Anovulatory functional bleeding ovulatory functional bleeding DUB occur in before the menopause (50%) after menarche (20%) in reproductive times(30%) 2021/221 26
2021/2/21 26 Anovulatory functional bleeding ovulatory functional bleeding DUB occur in before the menopause(50%) after menarche(20%) in reproductive times(30%)
Anovulatory functional bleeding 2021/2/21
2021/2/21 27 Anovulatory functional bleeding
Etiology of dub: 1。 disorders of hypothalamus---pituitary ---ovary axis O immature of feedback regulation in young women Ovarian function failure in climacteric women 2. other factors O the effects of sex hormones 口 nervous 口 circumstance 口PCOS,TSH个,PRL↑ d excessive physical exercise 2021/2/21
2021/2/21 28 Etiology of DUB: 1. disorders of hypothalamus---pituitary ---ovary axis ❑immature of feedback regulation in young women ❑ovarian function failure in climacteric women 2.other Factors: ❑ the effects of sex hormones ❑ nervous ❑ circumstance ❑ PCOS,TSH↑,PRL↑ ❑ excessive physical exercise
Pathology Change in the endometrium asimple hyperplasia(Cystic hyperplasia, benign) acomplex hyperplasia(Adenomatous hyperplasia, precursor of carcinoma) 口 atypital hyperplasia(10%-25%→ carcinoma) Proliferative phase of endometrium(no secretive change Atrophic endometrium 2021/2/21
2021/2/21 29 Pathology Change in the endometrium ❑simple hyperplasia(Cystic hyperplasia , benign) ❑complex hyperplasia(Adenomatous hyperplasia ,precursor of carcinoma) ❑atypital hyperplasia(10%-25%→ carcinoma) ❑proliferative phase of endometrium (no secretive change ) ❑atrophic endometrium
Mechanisms Anovulation have developing folliculi no mature follicle no corpus luteum only have estrogen, but no progestin breakthrough bleeding, spoting 2021/221 30
2021/2/21 30 Mechanisms Anovulation ---- ▪ have developing folliculi ▪ no mature follicle ▪ no corpus luteum ▪ only have estrogen, but no progestin ▪ breakthrough bleeding, spoting