Entrar/Registro  
INICIO ENGLISH
 
Boletín Médico del Hospital Infantil de México
   
MENÚ

Contenido por año, Vol. y Num.

Índice de este artículo

Información General

Instrucciones para Autores

Mensajes al Editor

Directorio






>Revistas >Boletín Médico del Hospital Infantil de México >Año 2012, No. 1


Serret MJ, Hernández CA, Mendoza RO, Cárdenas NR, Villasis KMÁ
Alteraciones menstruales en adolescentes
Bol Med Hosp Infant Mex 2012; 69 (1)

Idioma: Español
Referencias bibliográficas: 84
Paginas: 63-76
Archivo PDF: 468.19 Kb.


Texto completo




RESUMEN

Las alteraciones menstruales constituyen una causa de consulta ginecológica frecuente en adolescentes. Por esta razón, recientemente se ha propuesto que los ciclos menstruales sean considerados como un signo vital. Con el propósito de mejorar la calidad de atención de las adolescentes, en este artículo se describen los principales trastornos menstruales y la forma de abordarlos desde la perspectiva de los médicos de primer contacto.
El sangrado uterino disfuncional, la dismenorrea, así como la amenorrea u oligomenorrea son las principales alteraciones en las adolescentes. La anamnesis y la exploración física constituyen la base para la evaluación de estas adolescentes; sin embargo, en ciertas pacientes, los estudios de laboratorio y radiológicos ayudan a complementar el diagnóstico.
El sangrado uterino disfuncional es la causa más frecuente de los trastornos menstruales en la adolescencia; en general, esta condición se sospecha cuando la duración de la menstruación es mayor a 7 días y presenta una periodicidad menor a 21 días. Debido a que, primordialmente, se presenta por la inmadurez del eje hipotálamo-hipófisis, es habitual que ocurra en los primeros ciclos menstruales. El tratamiento médico está enfocado a disminuir la morbilidad y será suficiente en la mayoría de los casos. Por otra parte, la amenorrea es la condición donde hay ausencia de menstruación. Su tratamiento dependerá de la etiología, por lo que es necesario conocer si la amenorrea es primaria o secundaria. El síndrome de Turner es la causa más frecuente de amenorrea primaria en adolescentes sin desarrollo de caracteres sexuales secundarios. En la amenorrea secundaria, los estudios hormonales ayudan a orientar para descartar problemas de tiroides, hipófisis, trastornos de la alimentación o enfermedades crónicas que la ocasionen. Otro trastorno es la dismenorrea, que se clasifica en primaria y secundaria (o adquirida); la primaria ocurre en más de 80% de los casos y, a diferencia de la secundaria, no está asociada a alguna alteración, como la endometriosis. El tratamiento de elección para la dismenorrea primaria es el uso de antiinflamatorios no esteroideos mientras que para la secundaria éste dependerá de la etiología.


Palabras clave: alteraciones menstruales, adolescentes, amenorrea, dismenorrea, antiinflamatorios no esteroideos.


REFERENCIAS

  1. Hertweck P, Yoost J. Common problems in pediatric and adolescent gynecology. Expert Rev Obstet Gynecol 2010;5:311- 328.

  2. Zacharin M. Disorders of ovarian function in childhood and adolescence: evolving needs of the growing child. An endocrine perspective. BJOG 2010;117:156-162.

  3. Adams Hillard PJ. Menstruation in young girls: a clinical perspective. Obstet Gynecol 2002;99:655-662.

  4. American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care, Diaz A, Laufer MR, Breech LL. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics 2006;118:2245-2250.

  5. Popat VB, Prodanov T, Calis KA, Nelson LM. The menstrual cycle: a biological marker of general health in adolescents. Ann NY Acad Sci 2008;1135:43-51.

  6. Schiavon-Ermani R, Jiménez-Villanueva CH. Alteraciones menstruales en la adolescencia. Rev Endocrinol Nutr 2001;9:141-153.

  7. Escobar ME, Pipman V, Arcari A, Boulgoudjian E, Kaselman A, Pasqualini T, et al. Trastornos del ciclo menstrual en la adolescencia. Arch Argent Pediatr 2010;108:363-369.

  8. Parker MA, Sneddon AE, Arbon P. The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers. BJOG 2010;117:185-192.

  9. Nwankwo TO, Aniebue UU, Aniebue PN. Menstrual disorders in adolescent school girls in Enugu, Nigeria. J Pediatr Adolesc Gynecol 2010;23:358-363.

