Comparison of Combined Oral Contraceptives and a Transdermal Estrogen Patch With Oral Progesterone: Treatment of Abnormal Uterine Bleeding in Adolescents

Objective Abnormal uterine bleeding (AUB) is a frequent complaint in adolescents. Ovulatory dysfunction (AUB-O) is the most common etiology of AUB. We aimed to compare possible treatment modalities for idiopathic AUB-O, the most common reason for AUB-O in adolescents. Methods Thirty patients who were treated with either 30 μg ethinyl estradiol/3 mg drospirenone combined oral contraceptive (group A) or 1.95 mg 17β-estradiol transdermal patch and 5 mg oral medroxyprogesterone acetate combined treatment (group B) for six months in the pediatric endocrinology department between years 2017 and 2019 were enrolled in our study retrospectively, and a questionnaire was performed on them to assess their treatment satisfaction. Results In the first three months of treatment, four (26.6%) patients reported intermenstrual bleeding (IMB), three (20%) reported abdominal pain, two (13.3%) reported nausea-vomiting, and one (6.7%) reported headaches in group A, while eight (53.3%) patients reported IMB, six (40%) reported abdominal pain, two (13.3%) reported nausea-vomiting, and two (13.3%) reported headaches in group B. No major side effects were reported to cause cessation of treatment in any treatment group, but fewer mild side effects were reported in group A. Group A had better treatment compliance and satisfaction. Menstrual irregularity stopped after two months of treatment in both groups, but one (6.6%) and three (20.0%) patients reported that AUB repeated within three months of treatment cessation in group A and group B, respectively. Conclusion Immaturity of the hypothalamo-pituitary-ovarian axis in adolescence can present with a wide range of symptoms and proves challenging to choose the proper treatment regimen.