"Adolescent girl" THEY ARE DIFFERENT
A Anemia, Abortion, Abuse
D Developing, Depressed
O Obese, Overindulging
L Lack of information
S Social, Sexual,
N Never say no to peers
T Temperamental, Teenage pregnancy
Specific knowledge & expertise
No treatment is also an option
Gynaecological problems are common
Serious pathology is rare
S/T congenital disorders present 1st time
Vaginal examination only if sexually active or very necessary
Common - immature HPO axis for 2 years
May disguise other worries- contraception, bullying, abuse, STD, pregnancy
Privacy during counceling
MENORRHAGIA (Heavy Period )Clots, Prolonged Days
Menstrual diary, 3-7/21-45, explanation, reassurance is required.
Anti-Fibrinolytics - Tranexamic acid.
Anti-Prostaglandin- Mefenamic acid.
Cyclic Progesteron for 21days.
Intractable Menorrhagia (Very Heavy Period)
10-20% bleeding disorders.
USG, coagulation profile, EUA, Hysteroscopy.
Admission & Blood transfusions.
High doses of Estrogen, Factor VII
DYSMENORRHOEA (Painful period)
Mild - Anti-Prostaglandin / COC
Refractory - USG, MRI, Laparoscopy to rule out Obstruction of lower genital tract Endometriosis