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Symptoms of dysfunctional uterine bleeding
Last reviewed: 23.04.2024
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Symptoms of dysfunctional uterine bleeding in the pubertal period are very heterogeneous. Certain typical signs depend on whether at what level (central or peripheral) there were violations of the agreed activity (self-regulation).
If it is impossible to recognize the type of uterine bleeding of the pubertal period (hypo-, normo- or hyperestrogenic), in the absence of correlation between clinical and laboratory data, one can speak of atypical forms of uterine bleeding in the pubertal period.
Hyperestrogenic type. With a hyperestrogenic type of uterine bleeding in the pubertal period, apparently the patients look physically developed, but psychologically they can detect immaturity in judgments and deeds. Distinctive features of a typical form: a significant increase in the size of the uterus and the concentration of LH in the blood plasma relative to the age norm, as well as asymmetric enlargement of the ovaries. Most likely the development of hyperestrogenic type of uterine bleeding puberty period in the beginning (11-12 years) and the end (17-18 years) of the pubertal period. Atypical forms can occur up to 17 years.
Normoestrogenic type. In the normoestrogenic type of uterine bleeding of the pubertal period, the data of anthropometry and the degree of development of secondary sexual characteristics, that is, external signs, are harmoniously developed. The size of the uterus is less than the age norm, so more often with such parameters the patients are referred to as a hypoestrogenic type.
The most common and atypical forms are observed in patients aged 13 to 16 years.
Hypoestrogenic type of pubertal uterine bleeding most often reveals adolescent girls. Typically, these patients are fragile physique with a significant lag behind the age norm of the degree of development of secondary sexual characteristics, but rather high level of mental development. Such girls are characterized by psychoemotional stress, depressive anxiety disorders in combination with sleep disturbances. The size of the uterus is significantly (2 times) less than the age norm in all age groups, the endometrium is thin, the ovaries are symmetrical and in volume slightly exceed the normal parameters. The level of cortisol in the blood plasma significantly exceeds the normative values.
In the hypoestrogenic uterine bleeding period of the pubertal period, almost all patients were treated in a typical form.
Complications of dysfunctional uterine bleeding
The most severe complications of pubertal uterine bleeding are the acute blood loss syndrome, which, however, rarely leads to death in somatically healthy girls, as well as anemic syndrome, the severity of which is determined by the intensity of uterine bleeding of the puberty period and its duration.
Mortality of adolescent girls with uterine bleeding of the pubertal period is most often due to acute multi-organ disorders as a result of severe anemia and hypovolemia, complications of transfusion of native blood and its components, development of irreversible systemic disorders against chronic iron deficiency anemia in girls with prolonged and recurrent uterine bleeding.
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