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Menstrual Disorder Prevalence In Adolescents Undergoing Reduction Mammaplasty
Shannon Malloy, BS, Laura C. Nuzzi, BA, Gabrielle G. Massey, Catherine T. McNamara, BS, Joseph M. Firriolo, MD, Brian I. Labow, MD.
Boston Children's Hospital, Boston, MA, USA.

PURPOSE: Adolescent macromastia is likely due to disruptions in regulatory mechanisms responsible for breast growth. However, little is known regarding the association between breast hypertrophy and disruption of another part of the reproductive system--the menstrual cycle. This study seeks to elucidate the relationship between menstrual disorder prevalence and macromastia in adolescents undergoing reduction mammaplasty.
METHODS: Past and current medical and gynecological history was obtained from patients between the ages of 12-21 years undergoing bilateral reduction mammaplasty and corresponding female controls.
RESULTS: A total of 706 subjects (313 reduction mammaplasty patients and 393 controls) were included in analyses. Both macromastia patients (11.9 1.5 years) and controls (11.8 1.3 years) reached menarche at similar ages (p = 0.384). Almost half (48%) of the total sample presented with some form of gynecological dysregulation. The most common disorders were irregular periods (91%), dysmenorrhea (6%), amenorrhea (2%), and abnormal uterine bleeding (1%). Prevalence of menstrual irregularity did not significantly differ by case status (p = 0.299).
CONCLUSION: These results demonstrate that menstrual dysregulation is common among adolescents, not just those with macromastia. Given these findings, it is possible that there are distinct endocrine pathways regulating breast overgrowth and menstrual cycle dysregulation. Little is still known about the regulatory hormonal mechanisms implicated in adolescent macromastia. A deeper exploration is necessary to understand the underlying endocrine mechanisms responsible for both adolescent breast hypertrophy and menstrual dysregulation.


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