Abnormal uterine bleeding (AUB) is common in adolescents 1. Immaturity of the hypothalamic pituitary ovarian (HPO) axis is the most common cause of AUB in this age group2. Certain aspects of underlying inherited or acquired blood disorders, as discussed in this chapter, exacerbate the “expected” hormonal imbalance at this age, thereby, increasing the morbidity of the underlying problem3,4. Even though blood disorders may induce AUB, uterine structural and/or endocrine abnormalities tend to be overlooked in the presence of a blood disorder5. A multifactorial etiology demands a collaborative approach between hematologists and gynecologists or adolescent medicine physicians6,7. In this chapter, we will discuss management of AUB in adolescents within 4 clinical contexts: AUB while on anticoagulant therapy, and with inherited bleeding disorders, bleeding management with cytopenias, specifically, thrombocytopenia, and in sickle cell disease. Throughout, areas of controversy and opportunities for further research are highlighted.

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