What is the cause of functional uterine bleeding?

Patient's question:

I have had functional uterine bleeding for over a year. It starts bleeding 5 days after each menstrual period. I have seen countless doctors, but none of them have been able to help me (everything is fine, they said it's related to the endocrine system). I have taken An Gong and Liu Wei Di Huang Wan, but they haven't worked. It's getting worse and worse. Before, it lasted about three days, but now it lasts about five days. The timing and amount of my period are normal. Now I don't know who to see next. Should I check my estrogen levels or is there anything else to check?

Doctor's answer:

Endometrial hyperplasia, bleeding is known as "menstrual disorders" in traditional Chinese medicine.
Endometrial hyperplasia primarily occurs in women of childbearing age, and menstrual abnormalities are key in the condition analysis:
The prominent symptom of this disease often manifests as irregular vaginal bleeding, followed by infrequent menstruation or amenorrhea, eventually leading to heavy vaginal bleeding. Young women may experience infertility after marriage.
Guidelines:
Pay attention to physical health. Increase nutrition by consuming protein-rich foods, vegetables, and fruits. Maintain a balanced work-life rhythm, avoid heavy physical labor and strenuous exercise, ensure adequate sleep, stay mentally cheerful, and avoid unnecessary mental stress.
(2) Use medication for hemostasis. There are two methods for medication-induced hemostasis: one is to promote complete shedding of the endometrium, which can be achieved by injecting progesterone; the other is to stimulate endometrial growth, which can be done by injecting estradiol benzoate. Additionally, hemostatic drugs such as Yunnan Baiyao, Anluoxue, vitamin K, aminocaproic acid, and tranexamic acid can generally achieve the goal of hemostasis.
(3) Restore ovarian function and regulate the menstrual cycle. Generally, continuous medication with diethylstilbestrol (DES) at a dose of 0.5-1 gram per day for 20 days is recommended, with an increase in progesterone injections at 20 milligrams per day during the last 5 days of medication. For functional uterine bleeding during puberty, it can usually be cured quickly with age growth and proper treatment. For ovulatory functional uterine bleeding, injecting human chorionic gonadotropin (HCG) in the pre-ovulatory phase can help regulate the menstrual cycle.
(4) Traditional Chinese medicine (TCM) treatment. TCM has unique advantages in treating and regulating endocrine function and hemostasis. It is advisable to consult a TCM practitioner for appropriate treatment. All the aforementioned medications must be used under the guidance of a doctor and should not be self-prescribed, as drugs that regulate the endocrine system have complex effects. Improper use can lead to severe menstrual disorders.

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