How does Western medicine treat menopausal functional uterine bleeding?

Menopausal uterine bleeding is a common gynecological disease, which is caused by endocrine changes, estrogen reduction, increased pituitary secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH), mental over-stress, environmental changes, overwork and malnutrition.

Western medicine generally uses hormone therapy to treat menopausal functional uterine bleeding. Progesterone can make the endometrium fall off after the change of the secretory phase to stop bleeding. For those with little bleeding, 10-20 mg of progesterone is used daily, and it can stop bleeding within 2-3 days. For those with long bleeding time and heavy blood loss, the treatment time should be extended. A large amount of artificial progesterone can be taken orally, and the amount can be gradually reduced after the bleeding stops. The method is the same as above. Androgen treatment can also be used. Androgen can improve the hyperplasia of the endometrium; it can produce negative feedback and inhibit the function of the hypothalamus, reduce the secretion of ESH and LH, and thus reduce the secretion of ovarian estrogen; it has the effect of strengthening the tension of uterine muscles and uterine blood vessels; it can reduce pelvic congestion and reduce the amount of bleeding. In addition, it also promotes protein synthesis, thereby improving the patient's overall condition. However, androgen generally cannot be used alone to stop bleeding. It can be used in combination with estrogen or progesterone to make up for the defects of single medication and enhance the efficacy, and sometimes it can also reduce withdrawal bleeding. The usage is that when the menstrual blood volume is large, 25-50 mg of testosterone propionate can be injected intramuscularly every day for 3 consecutive days. Some people also use testosterone alone continuously to suppress ovarian function and make some patients enter menopause. People with hypertension, cardiovascular disease or liver damage should use it with caution. The total amount of androgen should not exceed 300mg per month to avoid side effects such as increased hair growth, acne, hoarseness, etc.

If treatment is ineffective for a long time or long-term treatment and observation are difficult, or if the patient is ≥55 years old, surgical removal of the hysterectomy can be considered.