Menstrual cycle disorders in adolescence. Hypermenorrhea, dysmenorrhea and dysfunctional bleeding

Menstrual cycle disorders are very common in female adolescents. It is important to distinguish between normal physiological variation and abnormal pathological bleeding. In addition to abnormally heavy, too long and painful menstruation, persistent juvenile bleeding is an important reason for clarification and regulation of bleeding. The causes of abnormal uterine bleeding are mostly hormonal dysregulation and coagulation disorders. Other reasons, such as structural anomalies are rare in adolescence but still have to be diagnostically excluded. Treatment options are hormone therapy combined with antifibrinolytic drugs and non-steroidal anti-inflammatory drugs (NSAIDs). Dysmenorrhea is usually primary and only occurs in ovulatory cycles and without pelvic pathology but it is important to rule out malformations or endometriosis. Treatment with NSAIDs and behavioral changes are the preferred initial treatment options for dysmenorrhea in non-sexually active adolescents. If birth control is required, oral contraceptives are indicated. If all measures are ineffective, surgical clarification is necessary.