I disturbi della mestruazione nelle adolescenti: quale diagnosi e quale trattamento

In: L'Endocrinologo · 2015 · vol. 16(2) , pp. 57–61 · doi:10.1007/s40619-015-0111-8 · W1999882903
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AI-generated summary by claude@2026-06+body, 2026-06-13

Excessive menstrual bleeding and pain in adolescents, often linked to ovarian-pituitary axis maturation, require differential diagnosis between functional and rare neoplastic causes, with ultrasound and hormone levels guiding treatment.

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The paper reviews menstrual disorders in adolescents, focusing on how cycle-duration abnormalities are commonly linked to maturation of the hypothalamic–pituitary–ovarian axis, while excessive uterine bleeding and menstrual pain warrant further clinical evaluation. It outlines the need for specialist differential diagnosis between more common dysfunctional forms and rare neoplastic causes, using tools such as transvaginal ultrasound and hormone testing to characterize dysmenorrhea and abnormal uterine bleeding and to define appropriate treatment strategies. A key limitation is that the article presents a diagnostic and management overview rather than original study data, so it does not provide new empirical results. Relevance to endometriosis: adenomyosis and deep infiltrating endometriosis are referenced via cited ultrasound findings in patients with deep infiltrating endometriosis, though the paper’s main focus is adolescent menstrual disorders broadly.

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Sommario L’incidenza dei disturbi mestruali nell’adolescenza è relativamente elevata e riguarda nella maggior parte dei casi le anomalie di durata del ciclo mestruale, legate per lo più alla maturazione dell’asse ipofisi-ovaio. Un rilievo clinico maggiore hanno invece i disturbi del ciclo correlati ai sanguinamenti uterini eccessivi e al dolore mestruale. In presenza di tale sintomatologia, il medico specialista deve fare una diagnosi differenziale tra le forme disfunzionali e quelle molto rare di tipo neoplastico. L’ecografia transvaginale e un dosaggio ormonale consentono di definire le condizioni di dismenorrea e di sanguinamento uterino anomalo, stabilendo idonee strategie di trattamento. Bibliografia American Academy of Pediatrics, Committee on Adolescence, American College of Obstetricians and Gynecologists, Committee on Adolescent Health Care (2006) Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics 118:2245–2250 Pescetto G, De Cecco L, Pecorari D, Ragni N (2009) Ginecologia e ostetricia, vol 2. Soc. Editrice Universo, Roma Munro MG, Critchley HO, Broder MS, Fraser IS for the FIGO Working Group on Menstrual Disorders (2011) FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 113:3–13 Lazzeri L, Di Giovanni A, Exacoustos C et al. (2014) Preoperative and postoperative clinical and transvaginal ultrasound findings of adenomyosis in patients with deep infiltrating endometriosis. Reprod Sci 21:1027–1033 Levine SB (2006) Dysfunctional uterine bleeding in adolescents. J Pediatr Adolesc Gynecol 19:49–51 Harel Z (2006) Dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol 19:363–371 Nur Azurah AG, Sanci L, Moore E, Grover S (2013) The quality of life of adolescents with menstrual problems. J Pediatr Adolesc Gynecol 26:102–108 Candiani M, Ronzoni S, Gentilini D et al. (2010) Peculiar aspects of endometriosis in adolescents. J Endometr 2:19–25 Nnoaham KE, Hummelshoj L, Webster P et al., for the World Endometriosis Research Foundation Global Study of Women’s Health consortium (2011) Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 96:366–373 Pinzauti S, Lazzeri L, Tosti C, Centini G, Orlandini C, Luisi S, Zupi E, Exacoustos C, Petraglia F (2015) Adenomyosis by transvaginal ultrasonographic features in nulligravid women without endometriosis aged 18–30 years: correlation with symptoms. Ultrasound Obstet Gynecol Janssen EB, Rijkers AC, Hoppenbrouwers K et al. (2013) Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Updat 19:570–582 Templeman C (2012) Adolescent endometriosis. Curr Opin Obstet Gynecol 24:288–292 Author information Authors and Affiliations Corresponding author Ethics declarations Conflitto di interesse Gli autori Serena Pinzauti, Cristina Regini, Lucia Lazzeri, Claudia Tosti e Felice Petraglia dichiarano di non avere conflitti di interesse. Consenso informato Lo studio presentato in questo articolo non ha richiesto sperimentazione umana. Studi sugli animali Gli autori di questo articolo non hanno eseguito studi sugli animali. Additional information Proposto da A.A. Sinisi. Materiale elettronico supplementare I link al materiale elettronico supplementare sono elencati qui sotto. Rights and permissions About this article Cite this article Pinzauti, S., Regini, C., Lazzeri, L. et al. I disturbi della mestruazione nelle adolescenti: quale diagnosi e quale trattamento. L'Endocrinologo 16, 57–61 (2015). https://doi.org/10.1007/s40619-015-0111-8 Published: Issue date: DOI: https://doi.org/10.1007/s40619-015-0111-8

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