(Click the link to comment and to vote – voting not working through email, sorry!)
You are seeing a 14-year-old girl with menorrhagia. She had menarche at age 12 ½ years, and has had very irregular, sometimes heavy menses since then. She currently has been menstruating for 8 days with no slowing of her menses, using several pads per day. Her hemoglobin is 10.5 g/dL and her pregnancy test is negative.
Loading ...
January 13, 2026 at 10:04 pm
E) All of the above
Adolescent girls frequently have anovulatory cycles in the first 1-2 years after menarche, which can lead to irregular, heavy menses. Initial treatment for moderate ongoing bleeding (hemoglobin 10-12) can include oral contraceptive pills that contain at least 30-35 mcg estrogen, typically started as 1 pill every 8 hours until bleeding stops and then tapered (patients may also need an antiemetic such as ondansetron); progestin-only pills such as 5-10 mg norethindrone or 10 mg medroxyprogesterone daily; placement of a 52 mg levonorgestrel IUD; and for those who refuse hormonal therapy and have no thromboembolic risk factors, tranexamic acid.