Methods for the examination of dysfunctional uterine bleeding during perimenopause

There are many clinical symptoms of perimenopausal dysfunctional uterine bleeding. If menopausal women find that their menstrual period is abnormal, they need to go to a regular hospital for examination and treatment in time. Early medical treatment will help the recovery of the disease. The examination methods for perimenopausal dysfunctional uterine bleeding are as follows:

1. Sex hormone measurement is the most accurate indicator of the reproductive endocrine status and ovarian function in the body. Before hormone treatment, or at a scheduled time under the guidance of basal body temperature (BBT), blood is collected to measure the levels of FSH, LH, prolactin (pRL), estradiol (E2), progesterone (p), and testosterone (T), to distinguish the type of dysfunctional uterine bleeding, polycystic ovary syndrome, and hyperprolactinemia, so as to guide the clinical formulation of treatment plans and make the treatment more targeted.

2. Vaginal exfoliated cell smears are used to dynamically observe vaginal exfoliated cells and the vaginal epithelial cell maturation index (MI) is used to understand the E level in the body as a monitoring indicator for diagnosis, classification and treatment.

1. Cervical mucus scoring can help understand the E level in the body. If the cervical mucus still presents fern-like crystals before or even during bleeding, it indicates a single E effect and no ovulation function. It can be used as a simple indicator for clinical classification of dysfunctional uterine bleeding, estimation of E levels, and observation of therapeutic effects.

2. BBT is one of the most commonly used and simple methods in the diagnosis of dysfunctional uterine bleeding. According to the BBT phase, combined with other monitoring indicators, it is the simplest and most practical means to classify dysfunctional uterine bleeding, observe the therapeutic effect and guide treatment.

3. Diagnostic curettage can understand the functional status of the endometrium and ovaries, and can directly stop bleeding. For those with perimenopausal bleeding and high-risk factors for endometrial cancer, segmented curettage should be performed first to rule out malignant lesions. The functional layer of the endometrium must be completely removed during diagnostic curettage, and the tissue should be sent for pathological examination. The depth, shape, and smoothness of the uterine cavity should also be noted. The sensitivity of diagnostic curettage is 78.8% to 84.5%, and the specificity is 100%.

4. B-mode ultrasound B-mode ultrasound can detect small submucosal fibroids that are overlooked by curettage, ovarian tumors, and endometrial thickness measurement and dynamic observation. Because it is non-invasive and repeatable, it plays an important role in the diagnosis and differential diagnosis of dysfunctional uterine bleeding, judging the treatment effect, and guiding clinical treatment.

5. Hysteroscopy Hysteroscopy can directly observe the appearance, location and range of lesions in the uterus and endocervical canal, and perform localized biopsy on suspicious lesions. Therefore, hysteroscopy can help detect lesions in uterine lesions and select samples under direct vision to reduce misdiagnosis for dysfunctional uterine bleeding that has not been cured for a long time. The sensitivity of hysteroscopy is 94.1%, and the specificity is 95.5%.

The emotions and daily behaviors of some perimenopausal women will be affected, which requires us to pay more attention and care to women in this period. Developed countries usually provide perimenopausal care for women.