Re: Re: Puberty menorrhagia

[Guest guest]

Dear Ashok,

Unable to access the article. If you could send it as a word/pdf document to

my mail I shall go thru it.

Malini

From: mgims [mailto:mgims ] On Behalf Of

Ashok Bhaskar

Sent: 21 December 2011 04:50

To: Ashok Bhaskar

Subject: Re: Puberty menorrhagia

Malini,

Can you give me your two cents on this topic.

Following article is definitely a good review but wanted to know your take.

> http://www.medscape.com/viewarticle/456474_3

Thanks,

Ashok 1984

>

>

> Sent from my iPad

[Guest guest]

Malini

That was very succinct. Thanks

Kishore Shah 1974

--------------------------------------------------

Sent: Sunday, December 25, 2011 12:47 AM

To: <mgims >

Subject: RE: Re: Puberty menorrhagia

> Dear Ashok,

>

> Brief review-

>

> Puberty menorrhagia is usually common in the initial years after menarche

> usually due to anovulation, due to an immature HPO axis- (usually painless

> heavy, regular cycles, may present as polymenorrhoea). (similar pathology

> to perimenopausal menstrual disorders).

>

> Investigations- FBC as a norm (generally if Hb and MCV and ferritin are

> normal- less likely to be having clinically significant menorrhagia and is

> usually a matter of perception). If symptomatic- TFTs. If family history

> dominant wrt menorrhagia look for von willibrands. Always suspect

> pregnancy related bleeds (we say anyone between 12-50 do a beta HCG).

>

>

>

> Treatment- depends on degree of menorrhagia and its impact on lifestyle.

> If in doubt get them to maintain a menstrual calendar for 4 months or so.

> Reassurance of mom/girl/sister/friend whosoever comes along is useful.

>

> Initially could try Fe supplementation with non-hormonal management- i.e.

> Tranexamic acid (up to 1 gm TDS during periods; start with 500 mg

> TDS)/mefenamic acid (500mg TDS during periods especially if dysmenorrhoea

> present), reassure.

>

> Next step would be hormonal- either cyclical progestogens (eg. Provera

> 10mg BD for 3 weeks out of four, or COCP especially if contraception too

> is a consideration).

>

>

>

> If the teenager is obese, very spotty, s/o hirsutism- look for PCOS- (LH,

> FSH day2 of cycle, USS for evidence of polycystic ovaries). If present

> COCP works well in regulating cycles.

>

>

>

> Starting youngsters on COCP is not uncommon here as usually contraception

> too is required in this age group. My threshold is low.

>

> If starting COCP only for menorrhagia- review the need annually as once

> HPO axis matures with regular ovulation- all should settle.

>

>

>

> Hope you find this useful.

>

>

>

> Malini

>

[Guest guest]

Excellent

Summarization

Malini.

Parag

1980

Re: Puberty menorrhagia

>

> Malini,

>

> Can you give me your two cents on this topic.

>

> Following article is definitely a good review but wanted to know your take.

>

> > http://www.medscape.com/viewarticle/456474_3

>

> Thanks,

>

> Ashok 1984

> >

> >

> > Sent from my iPad

>

>

[Guest guest]

Thank you so much Malini.

That's what I was looking for.

Ashok 1984 batch

> Dear Ashok,

>

> Unable to access the article. If you could send it as a word/pdf document to

> my mail I shall go thru it.

>

> Malini

>

> From: mgims <mailto:mgims%40yahoogroups.com>

[mailto:mgims <mailto:mgims%40yahoogroups.com> ] On Behalf Of

> Ashok Bhaskar

> Sent: 21 December 2011 04:50

> To: Ashok Bhaskar

> Subject: Re: Puberty menorrhagia

>

> Malini,

>

> Can you give me your two cents on this topic.

>

> Following article is definitely a good review but wanted to know your take.

>

> > http://www.medscape.com/viewarticle/456474_3

>

> Thanks,

>

> Ashok 1984

> >

> >

> > Sent from my iPad

>

>