eMedicine Specialties > Pediatrics: Surgery > Gynecology

Menstruation Disorders: Follow-up

Author: Latha Chandran, MD, MPH, Associate Professor of Pediatrics, Associate Dean for Academic Affairs, Director, Division of General Pediatrics, State University of New York at Stony Brook School of Medicine
Contributor Information and Disclosures

Updated: Jun 10, 2009

Follow-up

Complications

  • Excessive or prolonged bleeding can result in anemia.
  • Excessive stimulation of the endometrium by estrogens with chronic anovulation increases the risk of endometrial cancer. Treating patients intermittently with combination oral contraceptives or progestins is important.
  • Endometrial ablation procedures may cause uterine perforation.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Always rule out pregnancy in a female with abnormal bleeding who is sexually active.
  • Remember that a coexisting infectious disease may be present.
  • In severe cases of menorrhagia, rule out a coagulation disorder
 


More on Menstruation Disorders

Overview: Menstruation Disorders
Differential Diagnoses & Workup: Menstruation Disorders
Treatment & Medication: Menstruation Disorders
Follow-up: Menstruation Disorders
References

References

  1. Cosgrove L, Riddle B. Constructions of femininity and experiences of menstrual distress. Women Health. 2003;38(3):37-58. [Medline].

  2. Harel Z. Dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol. Dec 2006;19(6):363-71. [Medline].

  3. James AH, Kouides PA, Abdul-Kadir R, Edlund M, Federici AB, Halimeh S, et al. Von Willebrand disease and other bleeding disorders in women: Consensus on diagnosis and management from an international expert panel. Am J Obstet Gynecol. May 28 2009;[Medline].

  4. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG committee opinion. No. 337: Noncontraceptive uses of the levonorgestrel intrauterine system. Obstet Gynecol. Jun 2006;107(6):1479-82. [Medline].

  5. [Best Evidence] Marjoribanks J, Lethaby A, Farquhar C. Surgery versus medical therapy for heavy menstrual bleeding. Cochrane Database Syst Rev. 2006;(2):CD003855. [Medline].

  6. Braverman PK, Sondheimer SJ. Menstrual disorders. Pediatr Rev. Jan 1997;18(1):17-25; quiz 26. [Medline].

  7. Emans JS, Laufer M, Goldstein DP. Delayed puberty and menstrual irregularities. In: Pediatric and Adolescent Gynecology. 4th ed. 1998:163-261.

  8. Gordon CM. Menstrual disorders in adolescents. Excess androgens and the polycystic ovary syndrome. Pediatr Clin North Am. Jun 1999;46(3):519-43. [Medline].

  9. Harlow SD, Campbell OM. Epidemiology of menstrual disorders in developing countries: a systematic review. BJOG. Jan 2004;111(1):6-16. [Medline].

  10. Iglesias EA, Coupey SM. Menstrual cycle abnormalities: diagnosis and management. Adolesc Med. Jun 1999;10(2):255-73. [Medline].

  11. Mitan LA, Slap GB. Adolescent menstrual disorders. Update. Med Clin North Am. Jul 2000;84(4):851-68. [Medline].

  12. Slap GB. Menstrual disorders in adolescence. Best Pract Res Clin Obstet Gynaecol. Feb 2003;17(1):75-92. [Medline].

Further Reading

Keywords

menstruation disorders, irregularities of menstruation, menstrual disorders, amenorrhea, oligomenorrhea, dysmenorrhea, secondary dysmenorrhea, painful menstruation, menorrhagia, anovulatory cycles, irregular menstrual patterns, thelarche, menarche, dysfunctional uterine bleeding, DUB, menstruation disorders, hypothalamic-pituitary-ovarian axis, HPO axis, endometriosis, pelvic inflammatory disease, uterine fibroids, Crohn disease, constitutional delay of puberty, hypothalamic dysfunction, pituitary failure, gonadal failure, Turner Syndrome, Swyer syndrome, gonadotrophin deficiency, Kallmann syndrome, hyperandrogenic amenorrhea, hypothalamic amenorrhea, hypothyroidism, hyperprolactinemia, outflow tract obstructions, imperforate hymen, vaginal atresia, Müllerian agenesis, androgen insensitivity

Contributor Information and Disclosures

Author

Latha Chandran, MD, MPH, Associate Professor of Pediatrics, Associate Dean for Academic Affairs, Director, Division of General Pediatrics, State University of New York at Stony Brook School of Medicine
Latha Chandran, MD, MPH is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Medical Editor

Elizabeth Alderman, MD, Director of Fellowship Training Program, Director, Adolescent Ambulatory Service, Clinical Professor, Department of Pediatrics, Division of Adolescent Medicine, Albert Einstein College of Medicine and Montefiore Medical Center
Elizabeth Alderman, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Wayne Wolfram, MD, MPH, Clinical Associate Professor, Departments of Pediatrics, Children's Hospital and University of Cincinnati
Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

Paul D Petry, DO, FACOP, FAAP, Consulting Staff, Freeman Pediatric Care, Freeman Health System
Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association
Disclosure: Nothing to disclose.

Chief Editor

Andrea L Zuckerman, MD, Assistant Professor of Obstetrics/Gynecology and Pediatrics, Tufts University School of Medicine; Division Director, Pediatric and Adolescent Gynecology, Tufts Medical Center
Andrea L Zuckerman, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine
Disclosure: Nothing to disclose.

 
 
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