Treatment Options for the Adolescent Patient Experiencing Abnormal Uterine Bleeding

Abstract

Abnormal uterine bleeding (AUB) is one of the most common reasons adolescent patients present for gynecologic care. A new classification system has been created to provide a universally accepted system of nomenclature to describe uterine bleeding causes in reproductive-aged women. The acronym PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic and not yet classified) was introduced in 2011. This classification will help to target not only treatment but also future research into treatment options in the AUB population. In order for treatments to be effective, an accurate diagnosis is paramount. Adolescents tend to have anovulatory, infectious, or pregnancy-related causes of AUB. Traditional treatment modalities have been hormonal in nature, the most common being the use of oral contraceptive pills. The latest development has been the recognition of the effective use of the levonorgestrel intrauterine systems (LNG-IUS) in successful treatment of AUB in the adolescent population.Copyright © 2016, Springer International Publishing AG.