A clinical study of puberty menorrhagia in the modern era at a tertiary health-care center

Abstract

ABSTRACT Background: Puberty Menorrhagia is the most common gynecological complication. Puberty menorrhagia when accompanied by serious systemic complications such as anemia and high blood protein (i.e., hypoproteinemia) poses substantial difficulties among gynecologists. The foundation of managing puberty menorrhagia is its early diagnosis and individualized treatment customized to each and every patient. The exclusion of pregnancy is mandatory in all cases, regardless of the history, and following up regularly along with a balanced diet and iron therapy goes a long way towards successful treatment. Objectives: To evaluate the etiology, clinical presentation, and therapeutic efficacy in patients suffering from puberty menorrhagia in our program. Materials and Methods: The prospective observation study method was opted for this study. Study participants were forty women who presented to JMF’s ACPM Medical College, Dhule between November 1, 2019 and October 31, 2020 with excessive vaginal bleeding between the onset of menarche and 19 years of age. All cases were evaluated using history, physical assessment, and pertinent laboratory investigations. Results: In our study, half of the patients (50%) were between the age group of 13 and 16 years. Nine out of every ten patients had hemoglobin levels of 10 g% or less, and 55% of patients were suffering from puberty menorrhagia for 6 months to a year. Our study suggests that polycystic ovary disease (25%) and anovulatory dysfunctional uterine bleeding (DUB) (47.5%) were the basic etiological factors, resulting in the puberty menorrhagia. Genitourinary tuberculosis (7.5%), idiopathic thrombocytopenic purpura (5%), ectocervical polyps (5%), hypothyroidism (7.5%), and Von Willebrand’s disease (2.5%) were found to be a common cause of excessive bleeding. The fundamental medical therapy for managing puberty menorrhagia comprises nonsteroidal anti-inflammatory drugs, tranexamic acids, and hormones. Conclusion: Menorrhagia during puberty is a distressing ailment for both the sufferer and her parents. The majority of instances are caused by self-limiting anovulatory DUB. For effective diagnosis and therapy, a thorough history, clinical examination, and investigation are required. Patient counseling is an integral aspect of management. Surgical approaches are preferred in a few cases, while long-term medical assistance is largely effective.