Methods for regulating menstruation in patients with functional uterine bleeding

The cycle regulation of patients with functional uterine bleeding is based on hemostasis treatment, simulating the rhythm of reproductive hormones, and using artificial cycle therapy with estrogen-progesterone to promote the cyclical development and shedding of the endometrium and improve the feedback function of the HPO axis. Rebound ovulation and restoration of regular menstruation may occur after drug discontinuation.

Full cycle therapy

1. Estrogen-progesterone sequential therapy: Applicable to adolescent functional uterine bleeding. Take diethylstilbestrol 0.5-1.0 mg/d x 20-22 days starting from the fifth day of the menstrual cycle. Take 8-10 mg/d of medroxyprogesterone for the next 10 days, or inject progesterone 20 mg/d for the next 5 days. Three cycles constitute one course of treatment.

2. Estrogen-progestin combined therapy: Suitable for women of childbearing age and menopausal women with functional uterine bleeding, excessive endometrial hyperplasia, and menorrhagia. Oral contraceptive pills No. Ⅰ or No. Ⅱ are taken orally from the fifth day of the menstrual cycle, 1 tablet/dX22 days, for a total of 3 cycles. (Metronidazole 4mg + diethylstilbestrol 0.5mg)/d, or (norethindrone 2.5mg + diethylstilbestrol 0.5mg)/dX20-22 days, for a total of 3 cycles.

3. Progestin therapy: norethindrone 2.5-5.0 mg/d; or megestrol acetate, medroxyprogesterone acetate 4-8 mg/d; or chlormadinone acetate 12 mg/dX20-22 days. 3 cycles in total.

4. Progestogen-androgen therapy: On the basis of progestogen therapy, 5-10 mg of methyltestosterone is added orally every day to enhance the inhibitory effect on the HPOU axis.

Second half cycle therapy

It is limited to regulating the cycle, assisting the corpus luteum, and controlling bleeding by taking estrogen-progesterone orally or intramuscularly every day from the 15th to the 24th day of the menstrual cycle (the second half of the cycle) for a total of 10 days.

The drugs include: oral contraceptives No. Ⅰ or No. Ⅱ tablets (full or half tablets)/d; norethindrone 2.5-5.0 mg, or (megestrol acetate, medroxyprogesterone acetate 6-8 mg + diethylstilbestrol 0.25-0.5 mg)/d; compound progesterone 1 vial/dX5-7 days.