abnormal uterine bleeding
Introduction
Introduction Abnormal uterine bleeding refers to any bleeding that occurs outside the normal menstrual cycle, or an abnormal increase in menstrual bleeding or an increase in total menstrual flow. Here are some cases of abnormal bleeding: 1. The increase in total amount is called hypermenoeehea (menorrhagia). 2. Too many menstrual cycles (polymenorrhea), which is defined as the menstrual cycle interval is too short (<21 days). 3. The number of menstrual cycles is too small (oligomeoeehea), which means that the menstrual cycle interval is too long. 4. Hypomeorrhea refers to a significant reduction in the amount of menstrual blood flowing out. 5. Unexpected uterine bleeding (metrorrhagia) refers to any bleeding or punctiform bleeding between menstruation. 6. Postmenopausal bleeding (postmeopausalbleeding) refers to the occurrence of uterine bleeding after menopause for more than one year, is an abnormal phenomenon, need to be diagnosed immediately.
Cause
Cause
The cause of abnormal bleeding:
The causes of abnormal uterine bleeding can be roughly divided into two major categories: functional and organic. First, functional bleeding refers to abnormal uterine bleeding caused by dysfunction of the neuroendocrine system. It is more common in adolescent women and menopausal (peri-menopausal) women, and women of childbearing age may also appear. This type of disease is called dysfunctional uterine bleeding (referred to as dysfunctional uterine bleeding). In many cases, puberty dysfunctional uterine bleeding is characterized by menstrual cycle disorders, varying lengths of menstruation, bleeding for a long time, and even massive bleeding. The main reason for dysfunctional uterine bleeding is that the function of the reproductive system is immature, unstable, and susceptible to external environmental factors. The treatment should stabilize the mood, cultivate the ovaries, and improve the functional activities of restoring the reproductive system. Peri-menopausal dysfunctional uterine bleeding manifests in menstrual disorders, frequent menstruation or menstrual thinning, or menstrual bleeding, the main reason is the gradual decline in ovarian function, after the exclusion of organic lesions, to stop bleeding, transition to menopause. Menstrual thinners, only two or three months or even half a year to come to a menstruation, generally do not need special treatment, improve the working environment, reduce work stress, eliminate mental stimulation and other hopes to improve. However, if the amount of menstruation increases, it should be taken seriously. Secondly, due to the bleeding caused by organic diseases of the uterus, it should be highly concerned, including uterine inflammation, tuberculosis, tumors, polyps, hyperplasia of the endometrium, ovarian tumors and blood system diseases. Among them, uterine tumors are the main cause of abnormal uterine bleeding, such as cervical cancer and endometrial cancer.
Examine
an examination
Related inspection
Endometrial biopsy uterus and attachment examination electronic colposcopy
Examination of abnormal bleeding:
Abnormal uterine bleeding is complicated because of the high rate of missed diagnosis of diagnostic curettage, B-ultrasound and tubal iodine angiography. Hysteroscopy is comprehensive, rapid, accurate and safe.
In the past, patients with perimenopausal abnormal uterine bleeding often used B-ultrasound and diagnostic curettage. At present, diagnostic curettage is still the main means of diagnosis of endometrial lesions, but the rate of missed diagnosis is high, for tiny endometrial polyps and diameter less than 1.0cm. Submucosal fibroids, B ultrasound images sometimes only show echo thickening, enhancement, lack of specificity, often missed diagnosis. This data shows that lesions with obvious morphological features such as uterine submucosal fibroids, cervical fibroids, endometrial polyps and uterine embryo residues, and the coincidence rate with pathological diagnosis is almost 100%.
Hysteroscopy is the gold standard for diagnosing abnormal types of uterine bleeding. At the same time, on the basis of high diagnosis rate and accuracy, hysteroscopy is economical, safe, and suitable for outpatients. The operation is simple and fast, and the patient does not need to be prepared. In terms of abnormal uterine bleeding, it completely replaces the traditional method of B-ultrasound combined with diagnostic curettage. After clearing the intrauterine lesions, there is a targeted treatment for the reduction of hysterectomy caused by unexplained uterine bleeding.
Diagnosis
Differential diagnosis
Symptoms of abnormal bleeding:
To distinguish from uterine bleeding: abnormal uterine bleeding caused by abnormal 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.
Abnormal uterine bleeding is complicated because of the high rate of missed diagnosis of diagnostic curettage, B-ultrasound and tubal iodine angiography. Hysteroscopy is comprehensive, rapid, accurate and safe.
In the past, patients with perimenopausal abnormal uterine bleeding often used B-ultrasound and diagnostic curettage. At present, diagnostic curettage is still the main means of diagnosis of endometrial lesions, but the rate of missed diagnosis is high, for tiny endometrial polyps and diameter less than 1.0cm. Submucosal fibroids, B ultrasound images sometimes only show echo thickening, enhancement, lack of specificity, often missed diagnosis. This data shows that lesions with obvious morphological features such as uterine submucosal fibroids, cervical fibroids, endometrial polyps and uterine embryo residues, and the coincidence rate with pathological diagnosis is almost 100%.
Hysteroscopy is the gold standard for diagnosing abnormal types of uterine bleeding. At the same time, on the basis of high diagnosis rate and accuracy, hysteroscopy is economical, safe, and suitable for outpatients. The operation is simple and fast, and the patient does not need to be prepared. In terms of abnormal uterine bleeding, it completely replaces the traditional method of B-ultrasound combined with diagnostic curettage. After clearing the intrauterine lesions, there is a targeted treatment for the reduction of hysterectomy caused by unexplained uterine bleeding.
