Abnormal Uterine Bleeding Treatment in Adolescents Population. Analysis of Treatment Experience in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics in 2017–2018

Abnormal uterine bleeding (AUB) is too excessive or too long menstrual bleeding with a regular cycle (menorrhagia), or irregular non-cyclic (dysfunctional) bleeding. The causes of AUB are divided into structural (polyps, myomas, leiomyomas, adenomyosis, malignancies or hyperplasia) and non-structural (ovarian dysfunction, coagulopathy, endocrinopathy, iatrogenic) causes. In adolescents, this gynecological problem is usually caused by non-structural causes, the main one being anovulatory cycles due to the immature hypothalamic-pituitary-ovarian axis. About 20 percent AUB in girls occurs due to haematological causes such as coagulopathy, Von Willebrand's disease, thrombocytopenia and other coagulatory disorders. The method of AUB treatment is selected based on the etiology of bleeding, bleeding intensity, hemodynamic status, and anemia. The main goal of treatment is to reduce or stop the bleeding and adjust the regularity of menstrual cycle. Adolescents AUB may be treated with hormonal combined contraceptives or progestin-only agents, hormonal IUD with levonorgestrel, or non-hormonal treatment with NSAIDs, tranexamic acid (TXA), or desmopressin if bleeding disorders are confirmed. According to the ACOG recommendations (2013), the primary treatment for AUB in adolescents is hormone therapy with COC’s or progestins and TXA. In this retrospective study we analyzed medical records from the period of 2017-2018 of adolescents treated for AUB at the Hospital of LUHS Kaunas Clinics at Obstetrics and Gynecology and Pediatric Clinics