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.