Adolescence and Menarche

Key Topics

• Menarche counseling
• Dysmenorrhea
• Heavy menstrual bleeding
• Hormonal therapy options
• Contraception
• Sexual health
• Fertility considerations
• Transition to adult care
• Mental health/body image
• Exercise participation

Clinical Considerations

• Menstrual management: how SCD pain may overlap with dysmenorrhea when bleeding is abnormal, impact of anticoagulation, risk of hemorrhagic ovarian cysts, possible endometriosis, iron balance considerations
• Contraception section: Estrogen considerations thrombosis risk, progestin-only methods, IUD considerations, menstrual suppression strategies
• High-value clinical pearls: Menstrual pain may trigger vaso-occlusive episodes, Hormonal suppression may improve quality of life, Avoid fragmented care between hematology and gynecology

Suggested resources

• Menstrual management algorithms
• Contraceptive counseling tools
• Transition checklists
• Patient handouts