What causes irregular menstrual bleeding?

Irregular menstrual bleeding may be related to endocrine disorders, uterine fibroids, endometrial polyps, coagulation disorders, endometriosis and other factors. It is recommended to seek medical examination promptly and provide targeted treatment after the cause is determined.

1. Endocrine disorders

Long-term mental stress or excessive dieting may lead to hypothalamic-pituitary-ovarian axis dysfunction, which is manifested by shortened or prolonged menstrual cycles and sometimes heavy and sometimes small amounts of bleeding. You can use progesterone capsules, estradiol valerate tablets, dydrogesterone tablets and other drugs as directed by your doctor to regulate the cycle, while maintaining a regular schedule.

2. Uterine fibroids

Intramural fibroids may increase the area of ​​the uterine cavity, resulting in prolonged menstruation and increased menstrual flow. Submucosal fibroids may also cause non-menstrual bleeding. Ultrasound examination can confirm the diagnosis, and if necessary, myomectomy is performed or drugs such as mifepristone tablets and Guizhi Fuling capsules are used to control the progression.

3. Endometrial polyps

Excessive estrogen levels stimulate local proliferation of the endometrium to form polyps, which often manifest as intermenstrual spotting or postmenstrual bleeding. Hysteroscopic polypectomy is a radical cure, and drospirenone and ethinylestradiol tablets can be taken for a short period of time after surgery to prevent recurrence.

4. Coagulation dysfunction

Diseases such as thrombocytopenia or hemophilia can cause abnormalities in the coagulation mechanism, causing heavy menstrual bleeding or spontaneous non-menstrual bleeding. Four coagulation tests need to be completed. After diagnosis, coagulation factors must be infused or hemostatic drugs such as tranexamic acid tablets must be used.

5. Endometriosis

Ectopic endometrial tissue invades the myometrium to form adenomyosis, which is typically characterized by increased menstrual flow, worsening dysmenorrhea, and premenstrual spotting. The diagnosis requires a combination of CA125 testing and imaging examinations, and levonorgestrel intrauterine sustained-release system or injectable leuprolide acetate microspheres can be used for treatment.

Daily attention should be paid to recording the bleeding time and amount, and avoiding strenuous exercise and heavy physical labor. Add more iron-containing foods such as animal liver, spinach, etc. to your diet to prevent anemia. Wear loose cotton underwear and change sanitary products frequently to keep your perineum clean. If the bleeding lasts for more than 7 days or the amount of bleeding per hour soaks through more than 1 sanitary napkin, you must seek medical attention immediately. When women over 40 years old experience irregular bleeding, they should be particularly vigilant about the possibility of endometrial lesions.