Management of Heavy Menstrual Bleeding in Adolescents Within the Primary Care Setting [ID 1322]

INTRODUCTION: Heavy menstrual bleeding (HMB) is a common adolescent concern with significant consequences. This study aimed to understand primary care provider (PCP) practices for HMB at the initial visit. METHODS: We conducted a retrospective cohort study of 9–16 year olds presenting to PCPs for initial HMB evaluation between January 2017 and June 2019. Patients were identified by ICD-10 codes and confirmed through chart review. Quantitative analysis assessed gynecologic referrals and hormonal prescriptions. Secondary outcomes included HMB quantification and hormonal contraception discussion. Subgroup analyses using chi-squared tests were performed to evaluate differences in outcomes across national area deprivation index (ADI) quartiles. RESULTS: Three hundred forty-five patients met inclusion criteria. 74.7% were asked to quantify their bleeding (63.7% duration of menses, 33.9% frequency of product changes, 17.9% amount of product use). Although 74.4% of adolescents discussed hormonal contraception, only 46.9% received prescriptions. 23.7% of these discussions were patient/family-driven. 10.7% of patients were referred to gynecology. No statistically significant differences in outcomes were observed across ADI quartiles, although individuals in the fourth quartile had the lowest rate of hormonal prescriptions (26.3%). CONCLUSIONS/IMPLICATIONS: This study revealed significant variability in HMB management among adolescents, with fewer than half receiving hormonal treatment and even fewer referred to gynecology during initial PCP visits for HMB. These findings underscore the need for standardized management practices in primary care. Future research should evaluate whether HMB is adequately assessed and treated in follow-up appointments to ensure comprehensive care for affected adolescents.