The problem of endometrial shedding needs to be carefully analyzed to understand the causes. For example, systemic diseases or abnormal bleeding caused by some gynecological diseases are all related to it. It is necessary to pay attention to the clear causes before the appropriate treatment can be carried out. 1. Systemic diseases The most common systemic diseases are mainly seen in the blood system diseases, such as idiopathic thrombocytopenia, coagulation factor deficiency, and hematopoietic functional diseases, which can usually be diagnosed and excluded through routine blood tests and coagulation function tests. Secondly, it is seen in severe liver and kidney diseases. 2. Abnormal uterine bleeding caused by pregnancy-related diseases The early clinical symptoms of ectopic pregnancy and threatened abortion include irregular vaginal bleeding, which can be easily misdiagnosed when the patient does not have a clear history of amenorrhea and abdominal pain. Therefore, for women who have sexual activities, HCG tests should be performed routinely when vaginal bleeding occurs to rule out pregnancy-related diseases. 3. Abnormal bleeding caused by gynecological diseases Abnormal bleeding may occur due to injuries to the vulva and vagina, inflammation of the vagina, cervix and uterus, and tumors of the cervix, uterus, ovaries and fallopian tubes. For these patients, medical history inquiry and gynecological examination are very necessary, and appropriate auxiliary examinations, such as ultrasound, CT or MRI, should also be performed to clarify the source of bleeding. 4. Abnormal bleeding caused by iatrogenic factors (1) If menstruation is prolonged in the first few months or after a period of time after the placement of an intrauterine contraceptive device, the intrauterine contraceptive device can be removed if necessary, and endometrial curettage can be performed if necessary; (2) When using steroid hormone contraceptive measures, such as subcutaneous implants of a single progestin, menstrual bleeding may occur in the early stages or before the expiration date; (3) Taking emergency contraceptive pills repeatedly in a short period of time. Endometrial/myometrial lesions: The endometrium/myometrium participates in hemostasis during normal "self-limiting" menstruation through the balance of locally secreted prostaglandins and coagulation factors/antifibrinolytic factors, thereby ensuring that the normal menstrual period does not exceed 7 days and the amount of bleeding is 20-60ml. However, local factor imbalance or abnormality caused by various reasons may cause excessive uterine bleeding or menorrhagia. |
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