  10. Neinstein LS. Menstrual dysfunction in pathophysiologic states (clinical review). West J Med 1985;143:476-484.

  11. Hawkins SM, Matzuk MM. The menstrual cycle: basic biology. Ann NY Acad Sci 2008;1135:10-18.

  12. Gray SH, Emans SJ. Abnormal vaginal bleeding in adolescents. Pediatr Rev 2007;28:175-182.

  13. Wilkinson JP, Kadir RA. Management of abnormal uterine bleeding in adolescents. J Pediatr Adolesc Gynecol 2010;23(suppl 6):S22-S30.

  14. Adams Hillard PJ. Menstruation in adolescents: what’s normal, what’s not. Ann NY Acad Sci 2008;1135:29-35.

  15. Semiz S, Kurt F, Kurt DT, Zencir M. Sevniç O. Pubertal development of Turkish children. J Pediatr Endocrinol Metab 2008;21:951-961.

  16. Rosenfield RL, Lipton RB, Drum ML. Telarche, pubarche, and menarche attaintment in children with normal and elevated body mass index. Pediatrics 2009;123:84-88.

  17. Kaplowitz P. Pubertal development in girls: secular trends. Curr Opin Obstet Gynecol 2006;18:487-491.

  18. Barsom SH, Dillaway HE, Koch PB, Ostrowski ML, Mansfield PK. The menstrual cycle and adolescent health. Ann NY Acad Sci 2008;1135:52-57.

  19. Siemaszko K, Call A. Enfoque del crecimiento y desarrollo puberal por el ginecólogo. En: Sociedad Argentina de Ginecología Infanto Juvenil, eds. Manual de Ginecología Infanto Juvenil. Argentina: Ascune Hnos; 2003. pp. 87-102.

  20. Benjamins LJ. Practice guideline: evaluation and management of abnormal vaginal bleeding in adolescents. J Pediatr Health Care 2009;23:189-193.

  21. Venkateswaran L, Yee DL. Rare bleeding disorders in young women. J Pediatr Adolesc Gynecol 2010;23(suppl 6):S38-S42.

  22. Mikhail S, Kouides P. von Willebrand disease in the pediatric and adolescent population. J Pediatr Adolesc Gynecol 2010;23(suppl 6):S3-S10.

  23. Benjamin HJ. The female adolescent athlete: specific concerns. Pediatr Ann 2007;36:719-726.

  24. Frishman GN. Evaluation and treatment of menorrhagia in an adolescent population. J Minim Invasive Gynecol 2008;15:682-688.

  25. Slap GB. Menstrual disorders in adolescence. Best Pract Res Clin Obstet Gynaecol 2003;17:75-92.

  26. Deligeoroglou E, Tsimaris P. Menstrual disturbances in puberty. Best Pract Res Clin Obstet Gynaecol 2010;24:157-171.

  27. Philipp CS. Platelet disorders in adolescents. J Pediatr Adolesc Gynecol 2010;23(suppl 6):S11-S14.

  28. Boswell HB. The adolescent with menorrhagia: why, who, and how to evaluate for a bleeding disorder. J Pediatr Adolesc Gynecol 2011;24:228-230.

  29. Winikoff R, Lee C. Hemophilia carrier status and counseling the symptomatic and asymptomatic adolescent. J Pediatr Adolesc Gynecol 2010;23(suppl 6):S43-S47.

  30. Stranzinger E, Strouse PJ. Ultrasound of the pediatric female pelvis. Semin Ultrasound CT MR 2008;29:98-113.

  31. Chi C, Pollard D, Tuddenham EG, Kadir RA. Menorrhagia in adolescents with inherited bleeding disorders. J Pediatr Adolesc Gynecol 2010;23:215-222.

  32. Chi C, Huq FY, Kadir RA. Levonorgestrel-releasing intrauterine system for the management of heavy menstrual bleeding in women with inherited bleeding disorders: long-term follow-up. Contraception 2011;83:242-247.

  33. Pillai M, O`Brien K, Hill E. The levonorgestrel intrauterine system (Mirena) for the treatment of menstrual problems in adolescents with medical disorders, or physical or learning disabilities. BJOG 2010;117:216-221.

  34. Practice Committee of American Society for Reproductive Medicine. Current evaluation of amenorrhea. Fertil Steril 2008;90(suppl 5):S219-S225.

  35. Golden N. Carlson JL. The pathophysiology of amenorrhea in the adolescent. Ann NY Acad Sci 2008;1135:163-178.

  36. Morcel K, Guerrier D, Watrin T, Pellerin I, Levêque J. The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: clinical description and genetics. J Gynecol Obstet Biol Reprod (Paris) 2008;37:539-546.

