Clinical manifestations of menopausal dysfunctional uterine bleeding

After women enter menopause, their ovarian function begins to decline, the hormone level of the ovaries decreases, and the feedback function to the hypothalamus and pituitary gland is lost, causing the gonadotropin secreted by the pituitary gland to increase to varying degrees. Although the remaining follicles in the ovaries also develop, they do not ovulate. Under the long-term effect of estrogen, the endometrial glands show a continuous hyperplasia reaction, which can cause mild hyperplasia, adenocystic hyperplasia, or adenomatous hyperplasia. When the estrogen level fluctuates greatly, the endometrium will shed incompletely, causing irregular uterine bleeding.

Dysfunctional uterine bleeding is one of the common gynecological diseases, about 50% of which occur during menopause. It is also called menopausal functional uterine bleeding. Menopausal women have irregular menstruation. After examination, pregnancy, tumors, inflammation, trauma and blood system diseases are ruled out, and it is confirmed that there is no intrauterine device in the uterus, then it can be diagnosed as menopausal functional uterine bleeding.

It is generally believed that functional uterine bleeding is caused by neuroendocrine disorders. Its main manifestation is changes in menstruation, including changes in cycle and volume. The clinical manifestations of menopausal functional uterine bleeding have the following characteristics:

(1) Irregular menstrual cycle: One is a shortened menstrual cycle, the other is a prolonged menstrual cycle, which can occur every 2-3 months or longer, or alternating between amenorrhea and regular menstruation.

(2) Irregular menstrual cycle and menstrual period: The menstrual cycle and menstrual period can be long or short, sometimes more, sometimes less, or continuous.

(3) Changes in menstrual volume: Some women experience a gradual decrease in menstrual volume, but some women experience a significant increase in menstrual volume, accompanied by large blood clots and heavy bleeding. In severe cases, symptoms of anemia such as palpitations and dizziness may occur.