Prevalence of hemostatic disorders in adolescents with abnormal uterine bleeding

J Pediatr Adolesc Gynecol. 2013 Oct;26(5):285-9. doi: 10.1016/j.jpag.2013.06.003.


Study objective: To evaluate the incidence of hemostatic disorders in a population of adolescents with various patterns of abnormal uterine bleeding (AUB).

Design: Retrospective observational study.

Setting: University hospital.

Participants: One hundred thirteen adolescents with AUB; mean age at menarche and mean age at the onset of symptoms 12 ± 1.2 years and 13.5 ± 2.8 years, respectively.

Main outcome measures: Data on menstrual history, bleeding symptoms, co-existing medical conditions, and medical therapies were assessed. All patients were screened for hemostatic disorders with laboratory testing. The incidence of the disorders was calculated. Subjects were further divided in 2 groups based on whether the AUB started in the first 2 years from menarche (group 1) or later (group 2). A statistical analysis was performed using a chi-square test to compare incidence of hemostatic disorders between the groups.

Results: One hundred thirteen adolescents with AUB were identified. Overall, 54 (47.8%) patients had some underlying hemostatic disorder, of which a platelet dysfunction was the most common (17.7%). Von Willebrand disease was detected in 13.3% of cases and a deficiency of a coagulation factor in 12.4%. In 7.1% of patients an isolated increase of bleeding time was observed. When divided in 2 groups, 44.2% of patients in group 1 and 59.2% in group 2 had a coagulation disorders, with no statistically significant difference between the 2 groups (P = .17).

Conclusion: AUB in adolescents is frequently associated with an underlying disorder of hemostasis, most commonly a platelet function disorder. The results highlight the importance of screening for coagulation disorders in adolescents with AUB, independently from the gynecologic age at onset.

Keywords: Abnormal uterine bleeding; Adolescents; Hemostatic disorders; Platelet function disorders; von Willebrand disease.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Coagulation Protein Disorders / complications
  • Coagulation Protein Disorders / epidemiology*
  • Female
  • Hemostatic Disorders / complications
  • Hemostatic Disorders / epidemiology*
  • Humans
  • Menarche
  • Menorrhagia / epidemiology*
  • Menorrhagia / etiology
  • Metrorrhagia / epidemiology*
  • Metrorrhagia / etiology
  • Prevalence
  • Retrospective Studies
  • Time Factors
  • Young Adult
  • von Willebrand Diseases / complications
  • von Willebrand Diseases / epidemiology*