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Adolescent Gynaecology - Lower Abdominal Pain
Menstrual cycles are often irregular in the first years after menarche.
Most cases of cases of heavy menstrual bleeding in adolescents can be caused by anovulatory cycles, which is related to immaturity of the hypothalamic-pituitary-ovarian axis. Other causes include pregnancy, infection, the use of hormonal contraceptives, stress (psychogenic or exercise induced), under- and over-weight or weight changes, and bleeding disorders.
Less common causes of heavy menstrual bleeding in adolescents include systemic illness and endocrine disorders. Structural lesions that cause heavy menstrual bleeding in adolescents are incredibely rare (cervical polyps and uterine leiomyomas such as fibroids).
Organize follow up with GP within a month. If concerned or persistent symptoms refer to Paediatrician or local Gynaecologist.
Admission for hemodynamically unstable adolescents with a low hemoglobin concentration, or who have symptomatic anemia.
If unable to control bleeding
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Information Specific to RCH – contact the oncall gynaecology fellow/consultant via switch for advice and/or admission.