title: Menstrual management and reproductive concerns in adolescent and young adult women with underlying hematologic or oncologic disease.
abstract: Heavy menstrual bleeding is common among adolescent and young adult women, and can affect health-related quality of life. The cause of heavy menstrual bleeding is not uncommonly because of an underlying hematologic or oncologic disease process, which substantially influences the way patients are counseled and treated.
  
  
  
  Options for menstrual management are more numerous today than ever before and range from minimizing monthly blood loss to suppressing the cycle altogether. However, an underlying bleeding disorder or malignancy can introduce many nuances and limits in individual patient care, which this review highlights. Additionally, because survival rates for adolescent and young adult cancers are improving, more of these patients are planning for lives after their disease, which may include starting or adding to a family. Options for fertility preservation during cancer therapy regimens are solidifying and both primary practitioners and subspecialists should be aware of the possibilities.
  
  
  
  Patients with underlying hematologic or oncologic disease require management of menstrual bleeding, but also deserve a comprehensive evaluation and counseling regarding their individualized contraceptive needs and fertility preservation options during their reproductive years. This review employs the latest evidence from current literature to help guide clinicians caring for this unique demographic.
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, USA.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Quinn
authors.forename: Jennifer
authors.initials: J
authors.lastname: Louis-Jacques
mesh_terms: D000293:Adolescent; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000523:psychology; D003267:Contraception / Q000379:methods*; D037001:Directive Counseling; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D008595:Menorrhagia / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012017:Referral and Consultation; D034121:Reproductive Health Services; D014565:Urogenital Neoplasms / Q000150:complications* / Q000523:psychology; D016387:Women's Health; D055815:Young Adult