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Symptoms of dysfunctional uterine bleeding
Last reviewed: 04.07.2025
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The symptoms of dysfunctional uterine bleeding in puberty are very heterogeneous. Certain typical signs depend on the level (central or peripheral) at which the disruption of coordinated activity (self-regulation) occurred.
If it is impossible to recognize the type of uterine bleeding during puberty (hypo-, normo- or hyperestrogenic), and there is no correlation between clinical and laboratory data, we can talk about atypical forms of uterine bleeding during puberty.
Hyperestrogenic type. With the hyperestrogenic type of uterine bleeding in puberty, patients look physically developed, but psychologically they may show immaturity in judgment and actions. Distinctive features of the typical form: a significant increase in the size of the uterus and the concentration of LH in the blood plasma relative to the age norm, as well as an asymmetrical increase in the ovaries. The hyperestrogenic type of uterine bleeding in puberty is most likely to develop at the beginning (11-12 years) and the end (17-18 years) of puberty. Atypical forms can occur up to 17 years.
Normoestrogenic type. With the normoestrogenic type of uterine bleeding in the pubertal period, anthropometric data and the degree of development of secondary sexual characteristics, i.e. external signs, are harmoniously developed. The size of the uterus is smaller than the age norm, therefore, with such parameters, patients are more often classified as hypoestrogenic type.
Most often, typical and atypical forms are observed in female patients aged 13 to 16 years.
Hypoestrogenic type of uterine bleeding during puberty is most often detected in adolescent girls. Usually, such patients are of fragile constitution with a significant lag behind the age norm in the degree of development of secondary sexual characteristics, but a fairly high level of mental development. Such girls are characterized by psychoemotional stress, depressive and anxiety disorders in combination with sleep disorders. The size of the uterus is significantly (2 times) smaller than the age norm in all age groups, the endometrium is thin, the ovaries are symmetrical and slightly exceed normal values in volume. The level of cortisol in the blood plasma significantly exceeds the normative values.
In the hypoestrogenic type of uterine bleeding during puberty, almost all patients were classified as having the typical form.
Complications of dysfunctional uterine bleeding
The most severe complications of uterine bleeding during puberty are acute blood loss syndrome, which, however, rarely leads to death in somatically healthy girls, as well as anemic syndrome, the severity of which is determined by the intensity of uterine bleeding during puberty and its duration.
Mortality of adolescent girls with uterine bleeding during puberty is most often due to acute multiorgan disorders as a result of severe anemia and hypovolemia, complications of transfusion of native blood and its components, and the development of irreversible systemic disorders against the background of chronic iron deficiency anemia in girls with prolonged and recurrent uterine bleeding.
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