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[Meno-metrorrhagia, dysmenorrhea in adolescents].

Abstract
Menometrorrhagia is a common symptom in adolescents. It is idiopathic in most cases. In case of menometrorrhagia, it is necessary to exclude a pregnancy, a disorder of hemostasis, particularly the von Willebrand disease, as it represents the most common inherited disorder, and more rarely a chronic disease or an endocrinopathy. History of the bleedings, menstrual blood loss quantification by the Higham score and tolerance of the bleedings (blood pressure) should be evaluated. Laboratory testing includes hCG, ferritin level, a complete blood count, a prothrombin time, an activated partial thromboplastin. Management of menometrorrhagia is related to the severity of the blood loss. It associates antifibrinolytics or non-steroidal anti-inflammatory agents (NSAIDS) with hormonal treatments, such as estrogen-progestin oral contraceptive pill or cyclic oral progestins. Primary or functional dysmenorrhea concerns 40 to 90% of the teenagers and represents a frequent cause of school absenteeism. Management of primary dysmenorrhea is primarily based on a treatment by NSAIDS. In case of its inefficacy or if contraception is needed hormonal treatments, such as estrogen-progestin combined pill should be prescribed. It is very important when pelvic pain is chronic and not soothed by simple medications to look for a secondary dysmenorrhea, mainly endometriosis. In such cases, pelvic magnetic resonance imaging should be performed.
AuthorsL Bricaire, E Laroche, S Christin-Maitre
JournalArchives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 20 Issue 8 Pg. 910-4 (Aug 2013) ISSN: 1769-664X [Electronic] France
Vernacular TitleMénométrorragies, dysménorrhées de l'adolescente.
PMID23727373 (Publication Type: English Abstract, Journal Article, Review)
CopyrightCopyright © 2013 Elsevier Masson SAS. All rights reserved.
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antifibrinolytic Agents
  • Contraceptives, Oral, Hormonal
Topics
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Antifibrinolytic Agents (therapeutic use)
  • Blood Coagulation Disorders (complications)
  • Contraceptives, Oral, Hormonal (therapeutic use)
  • Dysmenorrhea (etiology)
  • Endocrine System Diseases (complications)
  • Endometriosis (complications)
  • Female
  • Humans
  • Metrorrhagia (etiology)
  • Pregnancy

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