Is it necessary to induce ovulation in adolescent functional uterine bleeding?

Dysfunctional uterine bleeding is mainly caused by dysfunction of the hypothalamus-pituitary-ovarian axis. The secretion of FSH (follicle stimulating hormone secreted by the pituitary gland) and LH (luteinizing hormone) is at the level of the follicular phase, without the secretion pattern of the normal menstrual cycle, showing irregular fluctuations and no ovulation peak. The secretion of estrogen and progesterone is also irregular, showing high and low fluctuations. When estrogen decreases, bleeding often occurs, and the continuous low level of progesterone is caused by the lack of corpus luteum formation.

At this time, FSH and LH are secreted in a pulsed manner, and the FSH level is often higher than the LH level. If GnRH (gonadotropin-releasing hormone) is injected, the release of FSH is also greater than that of LH. The E2 (estradiol) level is in the follicular phase range. If E2 reaches the level of the late follicular phase, there is no LH peak, which means that the hypothalamus and pituitary lack positive feedback to estrogen.

After menarche, the function of the hypothalamus-pituitary-ovarian axis is initially established and fully mature, so it is often anovulatory menstruation. Different individuals go through different periods to establish a menstrual cycle with ovulation. It is reported that 80% of menstruation is anovulatory within one year after menarche; 50% is anovulatory menstruation in the second year; and 20% is anovulatory menstruation in the third year. It can be seen that after menarche, the hypothalamus, pituitary gland, and ovaries of different individuals need different times of mutual adjustment and adaptation to establish normal functions, leading to ovulatory menstruation. Generally, within 3 years after menarche, unless the menstruation is obviously disordered, it is not necessary to forcibly adjust the cycle with exogenous sex hormones, let alone actively induce ovulation. According to domestic and foreign reports, those with a short course of adolescent functional uterine bleeding are easy to restore ovulation, and those with a course of more than 4 years are difficult to establish a normal menstrual cycle. Therefore, it is of positive significance to adjust the menstrual cycle for those with obvious menstrual disorders and induce ovulation with the camera.