What causes functional uterine bleeding?

Written by Li Shun Hua
Obstetrics and Gynecology
Updated on September 17, 2024
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Functional uterine bleeding is commonly seen in adolescence and menopause, primarily caused by the absence of normal ovulation. Without ovulation, there is no production of progesterone, leading to irregular vaginal bleeding or heavy bleeding under the influence of estrogen. The main treatment method is menstrual regulation. For adolescent girls, menstrual regulation and ovulation induction treatment are needed, as this is caused by abnormal development of the gonadal axis. Progesterone can be used for menstrual regulation. In menopausal women, menopausal functional uterine bleeding mostly results from abnormal ovulation, essentially due to a lack of progesterone, so treatment with progesterone can be applied. (Please use medication under the guidance of a doctor.)

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Written by Liu Jian Wei
Obstetrics and Gynecology
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Is functional uterine bleeding easy to treat?

Functional uterine bleeding is a common gynecological disease. The cause of functional uterine bleeding is relatively clear, so it is easier to treat clinically. Currently, oral hormonal drugs are widely used to treat functional uterine bleeding. Most patients have their endocrine disorders readjusted after taking oral hormonal drugs, returning to normal levels. After several courses of hormonal drug treatment, most women can recover and resume regular menstrual cycles.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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How to examine functional uterine bleeding?

Dysfunctional uterine bleeding primarily requires checking for any present anemia with routine blood tests and coagulation studies. Ultrasound is needed to examine the pelvis and uterine cavity, including the thickness of the endometrium. Treatment methods should be considered based on these results. Some cases can be managed with medication; others may require another diagnostic curettage to further clarify the condition of the endometrium; some may need contraceptives or similar treatments for 3-6 months, as this is fundamentally an endocrine issue involving hormonal imbalance, where hormonal treatment tends to be quite effective.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Is functional uterine bleeding related to a previous miscarriage?

Functional uterine bleeding in women, also known as dysfunctional uterine bleeding, occurs not due to organic lesions in the reproductive system but due to abnormalities in the function of the gonadal axis, leading to hormonal imbalances and dysfunctional uterine bleeding. This condition is generally unrelated to procedures like abortion or curettage. In some cases, it is triggered by issues such as delayed recovery of ovarian function following an abortion, excessive fatigue, or abnormalities in thyroid and adrenal gland functions, causing dysfunction of the gonadal axis. To address this issue, it is essential to first conduct tests, including a hormone panel and assessments of thyroid and adrenal gland functions, to identify the cause of the dysfunctional uterine bleeding and provide appropriate treatment.

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Written by Shen Li Wen
Obstetrics and Gynecology
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What causes functional uterine bleeding?

Dysfunctional uterine bleeding refers to the situation where a woman's uterus, ovaries, and brain do not have any actual organic lesions, such as the absence of uterine fibroids or ovarian cysts, yet there are functional changes that lead to bleeding. For example, the most common causes include excessive mental stress during schooling, emotional changes due to the death of a family member, or changes in living environment due to business trips, all of which can trigger uterine bleeding. In some cases, uterine bleeding may be a manifestation of a systemic disease; for instance, some women may experience it due to severe anemia or as a result of prolonged dieting and poor dietary habits leading to malnutrition and weight loss, especially if there is a sudden drop in weight. Additionally, some women may have metabolic diseases that can also cause uterine bleeding. Metabolic diseases include conditions such as elevated blood sugar, abnormal lipid levels, or anomalies in thyroid and adrenal gland functions.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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Is functional uterine bleeding heavy?

Functional uterine bleeding can be classified into different types. Clinically, some functional uterine bleeding can cause a large amount of bleeding in the vagina in a short period of time. In such cases, hemostatic treatment is crucial. If the patient does not receive timely hemostatic treatment, the continued vaginal bleeding and increasing blood loss can potentially lead to hemorrhagic shock. Therefore, in clinical practice, if there is a significant amount of functional uterine bleeding, diagnostic curettage is often used as a treatment approach. This method not only serves a diagnostic purpose but also achieves immediate hemostatic effects in a short duration.