Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Article

The Adolescent with Menorrhagia: Diagnostic Approach to a Suspected Bleeding Disorder

Rudi-Ann Graham, Joanna A. Davis and Fernando F. Corrales-Medina
Pediatrics in Review December 2018, 39 (12) 588-600; DOI: https://doi.org/10.1542/pir.2017-0105
Rudi-Ann Graham
*Department of Pediatrics, Holtz Children’s Hospital–Jackson Memorial Medical Center, Miami, FL
†Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami–Miller School of Medicine, Miami, FL
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joanna A. Davis
†Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami–Miller School of Medicine, Miami, FL
‡University of Miami–Hemophilia Treatment Center, Miami, FL
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fernando F. Corrales-Medina
*Department of Pediatrics, Holtz Children’s Hospital–Jackson Memorial Medical Center, Miami, FL
†Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami–Miller School of Medicine, Miami, FL
‡University of Miami–Hemophilia Treatment Center, Miami, FL
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
  • Quiz
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF
  1. Rudi-Ann Graham, MD*,†
  2. Joanna A. Davis, MD†,‡
  3. Fernando F. Corrales-Medina, MD*,†,‡
  1. *Department of Pediatrics, Holtz Children’s Hospital–Jackson Memorial Medical Center, Miami, FL
  2. †Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami–Miller School of Medicine, Miami, FL
  3. ‡University of Miami–Hemophilia Treatment Center, Miami, FL
  • AUTHOR DISCLOSURE

    Dr Graham has disclosed no financial relationships relevant to this article. Dr Davis has disclosed that she is a medical advisory board member for Bayer Pharmaceuticals, Genentech, CSL Behring, Novo Nordisk, Bioverativ, and Octapharma and a phase III trial study coordinator for CSL Behring and Bayer Pharmaceuticals. Dr Corrales-Medina has disclosed that he has grant awards from Bayer and Shire and is an advisory board member for Bayer, Genentech, Octapharma, and Shire. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

  • Abbreviations:
    ACOG:
    American Academy of Obstetrics and Gynecology
    COCP:
    combined oral contraceptive pill
    DDAVP:
    1-deamino-8-D-arginine vasopressin
    FVIII:
    factor VIII
    FIX:
    factor IX
    GnRH:
    gonadotropin-releasing hormone
    HMB:
    heavy menstrual bleeding
    LNG-IUS:
    levonorgestrel-releasing intrauterine system
    LTA:
    light transmission aggregometry
    PBAC:
    pictorial bleeding assessment calendar
    PFD:
    platelet function defect
    TA:
    tranexamic acid
    vWD:
    von Willebrand disease
    vWF:
    von Willebrand factor
  • Practice Gaps

    1. To deliver comprehensive care to the adolescent with menorrhagia, clinicians should recognize patterns of menstrual loss that are atypical of that associated with physiologic hormonal changes. There remains a need for consideration of possible underlying bleeding diatheses when screening the adolescent with heavy menstrual bleeding.

    2. Clinicians should be aware of the treatment modalities available to the adolescent with menorrhagia and an underlying bleeding disorder and understand when referral to a hematologist is indicated.

    Objectives

    After completing this article, readers should be able to:

    1. Define menorrhagia.

    2. Use validated screening tools to identify menorrhagia.

    3. Identify cases of menorrhagia in the adolescent that warrant further hematologic evaluation based on predictors noted on history and physical examination.

    4. Review the most common bleeding disorders associated with menorrhagia in the adolescent and the diagnostic approach to each disorder.

    5. Identify the hormonal and hematologic treatment modalities available for use in the adolescent with menorrhagia and understand the limitations of using each treatment in this age group.

    6. Recognize when a referral to a pediatric hematologist/oncologist is indicated.

    Overview

    Adolescent girls and young women often seek medical attention because of menorrhagia, or heavy menstrual bleeding (HMB). Menorrhagia is defined as menstrual bleeding lasting for more than 7 days, sanitary product use greater than 7 per day, and greater than 80 mL of …

    Individual Login

    Log in
    You will be redirected to aap.org to login or to create your account.

