Interpretation of Expert Consensus on Issues Related to Abnormal Uterine Bleeding during Puberty

YANG Xin

doi:10.3969/j.issn.1674-3806.2025.05.04

Abstract：Abnormal uterine bleeding(AUB)during puberty is most commonly caused by ovulatory dysfunction(AUB-O)and coagulation-related diseases(AUB-C).The bleeding patterns of AUB during puberty are mainly irregular bleeding,prolonged menstrual period,heavy menstrual bleeding(HMB),intermenstrual bleeding,and absence of menstruation.Expert Consensus on Issues Related to Abnormal Uterine Bleeding during Puberty emphasizes the differential diagnosis of the etiology of AUB through inquiring a detailed medical history,physical examination,and auxiliary examinations.For adolescent females with acute HMB,the severity of bleeding and vital signs should be determined promptly and accurately,and the grade-based treatment should be carried out.The evaluations should include the degree of anemia caused by blood loss,serum ferritin levels,the presence or absence of endocrine disorders,and coagulation dysfunction.For adolescent females with acute HMB,the primary treatment methods include short-acting combined oral contraceptives and progestogen-based drugs for emergency hemostasis,but for some patients with refractory AUB who received adequate and standardized medications but the medications failed,surgical treatment or endometrial pathologic evaluation can be performed.Given that it is difficult for adolescent AUB-O patients to establish a regular menstrual cycle in a short term and that AUB-C patients have HMB in a long term,it is necessary to maintain medication after acute hemostasis to manage menstruation for a long time to avoid the recurrence of abnormal bleeding,and pay attention to follow-up and monitoring.