What is the best treatment for functional uterine bleeding?

We all know that women have menstrual periods every month. Due to the different body structures of women, some gynecological diseases often occur. Dysfunctional uterine bleeding is not unfamiliar to many women. It is a disease that often occurs among female friends, especially women in menopause and adolescence are particularly prone to functional uterine bleeding. Dysfunctional uterine bleeding seriously affects our physical health. So what are the treatments for blood supply? Let's take a look at the best treatments for functional uterine bleeding.

What is the best treatment for functional uterine bleeding: 1. Generally, patients with this condition often have poor physical condition and are anemic. They should strengthen their nutrition and improve their general condition. They can supplement iron, vitamin C and protein. Those with severe anemia may need blood transfusions. Avoid excessive fatigue and strenuous exercise during bleeding, and ensure adequate rest. Patients with prolonged bleeding should be given antibiotics to prevent infection, and appropriate coagulation drugs should be used to reduce the amount of bleeding.

2. Drug treatment Endocrine therapy is extremely effective, but different methods should be adopted for subjects of different ages. The treatment for adolescent girls is mainly to stop bleeding, adjust the cycle, and promote ovarian ovulation; the principle for perimenopausal women is to adjust the cycle and reduce menstrual flow after stopping bleeding. When using sex hormone treatment, careful planning and a reasonable regimen should be formulated, the lowest effective dose should be used as much as possible, and close observation should be carried out to avoid bleeding caused by improper use of sexual stimulation.

Hemostasis: For patients with heavy bleeding, sex hormone treatment is required to take effect within 6 hours, and bleeding should basically stop within 24 to 48 hours. If the bleeding still does not stop after more than 96 hours, the presence of organic lesions should be considered.

1. Progesterone: Anovulatory functional uterine bleeding is caused by the stimulation of a single estrogen. Progesterone supplementation can transform the endometrium in the proliferative phase or excessive hyperplasia into the secretory phase. After drug discontinuation, the endometrium will fall off and withdrawal bleeding will occur. Because this type of endometrial shedding is more complete, it is also called "drug-induced curettage." It is suitable for patients who already have a certain level of estrogen in their body. Synthetic progestins are divided into two categories, the most commonly used are 17-hydroxyprogesterone derivatives (medroxyprogesterone, megestrol acetate) and 19-demethyltestosterone derivatives (norethindrone, norethindrone diacetate, etc.). You can choose 5-7.5 mg of norethindrone (Fukang tablets) with high potency on the endometrium, taken orally once every 6 hours. Generally, the amount of bleeding will be significantly reduced or stopped after 4 doses, and then change to once every 8 hours, and then gradually reduce the dose by 1/3 every 3 days until the maintenance dose is 5 mg per day. Continue to use it until the bleeding stops, and then stop the drug about 20 days later. Withdrawal bleeding will occur 3-7 days after stopping the drug.

2. Estrogen: The use of large doses of estrogen can quickly increase the estrogen concentration in the blood, promote the growth of the endometrium, repair the wound and stop bleeding in a short period of time. It is suitable for people with endogenous estrogen deficiency and is mainly used for functional uterine bleeding in adolescence. Currently, the most commonly used dose is 1.25-2.5 mg of pregnant mare's estrone, once every 6 hours. After the bleeding stops, the dose is reduced by 1/3 every 3 days until the maintenance dose is 1.25 mg. 1-2 mg of diethylstilbestrol can also be used, once every 6-8 hours. After the bleeding stops, the dose is reduced by 1/3 every 3 days until the maintenance dose is 1 ng per day. The disadvantages of oral diethylstilbestrol are severe gastrointestinal reactions, slow drug absorption, and difficulty in taking effect quickly. If necessary, micronized 17β-estradiol, preeclampsia, or intramuscular injection of estradiol benzoate can be taken orally. To achieve rapid hemostasis. Regardless of the type of estrogen used, progestin should be added 2 weeks after the bleeding stops to transform the endometrium. Medroxyprogesterone 10 mg can be taken orally once a day for a total of 10 days without taking the drug. The simultaneous withdrawal of estrogen and progesterone is conducive to the synchronous shedding of the endometrium. Withdrawal bleeding usually occurs 3-7 days after stopping the drug.

3. Androgen: Androgen increases blood flow and reduces the amount of bleeding. However, when heavy bleeding occurs, male hormones cannot immediately change the process of endometrial shedding, nor can they repair it quickly, and the effect is poor when used alone.

4. Combination medication: Since the hemostatic effect of combined sex hormone therapy is worse than that of a single drug, when progesterone is used to stop bleeding in adolescent functional uterine bleeding, a small dose of estrogen is used at the same time to overcome the shortcomings of single progesterone treatment, reduce the dosage of progesterone, and prevent breakthrough bleeding. Specifically, one tablet of progestin-dominant oral contraceptive is used. Once every 6 hours. After the bleeding stops, reduce the dosage to the maintenance dose according to the above method, one tablet per day, and stop taking the medicine for 20 days. ② For perimenopausal functional uterine bleeding, estrogen and androgen are combined on the basis of progestin hemostasis. Specifically, 2 ml of triple hormone (progesterone 12.5 mg, estradiol 1.25 mg, and testosterone 25 mg) is injected intramuscularly once every 12 hours. After the bleeding stops, the dose is reduced to once every 3 days, and the medication is discontinued for a total of 20 days.

5. Anti-prostaglandin drugs: Taking prostaglandin synthase inhibitors such as flufenamic acid 200 mg 3 times a day during bleeding can reduce bleeding during endometrial exfoliation. It works mainly by changing the balance between thromboxane A2 and prostacyclin. Thromboxane A2 is a platelet aggregation precursor and a synthetic smooth muscle contractile substance, while prostacyclin is a potent smooth muscle relaxant and antiplatelet aggregation substance.

6. Other hemostatic drugs: Anluoxue and Zhixuemin can reduce microvascular permeability. Aminocaproic acid, aminobenzoic acid, tranexamic acid, etc. can inhibit plasmin and have an auxiliary effect in reducing the amount of bleeding, but they cannot be relied upon to stop bleeding.

If symptoms of functional uterine bleeding appear, we must seek timely treatment, especially for women in adolescence. If they are not treated in time, it will affect their future fertility. By understanding the best treatment for functional uterine bleeding, we must seek timely treatment based on our own situation. At the same time, we must also develop good living habits. Female friends should eat less raw and cold food and pay more attention to their physical hygiene.