Anovulatory dysfunctional bleeding >Introduction eBreal only estrogen stimulate endometrium,no progesterone Low plasma concentrations of estrogens infrequent and light bleeding Chronic stimulation of endometrium from increased plasma concentrations of estrogens frequent and heavy bleeding With single estrogen influent endometrium,atresia of follicles>estrogen bleeding
➢ Introduction Breakthrough bleeding: only estrogen stimulate endometrium, no progesterone Low plasma concentrations of estrogens infrequent and light bleeding Chronic stimulation of endometrium from increased plasma concentrations of estrogens frequent and heavy bleeding Withdrawal bleeding: single estrogen influent endometrium, atresia of follicles estrogen bleeding Anovulatory dysfunctional bleeding
>Pathological changes of endometrium Hyperplasia of endometrium simple hyperplasia complex hyperplasia atypical hyperplasia:not belong to DUB, glandular epithelium hyperplasia,polarity of cell disappear,size enlarged,dark and large nucleus,karyokinesis Proliferative phase of endometrium Atrophic endometrium
➢ Pathological changes of endometrium Hyperplasia of endometrium simple hyperplasia complex hyperplasia atypical hyperplasia: not belong to DUB, glandular epithelium hyperplasia, polarity of cell disappear, size enlarged, dark and large nucleus, karyokinesis Proliferative phase of endometrium Atrophic endometrium
Clinical findings Irregular uterine bleeding Patterns: Menorrhagia Polymenorrhea Metrorrhagia Menometrorrhagia >No abdominal pain and discomfortable >Anemia >Pelvic exam:uterine size is normal
Clinical findings ➢ Irregular uterine bleeding Patterns: Menorrhagia Polymenorrhea Metrorrhagia Menometrorrhagia ➢ No abdominal pain and discomfortable ➢ Anemia ➢ Pelvic exam: uterine size is normal
Di程g0S5 Exclude anatomic causes of abnormal uterine bleeding >History Age,menses,marital,contraceptive,treatment >Physical exam: General:exclude systemic diseases Pelvic:exclude genital disease Lab exam Ultrasound:uterine size,shape,endometrium Hysteroscope:pathologic changes of cavity
Diagnosis ➢ Exclude anatomic causes of abnormal uterine bleeding ➢ History Age, menses, marital, contraceptive, treatment ➢ Physical exam: General: exclude systemic diseases Pelvic: exclude genital disease ➢ Lab exam Ultrasound: uterine size, shape, endometrium Hysteroscope: pathologic changes of cavity