Abnormal Uterine Bleeding in Adolescents: Treatment with Combined Oral Contraceptive Pills is Effective Even in Hospitalized Patients with Bleeding Disorders

Authors: M. METİN ALTAY, ALİ HABERAL

Abstract: Aims: To show the efficacy of oral contraceptive (OC) treatment for hospitalized adolescent patients with abnormal uterine bleeding (AUB). Materials and Methods: Thirty-one girls with AUB and anemia hospitalized within the last two years were included. The patients´ medical records were evaluated retrospectively. All patients were given combined OC containing 0.03 mg ethinyl estradiol plus 0.15 mg desogestrel according to a defined protocol. Results: Among 31 patients, 8 (25.8%) had bleeding disorders: 3 (9.7%) had factor VII deficiency, 3 (9.7%) thrombocytopenia, 1 (3.2%) factor VIII deficiency and 1 (3.2%) von Willebrand disease. Vaginal bleeding stopped in all patients within a few days with the treatment protocol. Conclusions: Adolescents are good responders to medical treatment despite the presence of bleeding disorders, probably due to the positive coagulative effect of the estrogen component of OCs on platelets and clotting factors. Continuation of OC will be a problem in adolescent girls, because there are some misconceptions about OC in the Turkish population, such as that OC can cause infertility or hormonal imbalance. Appropriate counselling is necessary to overcome this difficulty. We believe that the presence of an Adolescent Gynecology Unit affected the success of our treatment.

Keywords: Dysfunctional uterine bleeding, adolescence, bleeding disorder, ethinyl estradiol, desogestrel

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