Juvenile bleeding is called pathological bleeding from the genital tract, due to a violation of the normal monthly detachment of the endometrium. This process is associated with failures in the hypothalamus-pituitary-ovaries system.

Juvenile bleeding has another name — uterine bleeding during puberty. They occur during the puberty of a girl and can manifest themselves before the onset of adulthood.

In pediatric gynecological practice, such bleeding is not uncommon. The overall percentage of uterine bleeding in puberty is about 30%.

Possible causes of bleeding during puberty

Possible causes of bleeding during puberty

In the pathogenesis of juvenile bleeding lie disorders in the hypothalamic-pituitary-ovarian system, due to the immaturity of these structures or toxic effects on them. This process consists in insufficient production of gonadotropin-releasing hormones (GnRH), which stimulate the production of the main female hormones:

  • follicle stimulating (FSH),
  • luteinizing (LH).

As a result of the lack of these hormones, the maturation of follicles in the ovaries is disrupted: the follicles undergo atresia (reverse development) or a persistent follicle is formed (a mature follicle that does not break at the right time and continues to exist). At the same time, the cycle is anovulatory, that is, during the cycle, maturation and release of the egg did not occur.

In this case, the endometrium is not rejected in due time, its hyperplasia (growth) occurs. When the layer becomes too thick, the nutrition inside it is disturbed, and it begins to be rejected unevenly, which is accompanied by profuse and prolonged bleeding.

Some factors related to the girl’s lifestyle and her birth and heredity can lead to dishormonal bleeding.

Possible causes of bleeding during puberty:

  • Burdened heredity.

Similar bleeding was observed in the patient’s mother during puberty.

  • Difficult delivery of the mother.

Fetal hypoxia, placental insufficiency, developmental delay, etc.

  • Artificial feeding.
  • Stress.

Workload in studies, exams, additional classes and, as a rule, the lack of a good rest from study.

  • Physical exercise.

Long training sessions, competitions, part-time jobs where effort is required.

  • Infectious diseases.

Frequent tonsillitis, acute respiratory viral infections play a role in starting the mechanism. But all other acute and chronic infections can provoke this condition.

  • Inadequate nutrition.
  • Lack of vitamins, abuse of harmful products, malnutrition.

How to recognize juvenile bleeding?

Pubertal uterine bleeding can appear from the onset of menstruation and for several years from the onset of their appearance. Girls at the same time note the irregularity of the cycle, menstruation may be absent for several months. When they come, the bleeding is profuse, painful, lasts 1-2 weeks, sometimes longer.

The signs of anemia come to the fore. Prolonged or profuse blood loss leads to a drop in hemoglobin to very low numbers. The girl complains of weakness, dizziness, constant drowsiness. Interest in an active lifestyle is lost. The skin and mucous membranes are pale in color, appetite is reduced.

Diagnostic methods: blood tests, ultrasound, gynecological examination

Diagnostic methods: blood tests, ultrasound, gynecological examination

The doctor may suspect juvenile bleeding already during a conversation with the patient or her mother. Abundant and prolonged blood loss with an irregular menstrual cycle is the first bell. Next, the doctor must find out the causes of bleeding by asking about lifestyle and previous diseases, heredity, etc.

  • Blood tests can confirm the presence of anemia or detect abnormalities in the blood clotting system. Also, the girl may be prescribed a blood test to determine female hormones.
  • Ultrasound of the pelvic organs allows you to judge changes in the endometrium, indicate the presence of mature, atretic or persistent follicles, and also detect cystic changes.

  • Gynecological examination is carried out only in girls who are sexually active. With juvenile bleeding, the external and internal genital organs may not be changed, their underdevelopment can rarely be detected.

Uterine bleeding at puberty: health hazards and consequences

For a girl who is still on her way to puberty, uterine bleeding is dangerous, primarily due to the occurrence of anemia and the complications associated with it. In cases of severe anemia, pathological changes affect many organs and systems, which poses a threat to the life of a teenager.

Untimely detachment of the endometrium leads to the development of hyperplastic processes in the uterus. This contributes to the occurrence of endometriosis, increases the risk of developing malignant neoplasms. Violations of the maturation of the follicles often leads to the formation of ovarian follicular cysts.

And the saddest consequence of juvenile bleeding for a future woman is infertility. But with timely treatment, these complications can be avoided.

A mother needs to be in a trusting relationship with her daughter. Many teenagers hide these problems, embarrassed to start a conversation. Some do not speak due to ignorance of which state is the norm and which is not. Mom, as an experienced woman, should tell her daughter about the possible consequences of heavy blood loss. If you suspect uterine bleeding, the mother should take the child to the doctor.

Treatment of the disease: medical and surgical methods

Treatment of the disease: medical and surgical methods

First of all, in the treatment of this pathology, it is necessary to stop the bleeding as soon as possible. For this, uterotonics (drugs for uterine contraction) and hemostatic agents are prescribed. Next, a course of treatment should be carried out aimed at reducing the recurrence of the disease and eliminating the symptoms associated with blood loss.

Depending on the severity of the disease, there are two methods of treating the disease:

  • Medical therapy.
  • Surgical intervention.

In the conservative treatment of uterine bleeding during puberty, monophasic combined hormonal contraceptives (Regulon, Novinet, Jess) are used.

Surgical treatment consists in curettage of the uterine cavity. It is prescribed for the ineffectiveness of conservative therapy and in cases with severe endometrial hyperplasia. After surgery, the appointment of hormonal drugs is also required to prevent recurrence of juvenile bleeding.

Symptomatic therapy is carried out according to individual indications: antianemic drugs, vitamins, etc.

Regardless of the cause of bleeding, girls with this diagnosis should lead a healthy lifestyle: eat right, temper, play sports.

Pediatrics. National leadership / ed. A. A. Baranova 2014

Somatic and reproductive health of adolescent girls with connective tissue dysplasia syndrome / Chechulina O. V., Danilova O. V., Orlova Yu. A. // Practical medicine 2012 9(65)