Abnormal uterine bleeding refers to abnormal bleeding originating from the uterine cavity that does not match any one or more of the normal menstrual cycle frequency, menstrual period length, menstrual bleeding volume, regularity, and menstrual blood characteristics.
There are many causes of abnormal uterine bleeding, and before choosing a treatment method, it is necessary to determine the cause through examination. Patients not only need to undergo routine gynecological examinations, but also need to undergo examinations such as ultrasound, cervical scraping, hysteroscopy, and uterine biopsy.
There are many reasons that can lead to abnormal uterine bleeding, which may be caused by diseases such as endometrial polyps, uterine leiomyomas, adenomyosis, and endometrial malignancy. In addition, if the patient suffers from systemic coagulation disorders, it may also cause abnormal uterine bleeding, such as vascular hemophilia, or severe liver dysfunction, which can easily lead to coagulation abnormalities and cause abnormal uterine bleeding.
In addition to illness, abnormal uterine bleeding may also be caused by the use of hormone drugs or the consumption of health supplements containing hormones. In addition, placing an intrauterine device may also cause abnormal uterine bleeding.
Adopt corresponding treatment methods based on the causes. For functional uterine bleeding caused by abnormal levels of sex hormones, oral medication can be chosen to adjust sex hormone levels; For functional uterine bleeding that occurs after menopause, estrogen and progesterone drugs need to be used for treatment; For functional uterine bleeding caused by uterine fibroids, surgical treatment can be performed. If diagnosed with abnormal uterine bleeding and excluding bleeding caused by systemic diseases or reproductive organ lesions, treatment needs to be based on the patient's actual situation.
Drug hemostasis mainly involves the use of sex hormones to stop bleeding. Generally, progestogens such as progesterone, medroxyprogesterone, and progesterone can be taken orally. These hormone drugs regulate menstrual conditions by inhibiting the growth rate of the endometrium, achieving temporary hemostasis. However, excessive or long-term use of these drugs can lead to endocrine disorders, causing a series of adverse reactions. Therefore, they should be taken under the guidance of a doctor.
For patients with anovulatory abnormal uterine bleeding during menopause, efficient synthetic progesterone can be used to shrink the endometrium to achieve hemostasis; Compound short acting oral contraceptives can also be used to stop bleeding. Generally, before using compound short acting oral contraceptives, high-risk factors for cardiovascular disease and thrombosis should be ruled out, and smoking patients are not recommended to use them.
For patients with anovulatory abnormal uterine bleeding during adolescence, compound short acting oral contraceptives can be taken for treatment. However, it should be noted that the maximum dose of these drugs for hemostasis is 3 tablets. Increasing the dose may not only not increase the hemostatic effect, but may also cause adverse reactions. If taking three contraceptive pills still cannot effectively stop bleeding, then it is necessary to consider whether there is organic disease.
Curettage to stop bleeding. Scraping has diagnostic value, not only can it understand endometrial lesions, but it can also quickly stop bleeding. For patients in the menopausal transition period or those of childbearing age with a long course of illness, curettage should be considered first. For adolescents who have not had sexual activity, curettage is generally not a light procedure. For patients of puberty and reproductive age without ovulatory abnormal uterine bleeding, it is necessary to regulate the endocrine system and establish a normal menstrual cycle after hemostasis. For patients in the menopausal transition period, it is generally necessary to prevent endometrial hyperplasia and prevent the recurrence of dysfunctional uterine bleeding after controlling bleeding.
The specific method of adjusting the menstrual cycle, especially when using hormone drugs to adjust the menstrual cycle, must be carried out under the guidance of a doctor. In clinical practice, it is recommended to consider surgical treatment for patients who have poor drug efficacy, are not suitable for medication, do not have fertility requirements, and are older and inconvenient for follow-up. Surgical treatment includes endometrial resection, hysterectomy, etc. Doctors will choose different treatment methods based on the patient's different conditions during treatment.