  37. Carranza-Lira S, Forbin K, Martinez-Chéquer JC. Rokitansky syndrome and MURCS association—clinical features and basis for diagnosis. Int J Fertil Womens Med 1999;44:250-255.

  38. Rosenberg HK. Sonography of the pelvis in patients with primary amenorrhea. Endocrinol Metab Clin North Am 2009;38:739-760.

  39. Cordts EB, Christofolini DM, Dos Santos AA, Bianco B, Barbosa CP. Genetic aspects of premature ovarian failure: a literature review. Arch Gynecol Obstet 2011;283:635-643.

  40. Rebar RW. Premature ovarian “failure” in the adolescent. Ann NY Acad Sci 2008;1135:138-145.

  41. Hickey M, Balen A. Menstrual disorders in adolescence: investigation and management. Hum Reprod Update 2003;9:493-504.

  42. Witchel SF, Azziz R. Congenital adrenal hyperplasia. J Pediatr Adolesc Gynecol 2011;24:116-126.

  43. Lin-Su K, Nimkarn S, New MI. Congenital adrenal hyperplasia in adolescents: diagnosis and management. Ann NY Acad Sci 2008;1135:95-98.

  44. Nimkarn S, Lin-Su K, New MI. Steroid 21 hydroxylase deficiency congenital adrenal hyperplasia. Endocrinol Metab Clin North Am 2009;38:699-718.

  45. Diamanti-Kandarakis E. PCOS in adolescents. Best Pract Res Clin Obstet Gynaecol 2010;24:173-183.

  46. Blank SK, Helm KD, McCartney CR, Marshall JC. Polycystic ovary syndrome in adolescence. Ann NY Acad Sci 2008;1135:76-84.

  47. Forsbach G, Güitrón-Cantú A, Vázquez-Lara J, Mota-Morales M, Díaz-Mendoza ML. Virilizing adrenal adenoma and primary amenorrhea in a girl with adrenal hyperplasia. Arch Gynecol Obstet 2000;263:134-136.

  48. Viswanathan V, Eugster EA. Etiology and treatment of hypogonadism in adolescents. Endocrinol Metab Clin North Am 2009;38:719-738.

  49. Oktay K, Sönmezer M. Chemotherapy and amenorrhea: risks and treatment options. Curr Opin Obstet Gynecol 2008;20:408-415.

  50. Steffens M, Beauloye V, Brichard B, Robert A, Alexopoulou O, Vermylen C, et al. Endocrine and metabolic disorders in young adult survivors of childhood acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma (NHL). Clin Endocrinol (Oxf) 2008;69:819-827.

  51. Delman BN. Imaging of pediatric pituitary abnormalities. Endocrinol Metab Clin North Am 2009;38:673-698.

  52. Gordon CM. Functional hypothalamic amenorrhea. N Engl J Med 2010;363:365-371.

  53. Meczekalski B, Podfigurna-Stopa A, Warenik-Szymankiewicz A, Genazzani AR. Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations. Gynecol Endocrinol 2008;24:4-11.

  54. Covington SN, Martinez PE, Popat V, Nandagopal R, Ryan M, Nelson LM. The psychology of antecedents to adult reproductive disorders in adolescent girls. Ann NY Acad Sci 2008;1135:155-162.

  55. Friedman HL. Changing patterns of adolescent sexual behavior: consequences for health and development. J Adolesc Health 1992;13:345-350.

  56. Hornberger LL. Adolescent psychosocial growth and development. J Pediatr Adolesc Gynecol 2006;19:243-246.

  57. Vescovi JD, Jamal SA, De Souza MJ. Strategies to reverse bone loss in women with functional hypothalamic amenorrhea: a systematic review of the literature. Osteoporos Int 2008;19:465-478.

  58. Fothergill DJ. Common menstrual problems in adolescence. Arch Dis Child Educ Pract Ed 2010;95:199-203.

  59. Braverman PK, Breech L, Committee on Adolescence. Clinical report—Gynecologic examination for adolescents in the pediatric office setting. Pediatrics 2010;126:583-590.

  60. López KC, Bagnati EP, De la Parra I, Ortiz G, Churba G. Dismenorrea. En: Sociedad Argentina de Ginecología Infanto Juvenil, eds. Manual de Ginecología Infanto Juvenil. Argentina: Ascune Hnos; 2003. pp. 378-372.

