Division of Pediatric, Adolescent Gynecology and Reconstructive Surgery, 2nd Department of Obstetrics and Gynecology, University of Athens, Medical School, Aretaieion Hospital, Athens, Greece.
Gynecol Endocrinol. 2013 Jan;29(1):74-8. doi: 10.3109/09513590.2012.705384. Epub 2012 Sep 5.
Abnormal uterine bleeding (AUB), which is defined as excessively heavy, prolonged and/or frequent bleeding of uterine origin, is a frequent cause of visits to the Emergency Department and/or health care provider. While there are many etiologies of AUB, the one most likely among otherwise healthy adolescents is dysfunctional uterine bleeding (DUB), which is characterizing any AUB when all possible underlying pathologic causes have been previously excluded. The most common cause of DUB in adolescence is anovulation, which is very frequent in the first 2-3 post-menarchal years and is associated with immaturity of the hypothalamic - pituitary - ovarian axis. Management of AUB is based on the underlying etiology and the severity of the bleeding and primary goals are prevention of complications, such as anemia and reestablishment of regular cyclical bleeding, while the management of DUB can in part be directed by the amount of flow, the degree of associated anemia, as well as patient and family comfort with different treatment modalities. Treatment options for DUB are: combined oral contraceptives (COCs), progestogens, non steroidal anti inflammatory drugs (NSAIDs), tranexamic acid (anti-fibrinolytic), GnRH analogues, Danazol and Levonorgestrel releasing intra uterine system (LNG IUS).
异常子宫出血（AUB）定义为源自子宫的过度出血、延长和/或频繁出血，是急诊科和/或医疗保健提供者就诊的常见原因。虽然 AUB 有许多病因，但在其他方面健康的青少年中最有可能的病因是功能失调性子宫出血（DUB），当先前排除所有可能的潜在病理原因时，任何 AUB 都具有特征。青春期 DUB 的最常见原因是无排卵，这在初潮后 2-3 年内非常常见，与下丘脑-垂体-卵巢轴的不成熟有关。AUB 的治疗基于潜在病因和出血的严重程度，主要目标是预防并发症，如贫血和恢复正常周期性出血，而 DUB 的管理部分可以根据流量、相关贫血程度以及患者和家庭对不同治疗方式的舒适度来指导。DUB 的治疗选择包括：复方口服避孕药（COC）、孕激素、非甾体抗炎药（NSAIDs）、氨甲环酸（抗纤维蛋白溶解）、促性腺激素释放激素类似物、丹那唑和左炔诺孕酮释放宫内系统（LNG IUS）。
