Clinical manifestations of patients with dysfunctional uterine bleeding

Excluding causes such as organic lesions and blood abnormalities, abnormal uterine bleeding caused by neuroendocrine system disorders is called dysfunctional uterine bleeding.

Due to the dysfunction of the hypothalamus-pituitary-ovarian gonadal axis, the endometrium reacts abnormally and its histological changes lose regularity, which can be changes in any stage from the proliferative phase to the secretory phase. Most cases of dysfunctional uterine bleeding are anovulatory bleeding, in which the follicles develop to a certain extent and persist, but ovulation and corpus luteum formation are not possible, and the amount of bleeding and duration are uncertain.

1. Ovulation bleeding Due to the low estrogen level before ovulation, a small amount of vaginal bleeding can be seen during the ovulation period.

2. Premenstrual bleeding: There is a small amount of vaginal bleeding a few days before menstruation, followed by normal menstruation. This type of bleeding is caused by corpus luteum insufficiency and insufficient secretion of estrogen and progesterone.

3. Postmenstrual bleeding. The initial stage of menstruation is normal, but the bleeding lasts longer in the later stage. This type of bleeding is caused by incomplete exfoliation of the endometrium. The histological feature is the mixed existence of incomplete exfoliation of the secretory endometrium and the early proliferative endometrium. This is mainly caused by the slow regression of the corpus luteum and the continuous secretion of progesterone. The bleeding caused by endometrial hyperplasia is a typical anovulatory bleeding. Due to the continuous existence of follicles and the secretion of a certain amount of estrogen, the endometrium proliferates abnormally, and the endometrium is mostly glandular cystic hyperplasia.