Abnormal Uterine Bleeding in Adolescent Women

Purpose of Review: To review the current state of terminology, evaluation, and management of abnormal uterine bleeding (AUB) in adolescents. Recent Findings: The current terminology classifies the causes of AUB under the mnemonic “PALM-COEIN”: Polyps, Adenomyosis, Leiomyoma, Malignancy/hyperplasia; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified. Heavy menstrual bleeding (HMB) is one manifestation of AUB. Complete menstrual, gynecologic, medical, and family histories, together with a thorough physical exam, are critical to the determination of the underlying cause of AUB. Initial laboratory testing should be guided by the findings of history and physical. Hormonal therapy is the mainstay of acute and chronic management of AUB. Hemostatic treatments could be considered. Summary: The primary management for AUB is with hormonal medications. Further studies of combining estrogen-containing hormonal management and hemostatic therapies (such as tranexamic acid) are needed given the theoretical concerns about increased risk of thromboembolism in women with difficult to manage AUB. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.