Abnormal uterine bleedings in adolescents: treatment features

Abstract

Abnormal uterine bleedings in adolescence include abnormal bleeding at the age of menarche to 18 years, due to disorders of the cyclic production of sex steroid hormones, which leads to a deviation in the normal endometrial development. The frequency of abnormal uterine bleeding in adolescents is up to 38%.

The study to examine the efficacy of sublingual form of micronized progesterone (luteina) in the complex treatment and prevention of abnormal uterine bleeding in adolescent girls was performed.

The study included 36 patients aged 14 to 18 years with a clinical diagnosis “abnormal uterine bleeding”. Patients were divided into 3 groups. The first group consisted of 12 patients, which was administered for hemostasis combined oral contraceptives during the month followed by luteina intake (from the 5th to the 25th day of the menstrual cycle). The second group included 12 patients who were prescribed combined oral contraceptives during the month followed by luteina from the 16th to 25th days of the menstrual cycle. The third control group included 12 patients treated with combined oral contraceptives for 3 months.

Treatment efficacy was assessed by clinical and laboratory disease course on the basis of bleeding changes, normalization of the menstrual cycle, ultrasonic monitoring at 2, 4 and 6 months of follow-up.

The study showed that the use of combined oral contraceptives in the treatment of abnormal uterine bleeding in adolescent girls is an effective method. Hormonal hemostasis within 48 hours was achieved in all patients. It was found that the sublingual drug luteina promotes treatment, lead to menstrual cycle normalization and prevent abnormal uterine bleeding recurrence in adolescent girls. Duration of luteina use should be not less than 2 months after hormonal hemostasis. Prolonged scheme of the micronized progesterone use is most optimal (intake for 20 days in the menstrual cycle).