Patient's question:
NoDoctor's answer:
It could be functional uterine bleeding. There is no need to be overly anxious, as most women will spontaneously recover with the stabilization of their menstrual cycle. If it recurs frequently or the bleeding is excessive, it is advisable to seek medical attention. Below is a brief introduction to functional uterine bleeding. Functional uterine bleeding is now medically abbreviated as "Dysfunctional Uterine Bleeding" (DUB). DUB is a common gynecological condition. Any abnormal menstruation where no significant organic lesions are found in the internal and external reproductive organs, excluding pregnancy, tumors, inflammation, trauma, or systemic bleeding disorders, and which is caused by dysfunction of the neuroendocrine system regulating reproduction is termed functional uterine bleeding, abbreviated as DUB. In traditional Chinese medicine, it is known as "Sheng Liu." Clinically, DUB is divided into two types: ovulatory and anovulatory. Young women with functional uterine bleeding may exhibit the following symptoms:(1) Irregular uterine bleeding. Menstruation may come earlier or later without any regularity.
(2) Frequent menstruation. The menstrual cycle is shortened, generally less than 21 days, with normal bleeding volume and duration.
(3) Excessive menstrual flow. The menstrual cycle is normal, but the bleeding volume is excessive, sometimes reaching hundreds of milliliters.
(4) Prolonged menstrual bleeding. Some may experience light bleeding days before menstruation, often dark in color, followed by prolonged bleeding for more than ten days before and after menstruation.
(5) Ovulatory bleeding. A small amount of blood flows from the vagina about 10 days after menstruation, sometimes lasting only one or two days, known as ovulatory bleeding.
General age groups affected:
1. Ovulatory DUB: Reproductive age, approximately 16-45 years.
2. Anovulatory DUB:
- Pubertal DUB: Puberty, approximately 12-16 years.
- Perimenopausal DUB: Perimenopause, approximately 45-55 years.
Specific prevention and treatment measures can be adopted from the following points:
(1) Pay attention to physical health. Increase nutrition, consume more protein-rich foods, vegetables, and fruits. Maintain a balanced lifestyle, avoid heavy physical labor and strenuous exercise, ensure adequate sleep, stay mentally happy, and avoid unnecessary mental stress.
(2) Use medication to stop bleeding. There are two methods for medication-induced hemostasis: one is to induce complete shedding of the endometrium, such as injecting progesterone; the other is to promote endometrial growth, such as injecting estradiol benzoate. Additionally, hemostatic drugs like Yunnan Baiyao, Anluo blood, vitamin K, aminocaproic acid, and tranexamic acid can generally achieve the goal of stopping bleeding.
(3) Restore ovarian function and regulate the menstrual cycle. Generally, continuous medication with ethinyl estradiol (0.5-1 g per day) for 20 days, with an additional injection of progesterone (20 mg per day) in the last 5 days of medication. For pubertal DUB, with age growth and proper treatment, recovery can be rapid. For ovulatory DUB, injecting human chorionic gonadotropin (HCG) in the pre-ovulatory phase may help regulate the menstrual cycle.
(4) Traditional Chinese medicine treatment. In terms of regulating endocrine function and stopping bleeding, traditional Chinese medicine has unique advantages and should be appropriately consulted.
All the above medications must be taken under the guidance of a doctor and should not be self-prescribed, as drugs that regulate the endocrine system have complex effects and improper use can lead to severe menstrual disorders.
Additionally, regardless of the type of vaginal bleeding, it is important to seek medical attention promptly to rule out organic lesions in the whole body and reproductive system. Vaginal bleeding can generally be classified into the following types:
1. Increased menstrual volume with prolonged periods but normal cycles. This may be due to uterine fibroids, adenomyosis, or DUB. Additionally, women using intrauterine devices may also experience increased menstrual flow.
2. Irregular vaginal bleeding with abnormal cycles. This is often DUB but should first rule out endometrial cancer.
3. Prolonged vaginal bleeding. This is often caused by malignant tumors of the reproductive organs, such as cervical cancer or endometrial cancer.
4. Irregular bleeding after menopause. For women of reproductive age, consider pregnancy-related conditions like miscarriage, ectopic pregnancy, or molar pregnancy; for postmenopausal women, malignancy is more likely.
5. Bleeding after intercourse. This is often caused by cervical erosion, cervical polyps, cervical cancer, or submucosal fibroids.
6. Vaginal bleeding with leukorrhea. This may suggest advanced cervical cancer or endometrial cancer with infection.
7. Sudden vaginal bleeding with watery discharge. This may indicate primary fallopian tube cancer.
8. Intermenstrual bleeding. Occurring between two menstrual cycles, lasting 3-4 days with minimal blood volume, mostly ovulatory bleeding.
9. Spotting before or after menstruation. Light blood-tinged discharge days before or after menstruation is usually due to abnormal ovarian function or endometrial ectopic syndrome.
Due to frequent bleeding, excessive blood volume, and prolonged bleeding duration, patients with functional uterine bleeding often experience anemia or symptoms such as fatigue, dizziness, tinnitus, and pale complexion.