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KMID : 1216720100020010001
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Korean Journal of Gynecologic Endocrinology
2010 Volume.2 No. 1 p.1 ~ p.10
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Diagnosis of Adolescent Patients with Abnormal Uterine Bleeding
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Hwang Kyu-Ri
Choi Young-Min
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Abstract
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Abnormal uterine bleeding (AUB) is defined as any alteration in the pattern or volume of menstrual blood flow. Two
main categories of AUB are heavy menstrual bleeding or irregular menstrual bleeding. AUB is a common presenting
symptom in the gynecologic practice field. Abnormal menses include those that last for longer than 7 days, occur
more frequently than every 21 days or less frequently than every 35 days or a loss of more than 80 ml.
Dysfunctional uterine bleeding (DUB) in young adolescents is caused most frequently by chronic anovulation and
immaturity of the hypothalamic-pituitary-ovarian axis and is therefore a diagnosis of exclusion. The pathophysiology
of DUB is not fully understood and it is complex. Recognition of the pattern of bleeding may be helpful in determining
its cause.
Clinicians must perform a history, physical examination, and laboratory tests to exclude other medical causes. In the
adolescent, investigations for a coagulopathy should be performed. Because complications of pregnancy may present
with any bleeding pattern, pregnancy should be excluded in all those who have unexplained uterine bleeding, even
those who deny sexual activity. Utilizing a systemic approach to the differential diagnosis will help to avoid a
misdiagnosis. Most abnormal bleeding can be managed medically and the management of AUB should be individually
applied according to its severity and causes.
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KEYWORD
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Abnormal uterine bleeding, Adolescents, Diagnosis
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