Approaches for prevention and management of menstrual bleeding in adolescent patients undergoing cancer treatment

Abnormal uterine bleeding (AUB) is bleeding that is excessive in frequency, duration and/or volume of blood loss compared to normal menstruation. AUB is one of the most common gynecological problems and occurs in 3–30 % of women of reproductive age. Adolescent patients undergoing cancer treatment are at high risk of presenting AUB associated with thrombocytopenia, coagulopathies, dysfunctions of hypothalamic-pituitary-gonadal axis. According to the National Institution of Oncology up to 5 % of new cancer cases are diagnosed in women aged from 15 to 39 years, which underlines the relevance of the problem. AUB is a serious complication that can result in anemia and lifethreatening bleeding. Thus, even normal menstrual blood loss can cause adverse outcomes in women who already suffer from anemia and/or thrombocytopenia. To prevent severe uterine bleeding during the treatment of oncology oncologist, obstetrician-gynecologist and a hematologist are required. Causes of AUB, management approaches and prevention therapy for oncological patients are considered in this article.

About the authors L. V. Adamyan V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia;Russian University of Medicine, Ministry of Health of Russia ORCID iD: 0000-0002-3253-4512 4 Akademika Oparina St., Moscow 117997, Russia; 4 Dolgorukovskaya St., Moscow 127006, Russia Russian FederationE. V. Sibirskaya Russian University of Medicine, Ministry of Health of Russia;Russian Children’s Clinical Hospital, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia ORCID iD: 0000-0002-4540-6341 4 Dolgorukovskaya St., Moscow 127006, Russia; Build. 3, 117 Leninskiy Prospekt, Moscow 119571, Russia; 1 Ostrovityanova St., Moscow 117997, Russia Russian FederationL. G. Pivazyan V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; ORCID iD: 0000-0002-6844-3321 4 Akademika Oparina St., Moscow 117997, Russia Russian FederationS. G. Isaeva I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University) Author for correspondence. Email: [email protected] ORCID iD: 0000-0002-8560-0181 Sapiyat Gabibullaevna Isaeva 8 build., 2 Trubetskaya St., Моscow 119992, Russia Russian Federation S. L. Barsegyan I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University) ORCID iD: 0009-0000-5631-6627 8 build., 2 Trubetskaya St., Моscow 119992, Russia Russian FederationE. A. Zarova I.M. 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