Adolescent girl" THEY ARE DIFFERENT
- A Anemia, Abortion, Abuse
- D Developing, Depressed
- O Obese, Overindulging
- L Lack of information
- E Experimenting
- S Social, Sexual
- C Courageous
- E Emotional
- 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
- Mild - Anti-Prostaglandin / COC
- Refractory - USG, MRI, Laparoscopy to rule out Obstruction of lower genital tract Endometriosis