| Adolescents with excessive uterine bleeding should be evaluated for bleeding disorders, such as von Willebrand disease. | C | 4, 6, 15 | Consensus guidelines |
| Saline infusion sonohysterography is more sensitive and specific for the detection of endometrial abnormalities than transvaginal ultrasonography. | C | 21, 22 | Meta-analysis and a small prospective comparison trial |
| The levonorgestrel-releasing intrauterine system (Mirena) is an effective treatment for menorrhagia, with patient satisfaction scores similar to endometrial ablation and hysterectomy. | A | 35, 44 | Cochrane review and randomized trial |
| NSAIDs are effective in reducing heavy menstrual blood flow. There is no evidence that one NSAID is more effective than another. | B | 36 | Cochrane review of nine small randomized controlled trials |
