Abnormal uterine bleeding (AUB) is a frequent cause of visits to health care provider during adolescent period. Heavy menstrual bleeding is the most frequent clinical presentation of AUB. This condition particularly worrisome in this group not only when it occurs at menarche, but also anytime afterward when bleeding lasts longer than 7 days, blood loss is greater than 80 mL per cycle, or other warning signs that indicate a history of heavy bleeding such as anemia. Careful history and examination can help elucidate the best next steps for workup and management. The primary goal of treatment is prevention of hemodynamic instability. Therefore, assessing the severity and cause of bleeding is important. Therapeutic approach in the acute period should be established according to the degree of anemia and amount of flow. Treatment options for medical care of AUB generally include hormonal, nonhormonal and surgery. Additionally, long-term management with hormonal therapy in patients with severe uterine bleeding is known to be safe for developing HPO axis.