Puberty menorrhagia

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Excessive menstruation between puberty and 19 years of age is called puberty menorrhagia. Excessive menstruation is defined as bleeding over 80 ml per menstrual period or lasting more than 7 days.[1] The most common cause for puberty menorrhagia is dysfunctional uterine bleeding. The other reasons are idiopathic thrombocytopenic purpura, hypothyroidism, genital tuberculosis, polycystic ovarian disease, leukemia and coagulation disorders.[2] The most common physiological reason for puberty menorrhagia is the immaturity of hypothalamic-pituitary-ovarian axis, leading to inadequate positive feedback and sustained high estrogen levels. Most patients present with anemia due to excessive blood loss.

The patient is assessed with a thorough medical history, physical examination (to look for features of anemia), gynaecological examination (to rule out local causes) and laboratory investigations (to rule out coagulopathies and malignancy). It is mandatory to exclude pregnancy. The treatment is determined based on the cause of menorrhagia. In case of puberty menorrhagia due to immaturity of hypothalamic axis, hormonal therapy is beneficial. Treatment for blood loss should be done simultaneously with iron therapy in mild to moderate blood loss and blood transfusion in severe blood loss.

## References

[edit]

1. ^ Gillani, Salma (January 2012). "Puberty Menorrhagia : Causes and Management" (PDF). Journal of Medical Sciences (Peshwar). 20 (1): 15–18.
2. ^ Rao, Sanjay (April 2004). "Medical Interventions in Puberty Menorrhagia". Bombay Medical Journal. Retrieved 6 April 2020.

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Female diseases of the pelvis and genitals

Internal|

| Adnexa|

| Ovary|

* Endometriosis of ovary
* Female infertility
* Ovulatory disorder
* Anovulation
* Oligoovulation
* Poor ovarian reserve
* Mittelschmerz
* Oophoritis
* Ovarian apoplexy
* Ovarian cyst
* Corpus luteum cyst
* Follicular cyst of ovary
* Theca lutein cyst
* Ovarian hyperstimulation syndrome
* Ovarian cancer
* Ovarian germ cell tumors
* Ovarian torsion
* Paraovarian cyst
* Tubo-ovarian abscess
* Polycystic ovary syndrome
* Infertility in polycystic ovary syndrome

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Fallopian tube|

* Female infertility
* Fallopian tube obstruction
* Fallopian tube cancer
* Hematosalpinx
* Hydrosalpinx
* Salpingitis
* Tubo-ovarian abscess

Uterus|

| Endometrium|

* Asherman's syndrome
* Dysfunctional uterine bleeding
* Endometrial hyperplasia
* Endometrial polyp
* Endometriosis
* Endometritis
* Endometrial cancer

Menstruation|

* Flow
* Amenorrhea
* Hypomenorrhea
* Oligoamenorrhea
* Oligomenorrhea
* Polymenorrhea (epimenorrhea)
* Pain
* Dysmenorrhea
* Premenstrual syndrome
* Timing
* Menorrhagia (hypermenorrhea)
* Metrorrhagia
* Mixed
* Menometrorrhagia
* Polymenorrhagia
* Other
* Metropathia haemorrhagica

* Female infertility
* Recurrent miscarriage

Myometrium|

* Adenomyosis
* Uterine fibroid

Parametrium|

* Parametritis

Cervix|

* Cervical cancer
* Cervical dysplasia
* Cervical incompetence
* Cervical polyp
* Cervicitis
* Female infertility
* Cervical stenosis
* Nabothian cyst

General|

* Hematometra / Pyometra
* Retroverted uterus
* Vesicouterine fistula
* Uterine prolapse
* Uterine cancer
* Uterine sarcoma

Vagina|

* Hematocolpos / Hydrocolpos
* Leukorrhea / Vaginal discharge
* Vaginitis
* Atrophic vaginitis
* Bacterial vaginosis
* Candidal vulvovaginitis
* Hydrocolpos
* Vaginal atresia
* Vaginal anomalies

Sexual dysfunction|

* Dyspareunia
* Hypoactive sexual desire disorder
* Sexual arousal disorder
* Vaginal cancer
* Vaginismus

* Urogenital fistulas
* Ureterovaginal
* Vesicovaginal
* Obstetric fistula
* Rectovaginal fistula
* Prolapse
* Cystocele
* Cul-de-sac hernia
* Enterocele
* Rectocele
* Sigmoidocele
* Urethrocele

* Vaginal bleeding
* Postcoital bleeding

Other|

* Pelvic congestion syndrome
* Pelvic inflammatory disease

External|

| Vulva|

* Vulvar cancer
* Bartholin's cyst
* Kraurosis vulvae
* Vestibular papillomatosis
* Vulvitis
* Vulvodynia
* Persistent genital arousal disorder

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Menstrual cycle

Events and phases|

* Menstruation
* Follicular phase
* Ovulation
* Luteal phase

Life stages|

* Menarche
* Menopause

Tracking|

| Signs|

* Basal body temperature
* Cervical mucus
* Mittelschmerz

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Systems|

* Fertility awareness
* Calendar-based methods
* Billings Ovulation Method
* Creighton Model

Suppression|

* Extended cycle combined hormonal contraceptive
* Lactational amenorrhea

Disorders|

* Amenorrhea
* Anovulation
* Cryptomenorrhea
* Dysmenorrhea
* Hypomenorrhea
* Irregular menstruation
* Menometrorrhagia
* Menorrhagia (hypermenorrhea)
* Metropathia haemorrhagica
* Metrorrhagia
* Oligoamenorrhea
* Oligomenorrhea
* Oligoovulation
* Polymenorrhagia
* Polymenorrhea (epimenorrhea)

Related events|

* Folliculogenesis
* Menstrual synchrony
* Premenstrual water retention
* Sexual activity

Mental health|

* Premenstrual syndrome
* Premenstrual dysphoric disorder
* Menstrual psychosis

Hygiene|

* Menstrual hygiene management
* Feminine hygiene
* Menstrual pad
* Cloth menstrual pad
* Tampon
* Menstrual cup
* Menstrual pad
* Period underwear
* Menstrual Hygiene Day

In culture and religion|

* Chhaupadi
* In Islam
* Menstrual leave
* Menstrual stigma
* Menstrual suppression
* Menstrual taboo
* Menstruation celebration
* Menstruation hut
* Niddah
* Period poverty
* Sustainable menstruation
* Tampon tax

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