Menstrual patterns under hormonal contraception in adolescent girls and young women.

Adolescents are more likely to discontinue hormonal contraception because of disturbances in their menstrual patterns. Menstrual disturbances occur as spotting, breakthrough bleeding, as well as missed withdrawal bleeding depending on both the prevailing levels of estrogens and the more or less suppressed endometrium. Patients on cyclic prescribed oral combined micro-pills are found to have the fewest menstrual disturbances compared with all other hormonal regimens. Combined micro-pills as long term therapy should be given for medical indications only. Oral gestagen-only mini-pills are suitable for adolescent girls when estrogens are contraindicated. Irregular bleeding was found in more than 50% of patients. Long term contraceptives of all hormonal contraceptives show the highest rate of menstrual disturbance. They are suitable for adolescent girls in special indications only.