Therapeutic and Preventive Treatment of Uterine Bleeding During Puberty
Study Objective: To study clinical signs of uterine bleeding during puberty in girls who had low or high body weight at birth, and also to optimize therapeutic and preventive treatment strategies for this patient population. Study Design: The study had retrospective and prospective parts. Materials and Methods: The study population consisted of 530 female adolescents, aged 13 to 18. They were examined and divided into three groups: Group I consisted of 170 girls who had low body weight at birth (2,000 to 2,800 g); Group II (the control group) consisted of 182 girls who had normal body weight at birth (3,200 to 3,600 g); and Group III included 178 girls who had high body weight at birth (4,000 to 4,800 g). The patients had basic clinical examinations, hormone tests, and ultrasound scans. Results: In girls who had high body weight at birth, the frequency of uterine bleeding during puberty was higher (39.3%) than in the other groups. In girls with low body weight at birth, bleeding was associated with low estrogen levels; while in those who had high body weight at birth it was associated with high levels of estrogens. The authors provided different algorithms for diagnosis and treatment of uterine bleeding during puberty with regard to the girls' body weight at birth and their hormone profiles. Management strategies included therapeutic and prophylactic measures to prevent reproductive disorders. This treatment was provided based on patient characteristics revealed during an examination. Conclusion: Taking into account the constitutional characteristics of female adolescents helps in choosing the correct hemostatic treatment and appropriate therapeutic and preventive measures to regulate the menstrual cycle at later stages. Hormonal therapy is an optimal method to improve the menstrual cycle and prevent recurrent bleeding in female adolescents.