Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829 |
Resumo: | Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed. |
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Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary ApproachHemorragia Uterina Anormal em Adolescentes: Uma Abordagem MultidisciplinarAdolescentBlood Coagulation DisordersMenorrhagiaMetrorrhagiaUterine HemorrhageAdolescenteHemorragia UterinaMenorragiaMetrorragiaPerturbações da Coagulação SanguíneaAbnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed.A hemorragia uterina anormal constitui a queixa que mais frequentemente leva as adolescentes a procurar cuidados de saúde. Esta situação tem um impacto significativo na qualidade de vida, levando a absentismo escolar e limitações na vida social. Os episódios podem variar de ligeiros a potencialmente fatais, se não reconhecidos e tratados rapidamente. Os prestadores de cuidados de saúde devem ser capazes de distinguir um padrão menstrual anormal, uma vez que isto poderá permitir o diagnóstico precoce de um grave problema de saúde. A classificação de PALM-COEIN deve ser usada na avaliação. A causa mais frequente é a anovulação, frequentemente associada a imaturidade do eixo hipotálamo-hipófise-ovário. A história clínica e um exame objetivo cuidado são cruciais no diagnóstico diferencial. A abordagem terapêutica deve ser baseada na etiologia subjacente e gravidade da hemorragia, sendo frequentemente necessária uma intervenção multidisciplinar. A maioria das doentes melhora com tratamento farmacológico, cuja primeira linha é constituída pela terapêutica hormonal. O tratamento cirúrgico é raramente necessário. Apesar da prevalência ser superior em adolescentes, a maioria das recomendações não são específicas desta idade, o que dificulta o diagnóstico e abordagem. A literatura revela falta de uniformização de condutas em adolescentes e os esquemas posológicos são muito variáveis. Por este motivo, é fundamental a realização de estudos sobre a eficácia e segurança dos tratamentos nesta faixa etária.Ordem dos Médicos2021-03-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/mswordapplication/mswordapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829oai:ojs.www.actamedicaportuguesa.com:article/12829Acta Médica Portuguesa; Vol. 34 No. 4 (2021): April; 291-297Acta Médica Portuguesa; Vol. 34 N.º 4 (2021): Abril; 291-2971646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/6308https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/6345https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/11853https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/11854https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/11855https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12005https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12006https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12146https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12147https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12152Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessRamalho, InêsLeite, HelenaÁguas, Fernanda2022-12-20T11:06:42Zoai:ojs.www.actamedicaportuguesa.com:article/12829Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:14.343661Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach Hemorragia Uterina Anormal em Adolescentes: Uma Abordagem Multidisciplinar |
title |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach |
spellingShingle |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach Ramalho, Inês Adolescent Blood Coagulation Disorders Menorrhagia Metrorrhagia Uterine Hemorrhage Adolescente Hemorragia Uterina Menorragia Metrorragia Perturbações da Coagulação Sanguínea |
title_short |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach |
title_full |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach |
title_fullStr |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach |
title_full_unstemmed |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach |
title_sort |
Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach |
author |
Ramalho, Inês |
author_facet |
Ramalho, Inês Leite, Helena Águas, Fernanda |
author_role |
author |
author2 |
Leite, Helena Águas, Fernanda |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Ramalho, Inês Leite, Helena Águas, Fernanda |
dc.subject.por.fl_str_mv |
Adolescent Blood Coagulation Disorders Menorrhagia Metrorrhagia Uterine Hemorrhage Adolescente Hemorragia Uterina Menorragia Metrorragia Perturbações da Coagulação Sanguínea |
topic |
Adolescent Blood Coagulation Disorders Menorrhagia Metrorrhagia Uterine Hemorrhage Adolescente Hemorragia Uterina Menorragia Metrorragia Perturbações da Coagulação Sanguínea |
description |
Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-03-31 |
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info:eu-repo/semantics/publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829 oai:ojs.www.actamedicaportuguesa.com:article/12829 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829 |
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oai:ojs.www.actamedicaportuguesa.com:article/12829 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/6308 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/6345 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/11853 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/11854 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/11855 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12005 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12006 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12146 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12147 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12829/12152 |
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Direitos de Autor (c) 2021 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2021 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 34 No. 4 (2021): April; 291-297 Acta Médica Portuguesa; Vol. 34 N.º 4 (2021): Abril; 291-297 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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