Puberty Menorrhagia: Causes and Management

Objectives: To determine the causes of Puberty Menorrhagia and to evaluate the efficacy of Medical Management. Material and Methods: This descriptive study included 35 patients, who presented with puberty menorrhagia to Gynae C Unit Khyber Teacing Hospital, Peshawar from January 2008 to December 2010. Assessment of each case with thorough history, physical examination and laboratory investigations was done. Results: In 26 (74.2%) patients immaturity of hypothalamic pituitary ovarian axis was the cause of puberty menorrhagia. three (8.6%) patients had polycystic ovarian disease (PCOD), 1 (2.8%) patient had hypothyroidism, 3 (8.6%) had thrombocytopenia, 1 (28%) patient had VonWillebrand disease (vWD), 1 (2.8%) patient had multiple fibroids in the uterus. Twenty (57.14%) patients had menorrhagia of > 1years duration. Six (17.11%) patients had haemoglobin level of < 5gm/dl. One (2.8%) patient needed surgical intervention in the form of myomectomy. All other patients responded to medical management. Conclusion: Puberty menorrhagia is a distressing condition both for the patient as well as her parents. Most of the cases are due to anovulatory dysfunctional uterine bleeding (DUB) which is a self limiting condition. Counselling of the patients is an important part of management. Long term medical treatment is successful in the majority of cases.