  61. Harel Z. Dysmenorrhea in adolescents. Ann NY Acad Sci 2008;1135:185-195.

  62. Ortiz MI, Rangel-Flores E, Carrillo-Alarcón LC, Veras- Godoy HA. Prevalence and impact of primary dysmenorrhea among Mexican high school students. Int J Gynaecol Obstet 2009;107:240-243.

  63. Ortiz MI. Primary dysmenorrhea among Mexican university students: prevalence, impact and treatment. Eur J Obstet Gynecol Reprod Biol 2010;152:73-77.

  64. Wong LP. Premenstrual syndrome and dysmenorrhea: urbanrural and multiethnic differences in perception, impacts, and treatment seeking. J Pediatr Adolesc Gynecol 2011;24:272-277.

  65. Wong LP. Attitudes toward menstruation, menstrual-related symptoms, and premenstrual syndrome among adolescent girls: a rural school-based survey. Women Health 2011;51:340-364.

  66. Eryilmaz G, Ozdemir F, Pasinlioglu T. Dysmenorrhea prevalence among adolescence in eastern Turkey: its effects on school performance and relationships with family and friends. J Pediatr Adolesc Gynecol 2010;23:267-272.

  67. Unsal A, Ayranci U, Tozun M, Arslan G, Calik E. Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Ups J Med Sci 2010;115:138-145.

  68. Sultan C, Jeandel C, Paris F, Trimeche S. Adolescent dysmenorrhea. Endocr Dev 2004;7:140-147.

  69. Zhang K, Pollack S, Ghods A, Dicken C, Isaac B, Adel G, et al. Onset of ovulation after menarche in girls: a longitudinal study. J Clin Endocrinol Metab 2008;93:1186-1194.

  70. French L. Dysmenorrhea in adolescents: diagnosis and treatment. Pediatr Drugs 2008;10:1-7.

  71. Harel Z. Dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol 2006;19:363-371.

  72. Harel Z. Dysmenorrhea in adolescents and young adults: from pathophysiology to pharmacological treatments and management strategies. Expert Opin Pharmacother 2008;9:2661-2672.

  73. Proctor ML, Smith CA, Farquhar CM, Stones RW. Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhea. Cochrane Database Syst Rev 2002;(1):CD002123.

  74. Smith CA, Zhu X, He L, Song J. Acupuncture for primary dysmenorrhea. Cochrane Database Syst Rev 2011;(1):CD007854.

  75. Zahradnik HP, Hanjalic-Beck A, Groth K. Nonsteroidal antiinflammatory drugs and hormonal contraceptives for pain relief from dysmenorrhea: a review. Contraception 2010;81:185-196.

  76. Marjoribanks J, Proctor M, Farquhar C, Derks RS. Nonsteroidal anti-inflammatory drugs for dysmenorrhea. Cochrane Database Syst Rev 2010;(1):CD001751.

  77. Wong CL, Farquhar C, Roberts H, Proctor M. Oral contraceptive pill for primary dysmenorrhoea. Cochrane Database Syst Rev 2009;(4):CD002120.

  78. Giudice LC. Endometriosis. N Engl J Med 2010;362:2389-2398.

  79. O'Flynn N. Menstrual symptoms: the importance of social factors in women's experiences. Br J Gen Pract 2006;56:950-957.

  80. Matteson KA, Clark MA. Questioning our questions: do frequently asked questions adequately cover the aspects of women's lives most affected by abnormal uterine bleeding? Opinions of women with abnormal uterine bleeding participating in focus group discussions. Women Health 2010;50:195-211.

  81. McPherson ME, Korfine L. Menstruation across time: menarche, menstrual attitudes, experiences, and behaviors. Womens Health Issues 2004;14:193-200.

  82. Méndez RJM. La salud adolescente: planteamiento del problema. En: Enfoque Actual de la Adolescente por el Ginecólogo: una Visión Latinoamericana. Buenos Aires: Ascune Hnos; 2005. pp. 32-44.

  83. Mansfield PK, Stubbs ML. Tracking the course of menstrual life: contributions from the Society for Menstrual Cycle Research. Womens Health Issues 2004;14:174-176.

  84. Dulanto GE. Higiene de la menstruación. En: Dulanto GE, ed. El Adolescente. México: McGraw-Hill Interamericana; 2000. pp. 55-59.



>Revistas >Boletín Médico del Hospital Infantil de México >Año2012, No. 1
 

· Indice de Publicaciones 
· ligas de Interes 






       
Derechos Resevados 2019