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Committee Opinion Number 606, August 2014

(Reaffirmed 2016)

ABSTRACT: Adolescents undergoing cancer treatment are at high risk of heavy menstrual bleeding, and gynecologists may be consulted either before the initiation of cancer treatment to request strategies for menstrual suppression or during an episode of severe heavy bleeding to stop the bleeding emergently. Therapy in both situations should be tailored to the patient, her cancer diagnosis and treatment plan, and her desires for contraception and fertility. Options for menstrual suppression include combined hormonal contraceptives, progestin-only therapy, and gonadotropin-releasing hormone agoni...


Committee Opinion Number 557, April 2013

(Reaffirmed 2015)

ABSTRACT: Initial evaluation of the patient with acute abnormal uterine bleeding should include a prompt assessment for signs of hypovolemia and potential hemodynamic instability. After initial assessment and stabilization, the etiologies of acute abnormal uterine bleeding should be classified using the PALM–COEIN system. Medical management should be the initial treatment for most patients, if clinically appropriate. Options include intravenous conjugated equine estrogen, multi-dose regimens of combined oral contraceptives or oral progestins, and tranexamic acid. Decisions should be based on ...


American Congress of Obstetricians and Gynecologists
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