menopausal bleeding
Introduction
Introduction Menopausal women, due to gradual deterioration of ovarian function, can not produce mature follicles and ovulate, thus losing the irregular changes of normal female hormones, irregular vaginal bleeding, called menopausal dysfunctional uterine bleeding. After women enter menopause, ovarian function begins to decline, ovarian hormone levels decline, and feedback to the hypothalamus and pituitary gland is lost. The gonadotropins secreted by the pituitary gland are increased to varying degrees, and the remaining follicles in the ovary are also developed, but Does not ovulate, endometrial glands in the long-term estrogen effect of sustained proliferative reaction, can occur mild hyperplasia, glandular hyperplasia or adenoma hyperplasia.
Cause
Cause
1. Women with menopausal dysfunctional uterine bleeding are irregular uterine bleeding, menstrual cycle disorder, menstrual period varies, bleeding volume is often less, sometimes bloody for several months, accompanied by anemia. BBT single phase, vaginal exfoliated cells are mainly bottom layer cells, or medium and low layer cells. Cervical mucus crystallization shows poorly developed fern leaf shape, endometrial cystic gland hyperplasia or glandular hyperplasia. Blood endocrine examination increased FSH, decreased E2 and so on.
2, Chinese medicine believes that women are exhausted in seven or seven days, kidney weak, due to the decline of the cause, with kidney deficiency. Because menopausal women have a decline in kidney qi, viscera function is lost, temper is weak, and often no power to cause uterine bleeding. Therefore, menopausal dysfunctional uterine blood is more witnessed by spleen and blood type, seeing violent collapse or dripping, color and thinness, lack of strength and shortness of breath The face is white, the eyelids are swollen, the tongue is fat, and the pulse is weak. Expelling Qi and strengthening the spleen, solid photo Chong Ren.
Examine
an examination
Related inspection
Curettage examination gynecological ultrasound examination cervical smear (TCT) sex hormones six examination ovarian function test
Disease diagnosis check:
Functional uterine bleeding is one of the common diseases in gynecology, and about 50% occurs in menopause. It is also said that menopausal dysfunctional uterine bleeding, menopausal women have irregular menstruation, exclude pregnancy, tumor, inflammation, trauma and blood system diseases after examination, and determine the intrauterine device can be diagnosed as menopausal dysfunctional uterine bleeding.
It is generally believed that dysfunctional uterine bleeding is caused by neuroendocrine disorders. Its main manifestation is the change of menstruation, including changes in cycle and quantity. The clinical manifestations of climacteric dysfunctional uterine bleeding have the following characteristics:
1. irregular menstrual cycle: one is the shortening of the menstrual cycle, the other is the menstrual cycle is extended, up to 2-3 months or longer, or menopause and regular menstrual rotation.
2. Irregular menstrual cycle and menstrual period: menstrual cycle and menstrual period can be long or short, often for a long time or as a dripping.
3. Changes in menstrual flow: Some women showed a gradual decrease in menstrual flow, but some women showed a significant increase in menstrual flow, accompanied by large blood clots, massive bleeding, severe symptoms such as palpitation, dizziness and other anemia.
Diagnosis
Differential diagnosis
Differential diagnosis of menopausal dysfunctional uterine bleeding:
1. Postmenopausal bleeding: Postmenopausal bleeding is not a disease, but a clinical symptom. As people's lives continue to improve, women's life expectancy is gradually extended, one-third of life is spent after menopause, a series of geriatric diseases are coming one after another, and postmenopausal bleeding is one of the most common symptoms. Postmenopausal bleeding refers to vaginal bleeding after 1 year of menstruation, mainly refers to the symptoms caused by non-organic, benign and malignant lesions of the internal genitalia. Patients with postmenopausal bleeding should seek the cause. With the development of medical science and the popularization of medical knowledge, people are more alert to postmenopausal bleeding, and the proportion of postmenopausal bleeding caused by malignant lesions is gradually reduced, less than 10% reported abroad. Mainly due to non-organic lesions, followed by benign lesions. There are different reports in China, about 20% to 50%.
2, uterine bleeding: abnormal uterine bleeding caused by abnormalities in the neuroendocrine mechanism regulating the reproductive system, known as dysfunctional uterine bleeding (referred to as dysfunctional uterine bleeding), is a common gynecological disease, more common in adolescence and menopause. Western medicine is divided into ovulation dysfunctional uterine bleeding (luteal dysfunction) and anovulatory function (follicular dysfunction) according to the degree of ovarian dysfunction.