    Institutional Login

    via Institution

    You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

    Log in through your institution

    If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

    Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00

    Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

    Offer Reprints

    PreviousNext
    Back to top

    Advertising Disclaimer »

    In this issue

    Pediatrics in Review: 39 (12)
    Pediatrics in Review
    Vol. 39, Issue 12
    1 Dec 2018
    • Table of Contents
    • Table of Contents (PDF)
    • About the Cover
    • Index by author
    • Complete Issue (PDF)
    View this article with LENS
    PreviousNext
    Email Article

    Thank you for your interest in spreading the word on American Academy of Pediatrics.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    The Adolescent with Menorrhagia: Diagnostic Approach to a Suspected Bleeding Disorder
    (Your Name) has sent you a message from American Academy of Pediatrics
    (Your Name) thought you would like to see the American Academy of Pediatrics web site.
    CAPTCHA
    This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
    Request Permissions
    Article Alerts
    Log in
    You will be redirected to aap.org to login or to create your account.
    Or Sign In to Email Alerts with your Email Address
    Citation Tools
    The Adolescent with Menorrhagia: Diagnostic Approach to a Suspected Bleeding Disorder
    Rudi-Ann Graham, Joanna A. Davis, Fernando F. Corrales-Medina
    Pediatrics in Review Dec 2018, 39 (12) 588-600; DOI: 10.1542/pir.2017-0105

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
    Quiz
    Share
    The Adolescent with Menorrhagia: Diagnostic Approach to a Suspected Bleeding Disorder
    Rudi-Ann Graham, Joanna A. Davis, Fernando F. Corrales-Medina
    Pediatrics in Review Dec 2018, 39 (12) 588-600; DOI: 10.1542/pir.2017-0105
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
    Print
    Download PDF
    Insight Alerts
    • Table of Contents

    Jump to section

    • Article
      • Practice Gaps
      • Objectives
      • Overview
      • Epidemiology of Bleeding Disorders in Adolescents with Menorrhagia
      • Screening for Bleeding Disorders
      • Inherited Bleeding Disorders Associated with Menorrhagia
      • Management Strategies for the Adolescent with Menorrhagia and an Inherited Bleeding Disorder
      • Conclusion
      • References
    • Figures & Data
    • Info & Metrics
    • Comments
    • Quiz

    Related Articles

    • PubMed
    • Google Scholar

    Cited By...

    • No citing articles found.
    • Google Scholar

    More in this TOC Section

    • Review of Scabies Infestation and Selected Common Cutaneous Infections
    • Pediatric Ingestions: New High-Risk Household Hazards
    • Iron Deficiency: Implications Before Anemia
    Show more Articles

    Similar Articles

    Subjects

    • Medical Education
      • Medical Education
      • Journal CME
    • Gynecology
      • Menstrual Disorders
      • Gynecology
    • Hematology/Oncology
      • Hematology/Oncology
      • Blood Disorders
    • Journal Info
    • Editorial Board
    • ABP Content Specifications Map
    • Overview
    • Licensing Information
    • Authors
    • Author Guidelines
    • Submit My Manuscript
    • Librarians
    • Institutional Subscriptions
    • Usage Stats
    • Support
    • Contact Us
    • Subscribe
    • Resources
    • Media Kit
    • About
    • International Access
    • Terms of Use
    • Privacy Statement
    • FAQ
    • AAP.org
    • shopAAP
    • Follow American Academy of Pediatrics on Instagram
    • Visit American Academy of Pediatrics on Facebook
    • Follow American Academy of Pediatrics on Twitter
    • Follow American Academy of Pediatrics on Youtube
    American Academy of Pediatrics

    © 2021 American Academy of Pediatrics