Dysfunctional uterine bleeding and coagulation disorders: Concepts of management in adolescents

Dysfunction uterine bleeding (DUB) is defined as excessive, sustained, or unpatterned uterine bleeding not due to anatomical lesions. DUB is a frequent concern of adolescent females and leads to a marked reduction in the quality of life for these young patients. DUB may be complicated by the presence of a coagulation disorder that can induce severe menorrhagia. This article notes the importance of screening for coagulation disorders in these youth and presents principles of management. Surgical options should be avoided if at all possible, and therapy should be based on the use of oral contraceptives, factor replacement therapy, intranasal DDAVP, antifibrinolytics, and/or the levonorgestrel-releasing IUD.