Persistent metrorrhagia in a teenager’s first menstrual cycles

Metrorrhagia in teenagers is often caused by anovulatory cycles, characteristic of the first menstruations, that produce episodes of dysfunctional uterine bleeding. Only sometimes there is an underlying organic lesion.

We present a 12 years old teenager who consulted for heavy bleeding during menstruation that extended in time, with secondary ferropenic anemia. An abdominal ultrasound showed a right adnexal mass compatible with an ovarian endometrioma or a hemorrhagic follicle.

The persistence of bleeding beyond 3 to 6 months from the first consultation makes mandatory an abdominal ultrasound and a blood test. The referral to a specialist should be considered.