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 one-time survey completed by AYA females (and mothers if AYA unable). Setting Participants were recruited from pediatric cardiology clinics. Participants Female AYA with CHD, ages 14-21 (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 medicines 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). A majority (83%) reported one or more menstrual complaints: 67.5% cramping, 42.1% irregular menses, 46.5% heavy periods, and 88% reported any history of taking OTC for pain relief. Increased menstrual complaints were not associated with level of cardiac complexity, reported transplant, 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; two 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 that feel comfortable with this population and their complex needs.