title: Abnormal uterine bleeding and dysfunctional uterine bleeding in pediatric and adolescent gynecology.
abstract: Abnormal uterine bleeding (AUB), which is defined as excessively heavy, prolonged and/or frequent bleeding of uterine origin, is a frequent cause of visits to the Emergency Department and/or health care provider. While there are many etiologies of AUB, the one most likely among otherwise healthy adolescents is dysfunctional uterine bleeding (DUB), which is characterizing any AUB when all possible underlying pathologic causes have been previously excluded. The most common cause of DUB in adolescence is anovulation, which is very frequent in the first 2-3 post-menarchal years and is associated with immaturity of the hypothalamic - pituitary - ovarian axis. Management of AUB is based on the underlying etiology and the severity of the bleeding and primary goals are prevention of complications, such as anemia and reestablishment of regular cyclical bleeding, while the management of DUB can in part be directed by the amount of flow, the degree of associated anemia, as well as patient and family comfort with different treatment modalities. Treatment options for DUB are: combined oral contraceptives (COCs), progestogens, non steroidal anti inflammatory drugs (NSAIDs), tranexamic acid (anti-fibrinolytic), GnRH analogues, Danazol and Levonorgestrel releasing intra uterine system (LNG IUS).
authors.affiliation: Division of Pediatric, Adolescent Gynecology and Reconstructive Surgery, 2nd Department of Obstetrics and Gynecology, University of Athens, Medical School, Aretaieion Hospital, Athens, Greece. deligeoroglou@yahoo.gr
authors.forename: Efthimios
authors.initials: E
authors.lastname: Deligeoroglou
authors.forename: Vasileios
authors.initials: V
authors.lastname: Karountzos
authors.forename: George
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D002648:Child; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006801:Humans; D008595:Menorrhagia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008796:Metrorrhagia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014148:Tranexamic Acid / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000933:Antifibrinolytic Agents; D003277:Contraceptives, Oral, Combined; D004965:Estrogen Antagonists; D007987:Gonadotropin-Releasing Hormone; D014148:Tranexamic Acid