Abstract

Abnormal uterine bleeding (AUB) is a common gynecologic condition in adolescents, often caused by immaturity of the hypothalamic-pituitary-ovarian axis, leading to irregular or heavy menstrual bleeding. In Saudi Arabia, cultural stigma, low menstrual health literacy, and limited healthcare access delay diagnosis and treatment, worsening health outcomes. This review aimed to synthesize evidence on the epidemiology, causes, clinical features, diagnosis, and management of AUB in Saudi adolescents, emphasizing the importance of early diagnosis and patient education. Without applying any date or language restrictions, a search was conducted for all types of articles in the last 10 years that assessed the AUB and its current evidence, with particular care for studies that refer to Saudi Arabia. Physiological anovulation was the predominant cause of AUB in adolescents. In addition, bleeding disorders, endocrine dysfunctions such as PCOS, and rare structural abnormalities also contribute to the AUB pool of causes. Diagnosis requires a thorough history, physical exam, and laboratory tests guided by American College of Obstetricians and Gynecologists (ACOG) recommendations. Management includes hormonal therapies, treatment of underlying causes, and addressing anemia. Patient education plays a crucial role in empowering adolescents to recognize abnormal bleeding and seek care, particularly within the Saudi cultural context where stigma exists. Early diagnosis and culturally sensitive education are essential to improve the management and outcomes of AUB in Saudi adolescents. Enhancing multidisciplinary care and public health initiatives can help reduce the burden of AUB and promote reproductive health among young females in Saudi Arabia.

Key words: Abnormal uterine bleeding, adolescents, Saudi Arabia, early diagnosis, patient education