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What causes dysfunctional uterine bleeding?
Last reviewed: 19.10.2021
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Uterine bleeding of the pubertal period is a multifactorial disease that arises as a result of excessive or unbalanced interaction of random factors and individual reactivity of the organism. As the risk factors for uterine bleeding in the pubertal period, one can most often mention acute psychogenies or prolonged psychological stresses, an unfavorable ecological situation in the place of residence, hypovitaminosis, alimentary deficiency, obesity, weight loss, etc. The leading and most likely provocative role belongs to various kinds of psychological stress, acute psychological trauma and constant readiness for stress reactions (up to 70%). These unfavorable factors are more correctly regarded not as causal, but as provoking bleeding phenomena.
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 is isolated. In the pubertal period, the most frequently detected anovulatory acyclic bleeding, caused by atresia, less often - the persistence of follicles.
Depending on the clinical features, there are several types of uterine bleeding.
- Menorrhagia (hypermenorrhoea) - uterine bleeding in patients with a preserved rhythm of menstruation, in which the duration of blood discharge exceeds 7 days and blood loss is more than 80 ml. Note a small amount of blood clots in abundant blood discharges, the appearance of hypovolemic disorders in menstrual days and the presence of iron deficiency anemia of moderate and severe severity.
- Polymenorrhea - uterine bleeding that occurs against the background of a regular shortened menstrual cycle (less than 21 days).
- Metrorrhagia and menometrorrhagia are uterine bleeding that do not have a rhythm, often occurring after periods of oligomenorrhea and characterized by a periodic increase in bleeding against a background of meager or moderate bloody discharge.
Depending on the level of estradiol concentration in the blood plasma among the uterine bleeding of the pubertal period, hypoestrogenic, normoestrogenic and hyperestrogenic types are isolated.