Approach to testing for perimenopausal dysfunctional uterine bleeding

Perimenopausal dysfunctional uterine bleeding has a variety of clinical symptoms, and menopausal women who find abnormal menstruation should go to a regular hospital for examination and treatment in time, and seek medical attention as soon as possible is conducive to the recovery of the condition. Perimenopausal dysfunctional uterine bleeding is tested as follows:

1. Sex hormone measurement is the most accurate indicator to reflect the reproductive endocrine status and ovarian function in vivo. Before hormonal therapy, or under the guidance of basal body temperature (BBT), elective blood collection was carried out to measure the levels of FSH, LH, prolactin (pRL), estradiol (E2), progesterone (p), and testosterone (T), so as to distinguish the type of dysfunctional uterine bleeding and distinguish it from polycystic ovary syndrome and hyperprolactinemia, so as to guide the clinical formulation of treatment plans and make the treatment more targeted.

2. Vaginal exfoliated cell smears were dynamically observed in vaginal exfoliated cells, and the E level in vivo was understood through the vaginal epithelial cell maturation index (MI), which was used as a monitoring index in diagnosis, classification and treatment.

1. Cervical mucus score to understand the level of E in the body, if the cervical mucus is still in the shape of amnitic crystals before bleeding or even during the bleeding period, it indicates a single E effect, no ovulation function, which can be used as a simple indicator for clinical classification, E level estimation and observation of efficacy of dysfunctional uterine bleeding.

2. BBT is one of the most common simple and easy methods used in the diagnosis of dysfunctional uterine bleeding, according to the BBT phase, combined with other monitoring indicators, as the most simple and easy means to classify dysfunctional uterine bleeding, observe the efficacy and guide the treatment.

3. Diagnostic dilation and curettage can understand the functional status of the endometrium and ovaries, and can directly stop bleeding. For perimenopausal bleeding and high-risk factors for endometrial cancer, segmented dilation and curettage should be performed first to rule out malignant lesions. The functional layer of the endometrium must be completely scraped and the tissue should be sent for pathological examination. Attention should also be paid to the depth of the uterine cavity, the morphology, and whether the uterine wall is smooth.The sensitivity and specificity of diagnostic dilation and curettage were 78.8%~84.5% and 100%.

4. B-type ultrasound and B-ultrasound can find small submucosal fibroids that have been ignored by the diagnosis and curettage, find ovarian tumors, endometrial thickness measurement and dynamic observation, etc. Because of its non-traumatic and reproducible nature, it plays an important role in the diagnosis and differential diagnosis of dysfunctional uterine bleeding, judging the treatment effect, and guiding clinical treatment.

5. HysteroscopyHysteroscopy can directly observe the appearance, shape, location and scope of intrauterine and endocervical lesions, and perform positioning biopsy of suspicious lesions. Therefore, hysteroscopy for dysfunctional uterine bleeding that has not been cured for a long time is helpful to detect intrauterine lesions, and can be selected under direct vision to reduce misdiagnosis. The sensitivity and specificity of hysteroscopy were 94.1% and 95.5%.

Some perimenopausal women's emotions and daily behaviors will be affected, which requires us to pay more attention and care to women during this period, and developed countries usually have perimenopausal health care for women.