Clinical Evaluation of Puberty Menorrhagia -A Study of Fifty Cases

This study was done to find out the causes of puberty menorrhagia and to evaluate the efficacy of various treatment applied in this disorder. This Descriptive cross sectional study was conducted in the Obstetrics and Gynaecology department of MARKS Medical College Hospital and in my private practice settingfrom August 2012 to February 2014. Fifty unmarried girls from age of menarche to 19 years with history of excessive bleeding per vagina attending in my private practice and out patient department or admitted to this Hospital, were included in the study. They were prospectively analysed to assess the aetiological factors and the outcome of treatment required to manage these cases. The most common cause of menorrhagia was Dysfunctional Uterine Bleeding (DUB) (82%), followed by Polycystic Ovarian Syndrome(10%) and Hypothyroidism(6%). Thirty (60%) patients had menorrhagia of > 1 years duration and majority of them 48 patients (96%) were labeled anaemic at the time of presentation. All patients responded well to medical management. Non-steroidal anti-inflammatory drugs and anti fibrinolytic agents produced 75% subjective improvements in complaints. However, the Hormonal treatment (Pogesterone and combined oral contraceptive pills) produced 72% improvement. Regarding the treatment outcome, the NSAIDS and anti fibrinolytic drugs were found to be most effective, in reducing the complaints of menstrual blood loses etc. so these should be used as first line of treatment in this disorder. Pogesterone and combined oral contraceptive pills should be used as 2nd line of treatment. 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.