Abnormal uterine bleeding in the adolescent

Abnormal Uterine Bleeding (AUB) refers to menstrual bleeding abnormal in quantity, duration, or schedule in a nonpregnant female. In adolescent females, non-structural etiologies of AUB are far more common than structural causes. The evaluation of AUB in adolescents therefore focuses on these etiologies. Bleeding disorders such as von Willebrand's Disease, or ovulatory dysfunction due to an immature hypothalamic-pituitary-ovarian axis or other hormonal etiologies such as polycystic ovarian syndrome, are the most common causes in adolescent girls. Management of AUB depends not only on etiology, but also on the patient's hemodynamic status, degree of anemia, sexual history, presence of estrogen contraindications, and whether the patient is actively bleeding on presentation.