A 14-year-old girl with short stature, incomplete puberty and severe menstrual bleeding

A 14-year-old girl was seen in her local emergency department following multiple syncopal episodes with loss of consciousness following 1 week of severe vaginal bleeding. She was tachycardic and had orthostatic hypotension and a haemoglobin of 50 g/L. She was treated with multiple blood transfusions, tranexamic acid and oral contraceptive (OCP) tablets. Her menarche occurred 3 months earlier, and she had three normal cycles before presentation