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What causes dysfunctional uterine bleeding?
Last reviewed: 04.07.2025
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Uterine bleeding in puberty is a multifactorial disease that occurs as a result of excessive or unbalanced interaction of random factors and individual reactivity of the organism. The most common risk factors for uterine bleeding in puberty are acute psychogenic or prolonged psychological stress, unfavorable environmental conditions in the place of residence, hypovitaminosis, alimentary deficiency, obesity, underweight, etc. The leading and most likely provoking role belongs to various types of psychological stress, acute psychological trauma and constant readiness for stress reactions (up to 70%). It is more correct to regard these unfavorable factors not as causal, but as phenomena that provoke bleeding.
Classification of dysfunctional uterine bleeding
There is no officially accepted international classification of uterine bleeding in the pubertal period. Depending on the functional and morphological changes in the ovaries, ovulatory and anovulatory uterine bleeding are distinguished. In the pubertal period, anovulatory acyclic bleeding caused by atresia is most often detected, less often - by persistence of follicles.
Depending on the clinical characteristics, several types of uterine bleeding are distinguished.
- Menorrhagia (hypermenorrhea) - uterine bleeding in patients with a preserved menstrual rhythm, in whom the duration of blood discharge exceeds 7 days and blood loss is more than 80 ml. A small number of blood clots in abundant blood discharge, the appearance of hypovolemic disorders on menstrual days and the presence of moderate and severe iron deficiency anemia are noted.
- Polymenorrhea is uterine bleeding that occurs against the background of a regular shortened menstrual cycle (less than 21 days).
- Metrorrhagia and menometrorrhagia are uterine bleeding that does not have a rhythm, often occurring after periods of oligomenorrhea and characterized by periodic increases in bleeding against the background of scanty or moderate blood discharge.
Depending on the level of estradiol concentration in the blood plasma, uterine bleeding during puberty is divided into hypoestrogenic, normoestrogenic and hyperestrogenic types.