Adolescent girls undergoing treatment for cancer are at high risk for heavy menstrual bleeding, and gynecologic care is advised for careful management of this problem, according to a Committee Opinion published in Obstetrics & Gynecology.

The American College of Obstetricians and Gynecologists Committee on Adolescent Health Care has released a guideline describing the options for prevention and management of heavy menstrual bleeding in adolescent patients undergoing treatment for cancer.

The researchers found that adolescents receiving treatment for cancer are at high risk of heavy menstrual bleeding. Oncologists may consult with a gynecologist before initiation of therapy to consider options for menstrual suppression, such as combined hormonal contraceptives, progestin-only therapy, and gonadotropin-releasing hormone agonists.

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If a patient with cancer has an episode of severe uterine bleeding, the oncologist may consult with a gynecologist regarding emergent treatment to stop the bleeding, including hormonal therapy, antifibrinolytics, or, as a last resort, surgical management. Collaboration between the oncologist and the gynecologist, and tailored therapy considering the patient’s desires for contraception and fertility, should guide appropriate care.

“Addressing menstrual issues for adolescent patients undergoing cancer treatment is an important part of long-term management and will require collaborative involvement of obstetrician-gynecologists in the care of such patients,” the authors write.

  1. Committee on Adolscent Health Care. “Committee Opinion No. 606: Options for Preention and Management of Heavy Menstrual Bleeding in Adolescent Patients Undergoing Cancer Treatment.” doi: 10.1097/01.AOG.0000452745.44206.c3. August 2014.