Endometrial shedding

Introduction Irregular detachment of the endometrium can lead to abnormal uterine bleeding. It is more common in women of childbearing age. Due to follicular hypoplasia, despite ovulation, luteal atrophy or persistence, estrogen and progesterone cannot fall rapidly, and the endometrium irregularly falls off. Increase bleeding. Menstruation is still on schedule, but the bleeding time is extended to 10 days.

Cause

Due to dysfunction of the hypothalamic-pituitary-ovarian axis regulation or luteal body dysfunction caused by luteal body atrophy, the intima continues to be affected by progesterone, so that it can not completely fall off as scheduled.

On the 3-4th day of normal menstruation, the endometrium in the secretory phase has all fallen off. Instead, regenerate the membrane during the proliferative phase. However, in the case of atrophy of the corpus luteum, the endometrium showing a secretory reaction can still be seen on the 5th to 6th of menstruation. In some areas, there is bleeding in the intima, and in other areas, new membranes have appeared during the proliferative phase.

an examination

Related inspection

Gynecological ultrasound examination endoscopic ultrasonography

The diagnostic criteria is that the endometrial pathology still has a secretory phase on the fifth day of regular menstruation. The basal body temperature was biphasic, but it decreased slowly during the menstrual period or the progesterone level did not decrease during the menstrual period.

Differential diagnosis

1, systemic diseases

The most common systemic diseases are mainly found in blood system diseases such as idiopathic thrombocytopenia, clotting factor deficiency, hematopoietic functional diseases, and can be diagnosed and eliminated by blood routine and coagulation function tests. Secondly, it is seen in severe liver and kidney diseases.

2. Abnormal uterine bleeding caused by pregnancy-related diseases

There are irregular vaginal bleeding in the early clinical symptoms of ectopic pregnancy and threatened abortion. It is easy to be misdiagnosed when the patient has no clear history of menopause and abdominal pain. Therefore, for women with sexual life, in the case of vaginal bleeding, routine HCG examination should be performed to rule out pregnancy-related diseases.

3. Abnormal bleeding caused by gynecological diseases

Inflammation of the vulva, vagina, inflammation of the vagina, cervix and uterus, cervical, uterus, ovary and fallopian tube tumors may cause abnormal bleeding. For these patients, medical history and gynaecological examinations are necessary, and appropriate auxiliary examinations, such as ultrasound, CT or MRI, should be performed to determine the source of the bleeding.

4. Abnormal bleeding caused by iatrogenic factors

(1) The menstrual dripping in the first few months or a period of time after placing the intrauterine device, if necessary, the intrauterine device can be taken out, if necessary, the endometrial diagnosis;

(2) The use of steroid hormone contraceptives, such as the initial or subcutaneous implantation of a single progestogen, may occur after menstruation;

(3) Repeat the use of emergency contraceptives in the short term.

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