Abnormal Uterine Bleeding in Adolescent Korean Girls Clinical Manifestations and Management and Counseling Strategies

OBJECTIVE: To identify aspects of abnormal uterine bleeding (AUB) with menorrhagia and irregular menstruation in adolescents, compare ultrasound findings, provide treatment options, and establish a consultation strategy. STUDY DESIGN: Retrospective chart review at a single institution. Total of 353 adolescent girls aged 11 to 19 years who presented to the hospital from May 2006 to September 2019. RESULT: Among all patients, 91 (25.93%) had menorrhagia, 300 (84.99%) had irregular vaginal bleeding, and 81 (22.95%) had overlapping symptoms. The average hemoglobin value among 101 patients tested was 11.42 +/- 2.60 g/dL; the lowest hemoglobin value was 3.7 g/dL. At ultrasound, the most common uterine abnormality in both groups was thickened endometrium (24/39 [61.54%] and 49/72 [68.06%]), and 183 (53.8%) patients had ovarian abnormality, most commonly polycystic ovarian morphology. Eighteen patients required blood transfusion and 9 had surgical diagnoses based on ultrasound findings and clinical symptoms. CONCLUSION: Ultrasound, along with a thorough history and physical examination, can be useful for diagnosis and management of AUB in adolescent girls, reducing unnecessary evaluation and intervention. Prompt recognition of cases requiring surgical treatment requires an attempt for active diagnosis, and a strategy for appropriate explanation is needed.

Automated summary

In adolescent girls, irregular menstruation and menorrhagia are common with overlapping symptoms; ultrasound combined with medical history and physical examination can be useful for diagnosis and management of AUB, reducing unnecessary interventions; prompt recognition and active diagnosis are needed for cases requiring surgical treatment.