Diagnostic principles for oligomenorrhea in patients with irregular menstruation

If the menstrual bleeding volume of patients with irregular menstruation is less than 20 ml, it is considered as oligomenorrhea, which is related to endocrine factors, such as ovarian insufficiency, low estrogen level, hyperprolactinemia or certain endocrine diseases. In addition, congenital uterine hypoplasia, endometrial estrogen receptor deficiency, endometrial tuberculosis, drug effects, etc. can also lead to oligomenorrhea. The following principles should be noted in the diagnosis of oligomenorrhea in patients with irregular menstruation:

Pay attention to medical history to obtain basic information

Carefully inquire about the patient's medical history, including past menstrual history, menopausal history, reproductive history, abortion history, chronic disease history, etc. Also inquire about whether the patient has a history of taking medications that affect menstruation and a history of gynecological diseases.

Gynecological examination to rule out uterine abnormalities

1. Check the internal and external genitalia for any abnormalities. The ovaries of patients with polycystic ovary syndrome are slightly enlarged on both sides. The ovaries of patients with endometriosis are enlarged on one or both sides, which are cystic and adhere to the uterus, and nodules can be felt in the isthmus of the uterus.

2. Perform vaginal B-ultrasound to check the thickness of the endometrium 7 days after the basal body temperature rises or 7 days before the menstrual period to determine whether the endometrium is hypoplastic. At this time, the thickness of a normal endometrium single layer is about 0.5-0.8cm.

3. Blood endocrine examination is of reference value for diagnosing polycystic ovary syndrome, premature ovarian failure, anovulatory functional uterine bleeding, etc.

Basal body temperature and hormone levels

Measure basal body temperature to get a preliminary understanding of ovarian function; check sex hormones and thyroid stimulating hormone on the 2nd to 5th day of menstruation to rule out causes of oligomenorrhea such as ovarian insufficiency, hyperprolactinemia, or abnormal thyroid function. Measure thyroid function if necessary.

Hysteroscopy if necessary

Patients suspected of having intrauterine adhesions should undergo hysteroscopy. If there are intrauterine adhesions, the adhesions should be broken down during hysteroscopy.