Menstrual Dysfunction and Treatment Among Adolescents With Congenital Heart Disease

Abstract

Study objective: This study describes menstrual dysfunction and treatment among adolescent and young adult (AYA) females with congenital heart disease (CHD).

Design: Data collected from a 1-time survey completed by AYA females (and mothers if AYA unable).

Setting: Participants were recruited from pediatric cardiology clinics.

Participants: Female AYA with CHD, aged 14-21 years (N = 114).

Interventions: None.

Main outcome measures: The questionnaire assessed sexual and reproductive health (SRH) concerns, behaviors, and management. Outcome measures were self-reported menstrual complaints, use of over-the-counter (OTC) pain relief medications for dysmenorrhea, reported visits with a clinician for a menstrual problem, and reported use of hormones for menstrual problems or birth control.

Results: Mean age was 17.0 years (SD = 2.2). The majority of participants (83%) reported 1 or more menstrual complaints (67.5% cramping, 42.1% irregular menses, 46.5% heavy periods), and 88% reported any history of taking OTC medications for pain relief. Increased menstrual complaints were not associated with level of cardiac complexity, reported transplantation, or reported use of hormonal contraception. However, 32% of participants reported use of hormonal contraception for menstrual dysfunction. Combined oral contraceptive pills (COCs) were the most common; 2 of these women carried contraindications to estrogen.

Conclusions: A large majority of AYA females with CHD reported menstrual dysfunction. Use of OTC medication for menstrual pain and inappropriate use of estrogen creates concerns that menstrual disorders may be unaddressed or addressed inappropriately. Thus, gynecological needs of adolescents with CHD may need to be specifically targeted by providers who feel comfortable with this population and their complex needs.

Keywords: Cardiovascular abnormalities; Contraindications; Menstruation disturbances.