Menstrual Health in Adolescents with Congenital Heart Disease

Objective: As life expectancy increases in patients with congenital heart disease (CHD), providing appropriate gynecological care has become more important. While the gynecologic and reproductive health concerns of adults with CHD are increasingly recognized, studies focusing on menstrual problems in adolescents with CHD are limited. The aim was to evaluate menstrual characteristics and related symptoms in adolescents with CHD. Methods: Adolescents aged 12-21 years who had experienced menarche at least two years earlier were included. The CHD group was classified as mild, moderate, or severe, based on the European Society of Cardiology guidelines, and healthy adolescents served as controls. Menstrual histories were obtained from all participants. In the CHD group, additional clinical data (diagnosis, surgery/interventions, and medication use) were collected. Menstrual parameters were compared between the CHD and control groups, as well as across CHD subgroups. Results: A total of 108 adolescents with CHD (41 mild, 42 moderate, 25 severe) and 76 healthy controls were enrolled. No significant differences were found between groups in terms of age at menarche, menstrual cycle length, period duration, or daily pad use (p>0.05). Dysmenorrhea severity and frequency were similar; however, school absenteeism due to dysmenorrhea was significantly higher in the control group (p=0.037). Physical premenstrual symptoms, particularly bloating, anxiety, and mood swings, were more frequent in controls (p<0.05). Menstrual education rates from healthcare professionals were low in both groups. Conclusion: Our findings indicate that adolescents with CHD have menstrual characteristics comparable to those of healthy controls. However, despite these similarities, they may differ in their perception and tolerance of menstrual symptoms.