Mechanism of dysfunctional uterine bleeding caused by sex hormone secretion disorder

The normal menstrual cycle is a biological clock phenomenon. It is affected by internal and external environmental factors and regulated by neuroendocrine, so that female reproductive physiology and reproductive endocrine function follow strict biological rhythms. Sex hormone secretion disorders can lead to menstrual disorders and abnormal uterine bleeding.

Anovulatory Dysfunctional Uterine Bleeding

Single and long-term estrogen stimulation causes progressive hyperplasia and proliferation of the endometrium, leading to highly cystic and adenomatous hyperplasia, and even progression to endometrial cancer. Due to the lack of progesterone antagonism and glandular secretion, the endometrium is thickened, the glands increase, the glandular cavity is enlarged, and the glandular epithelium proliferates abnormally. The blood supply to the endometrium increases, and the spiral arterioles are tortuous. The polymerization and gelation of acid mucopolysaccharides (AMPS) caused by estrogen reduce the permeability of blood vessels in the interstitium, affect material exchange, cause local endometrial tissue ischemia, necrosis and shedding, and cause bleeding. The coagulation of AMPS also hinders the shedding of the endometrium, causing asynchronous exfoliation of the endometrium, resulting in long-term irregular bleeding of the endometrium.

Ovulatory dysfunctional uterine bleeding

In patients with ovulatory functional uterine bleeding, the corpus luteum degenerates prematurely, resulting in a short luteal phase, frequent menstruation or incomplete atrophy, and continuous secretion of progesterone, leading to premenstrual bleeding, prolonged menstruation, and continuous spotting, or both. The mechanism is: insufficient secretion of estrogen and progesterone, especially insufficient secretion of progesterone, which makes the endometrium completely secreted, the glands, stroma and blood vessels are immature, and due to the asynchronous withdrawal of estrogen and progesterone, irregular exfoliation of the endometrium and abnormal bleeding are caused.