Medical curettage can treat unmarried patients with anovulatory functional uterine bleeding

Anovulatory functional uterine bleeding is caused by the disorder of the neuroendocrine system that regulates reproduction. It is more common in adolescence and menopause. Adolescent functional uterine bleeding is caused by the immature or delayed development of the hypothalamus-pituitary-ovarian axis, which leads to the growth and development of follicles in the ovaries but the inability to ovulate; menopausal functional uterine bleeding is caused by the natural aging of the ovaries, lack of follicles, ovarian hypofunction, and reduced sensitivity to pituitary gonadotropin, resulting in the inability to ovulate and causing irregular vaginal bleeding. Patients with functional uterine bleeding can stop bleeding by curettage, but unmarried patients generally do not consider surgical curettage, and use medical curettage instead.

The medical curettage method is to inject progesterone into the patient's muscle, 20 mg per day, for 3 days, and the endometrium will change to the secretory phase. Then stop the drug, causing an artificial drop in blood progesterone levels. At this time, the endometrium is regularly exfoliated and bleeding occurs. This bleeding is similar to menstrual bleeding and lasts for about 7 days. Sometimes the amount is also large, which is expected and inevitable. Therefore, before using progesterone for medical curettage, it is necessary to explain to the patient that the hemostatic effect will only appear after the withdrawal bleeding stops, so as to prevent the patient from mistakenly thinking that the treatment has failed and taking other drugs.

When taking medical curettage, in order to reduce the amount of withdrawal bleeding, testosterone propionate can be injected at the same time as progesterone is injected intramuscularly, 25-50 mg per day, for 3 days. If the amount of blood is still large, the patient should rest in bed, take general hemostatic drugs such as vitamin K, hemostatic, vitamin C, hemostatic aromatic acid orally or intramuscularly, or transfuse glucose solution or blood.