1, anovulatory dysfunctional uterine bleeding were divided into two groups according to age.
( 1) adolescent dysfunctional uterine bleeding:
In the later menarche girls, since the HPOU axis is not mature, not the establishment of regular ovulation induced by.
Its clinical manifestations after menarche oligomenorrhea, short time after menopause hair irregular menorrhagia, the volume too much, prolonged menstruation, due to severe anemia.
( 2) ( menopause perimenopausal dysfunctional uterine bleeding ):
That is 40 years old in premenopausal and postmenopausal women to women with anovulatory dysfunctional uterine bleeding dub, the incidence increased year by year.
Clinical manifestations: polymenorrhea ( polymenorrhea ( polymenorrhea ) cycle is less than or equal to 21 days of irregular uterine bleeding, often with menorrhagia. ) , irregular cycles, the volume too much, prolonged menstrual period. 10 - 15% of patients showed severe menorrhagia, irregular uterine bleeding and severe anemia. Endometrial biopsy showed different degrees of endometrial hyperplasia, so the curettage is necessary, particular attention should be given to exclusion of Gynecologic Oncology ( uterine fibroids, endometrial cancer, ovarian cancer, uterine cervical cancer ) caused by non power bloody uterine bleeding.
2, anovulatory dysfunctional uterine bleeding is most common in women of childbearing age, in adolescent girls and menopausal women. Clinical divided into the following types:
( 1) anovulatory menstrual disorders
Ovulation oligomenorrhea:
In adolescent girls. After menarche follicular phase luteal phase extension, normal, more than 40 day cycle, oligomenorrhea ( cycle 40 days of irregular uterine bleeding, often associated with menstruation ) and menstruation ( refers to the menstrual cycle regularity, only by the amount of reduction. ), often for polycystic ovary of aura, uncommon in menopausal women in menopause, often progress to natural menopause.
Anovulatory menstrual frequency:
Adolescent ovarian on gonadotropin sensitivity enhancement and the follicular development accelerates, the follicular phase shortening, menstrual frequency ( period less than 21 days of irregular uterine bleeding, often with menorrhagia ), but the ovulation and luteal phase is normal. If the patient for menopausal women showed follicular and luteal phase were shortened and early menopause.
( 2) corpus luteum dysfunction
Luteal insufficiency:
The corpus luteum premature degradation, shorten the luteal phase is less than 10 days. Clinical manifestations of polymenorrhea, shorten the cycle, premenstrual bleeding and menorrhagia, with infertility and early spontaneous abortion. Endometrial pathology for irregular ripening ( irregular ripening ) or secretion of incomplete ( imcomplete secretion ).
Corpus luteum insufficiency:
Also known as the corpus luteum function extended, i.e. the corpus luteum can not be in 3 ~ 5 days completely degraded, or degradation time, or during the menstrual period continue to secrete a certain amount of progesterone and endometrial irregular shedding ( irregular shedding ). Prolonged menstrual period, the amount of bleeding, combined with the corpus luteum premature degradation, are polymenorrhea, menorrhagia ( refers to the volume too much and / or with prolonged menstrual period of regular periodic uterine bleeding ). More common in artificial abortion, induced abortion, myoma of uterus, endometrial polyps and adenomyosis.
3, intermenstrual bleeding:
Also known as the period of ovulation bleeding. To two times the normal amount of uterine bleeding between menstrual regularity, often accompanied by pain ovulation ( intermenstrual pain or mittelschmerz ) is the ovulation stimulation and estrogen fluctuations induced by a small amount of bleeding ( 1 ~ 3 days ) and abdominal pain. Individual bleeding more and continued to the menstrual period and the formation of pseudocysts in menstrual frequency ( pseadopolymenorrhea ).