Patient's question:
I am already 50 years old this year. I guess I am approaching menopause, because recently I feel that my menstruation is very irregular, with intermittent bleeding for about four or five months. The amount is small, and the color is dark. My colleague said I have dysfunctional uterine bleeding. I don't have any other discomforts, and I have taken medication without any significant effect. However, the ultrasound examination shows that the uterus is enlarged, the endometrium is thick, and there are no other abnormalities.Doctor's answer:
Women in menopause gradually lose their ovarian function, unable to produce mature follicles and ovulate, leading to irregular vaginal bleeding due to the loss of the cyclical changes in normal female hormones. Hormone therapy is generally used, where progesterone induces secretory changes in the endometrium, followed by shedding and hemostasis. For minor bleeding, a daily dose of 10–20 mg of progesterone is often sufficient to stop bleeding within 2–3 days. In cases of prolonged bleeding and significant blood loss, the treatment duration should be extended, and larger doses of synthetic progesterone can be taken orally. After hemostasis is achieved, the dosage should be gradually reduced.