases.

Objectives: To study the clinical presentation, etiological factors, and treatment outcomes in patients of puberty menorrhagia.

Materials and Methods: This study was a prospective analysis of 26 patients presenting with puberty menorrhagia requiring admission in Lalla Ded Hospital, Srinagar, from January 2014 to June 2015.

Results: In 18 (69.2%) patients, the immaturity of the hypothalamic-pituitary-ovarian axis was the cause of puberty menorrhagia, 4 (15.3%) patients had polycystic ovarian disease, and 3 patients had hypothyroidism while as one patient had fibroid uterus. All patients needed antifibrinolytic agents, PG synthase inhibitors, and hormones for control of bleeding.16 (61.5%) patients needed blood transfusion. Thyroxine replacement therapy was given in 3 (11.5%) patients. One patient (3.8%) needed myomectomy.

Conclusion: Anovulation caused by immaturity of hypothalamic-pituitary-ovarian axis is the most common cause of puberty menorrhagia, and medical management is successful in the majority of patients.

Key words: Puberty Menorrhagia; Anovulation; Hypothyroidism


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