Tests to diagnose functional uterine bleeding in adolescence

Dysfunctional uterine bleeding in adolescence is caused by the fact that the ovarian function and ovulation mechanism are not yet perfect in adolescence. Due to high pressure from study, mental stress, intense exercise, malnutrition, etc., ovarian dysfunction and abnormal secretion of sex hormones lead to irregular vaginal bleeding. The diagnosis of Dysfunctional uterine bleeding in adolescence requires the following examinations:

Basal body temperature measurement

The basal body temperature curve of patients with functional uterine bleeding is monophasic. Since the cycle center of the hypothalamus matures late in most patients, the hypothalamus-pituitary-ovary can only establish negative feedback, but not positive feedback. Therefore, there is no LH peak in the middle of the menstrual cycle, which prevents the ovulation of mature follicles, so it is anovulatory functional uterine bleeding.

Vaginal smear

On the one hand, guided secretion smear can be used to understand the estrogen level and cyclical changes. Since the patient's ovaries do not ovulate, there is no progesterone effect and no cyclical changes. On the other hand, it can also rule out rare malignant tumors.

Estrogen and progesterone measurement

There is no cyclical fluctuation in estrogen and progesterone levels in patients with functional uterine bleeding, especially progesterone, which always remains at the level of the proliferative phase.

Diagnostic curettage

Diagnostic curettage can help understand the endometrial response, exclude intrauterine lesions, and achieve the purpose of hemostasis. It is rare for adolescents to have organic lesions or malignant diseases, and diagnostic curettage is generally not needed to assist in diagnosis; diagnostic curettage is only needed for patients with severe bleeding or ineffective drug treatment. If curettage is for diagnosis, it should be performed 1-2 days before bleeding or within 12 hours after bleeding.

Laboratory examination

Routine blood tests, platelet count, and bleeding and clotting times should be performed to determine the degree of anemia and the presence of blood disease.

Other tests

Thyroid, adrenal and liver function tests should be routinely performed to exclude anovulatory functional uterine bleeding caused by these diseases.