Functional Uterine Bleeding

　　1.During the period of puberty, the ovulatory function of the ovary has not matured, and the ovarian function of women before menopause declines, with a sharp decrease in estrogen secretion. Both can lead to anovulatory dysfunctional uterine bleeding.

　　2.There is ovulation during the menstrual cycle, but the secretion of progesterone is insufficient or prematurely declines after ovulation, leading to ovulatory dysfunctional uterine bleeding.

　　3.Many internal and external factors, such as excessive mental stress, fear, sadness, sudden changes in environment and climate, and systemic diseases, can affect the synthesis and mutual regulation of hormones through the cerebral cortex and central nervous system, leading to menstrual disorders.

　　The characteristics of dysfunctional uterine bleeding are irregular cycles, varying lengths of menstruation, varying amounts of bleeding, and even severe bleeding. Those with excessive bleeding and prolonged duration often have anemia. Some may also have thyroid dysfunction, adrenal cortical hyperplasia, and polycystic ovary syndrome, etc.

　　1. Secondary anemia.

　　2. Infertility or miscarriage.

　　3. The menstruation is regular, but the cycle is shortened,

　　4. The cycle is normal, but the menstrual period is prolonged, lasting 9 to 10 days, and the amount of bleeding is significant.

　　5. Irregular vaginal bleeding. The characteristics are irregular cycles, varying lengths of menstruation, varying amounts of bleeding, and even severe bleeding.

　　These are the common and obvious symptoms of dysfunctional uterine bleeding.

　　Prevention of dysfunctional uterine bleeding: Maintaining good health is the main link to prevent the occurrence of dysfunctional uterine bleeding.

　　1. It is necessary to popularize health knowledge about puberty.

　　To help adolescent girls understand the normal growth and development process during puberty, what menstruation is, what factors can cause abnormal menstruation, and what should be done, girls generally start menstruating between the ages of 13 to 16. Most of them establish a normal menstrual cycle quickly after their first menstruation and menstruate monthly; however, a few may experience menstrual irregularities due to their incomplete maturity of endocrine function. Excessive mental stress, fatigue, malnutrition, and other factors can trigger such phenomena. Therefore, adolescent girls must arrange their studies and life well, pay attention to the combination of work and rest, exercise, strengthen their physical fitness, and ensure adequate intake of nutrition (proteins, vitamins, iron), avoiding cold and raw food. They should eat more fish, meat, poultry eggs, milk, and vegetables, and avoid spicy and刺激性 food; cook with an iron pot, take iron-containing drugs such as ferrous sulfate oral solution, and increase iron intake to improve anemia.

　　2. Prevention of infection

　　During bleeding, the uterine cavity is connected internally and externally, and bacteria, due to a good growth environment, will rapidly reproduce and cause disease. Therefore, not only should the occurrence of systemic diseases be prevented, but attention must also be paid to menstrual hygiene. Pay attention to the cleanliness of the external genitalia during bleeding, and clean the perineum 1 to 2 times a day to remove blood stains, and change menstrual pads and underwear frequently. Some external genitalia cleaning agents can be used, as well as warm water for cleaning, but avoid bathtubs; married women should avoid sexual intercourse during the menstrual period.

　　3. Other:

　　If the amount of bleeding is large, it can lead to anemia and decreased body resistance, so it is necessary to strengthen hemostatic measures and consider anti-infection treatment to prevent inflammation and acute infectious diseases. Pay attention not to wade through water in the rain, and change wet clothes and pants in a timely manner to avoid invasion of pathogenic cold, preventing blood stasis and congestion in the meridians and collaterals, leading to excessive bleeding or persistent bleeding.

　　Correctly understanding the process of adolescent development, reasonably arranging study and life, seeking medical treatment in a timely manner, and preventing complications, adolescent girls will smoothly go through this physiological development period.

　　1. Development and nutritional status:Whether there is anemia, jaundice of the skin and mucous membranes, and bleeding spots, purpura, and other hemorrhagic conditions, blood pressure, and pulse.

　　2. Gynecological examination:For those with vaginal bleeding, examination should be disinfected, and for unmarried individuals, rectal examination should be performed. Attention should be paid to exclude bleeding related to pregnancy, as well as bleeding caused by inflammation, tumors, and other factors.

　　3. Laboratory tests:Blood routine, platelet count, coagulation time, reticulocyte count, liver function, and necessary urine pregnancy test, blood hCG.

　　4. Auxiliary examinations:

　　(1) Basal body temperature measurement to understand the presence of ovulation and corpus luteum function.

　　(2) Examination of cervical mucus crystals and vaginal exfoliated cells to understand estrogen levels and the presence of progesterone influence.

　　(3) Measure the levels of estrogen, progesterone, and gonadotropin in the blood.

　　(4) Thyroid function tests such as T3, T4, and TSH.

　　5. Diagnostic curettage:It is recommended to perform diagnostic curettage for patients with excessive bleeding, ineffective conservative treatment, or who cannot be ruled out as having endometrial lesions. During the operation, segmental curettage should be performed, paying attention to the size, shape, and smoothness of the uterine cavity wall, and the nature of the material scraped out. A comprehensive curettage should be performed, ensuring that both uterine horns are not missed, and it may be necessary to operate under hysteroscopy guidance. To understand the presence of ovulation, corpus luteum function, and to exclude endometrial tuberculosis, curettage can be performed within 12 to 24 hours of the onset of menstruation; for suspected irregular desquamation of the endometrium and incomplete corpus luteum atrophy, curettage can be performed on the fifth day of menstruation; for irregular bleeding or prolonged bleeding, curettage can be performed at the same time as anti-infection treatment without regard to time.

　　6. Hysteroscopy:It can be found whether there are polyps or submucosal small myomas in the uterine cavity, and surgical treatment can be performed at the same time.

　　Functional失调性子宫出血食疗方(The following information is for reference only, detailed information needs to be consulted with a doctor)

　　1. Ginseng and Red Date Chicken Soup: Use 10 grams of Dangshen (sliced), 30 grams of red date (with seeds removed), and 1 child chicken (with feathers and internal organs removed) cleaned. Place them together in a steaming pot and simmer until the chicken is tender and can be taken.

　　2. Pomegranate Peel Decoction: Use 50 grams of sour pomegranate peel, 30 grams of Codonopsis pilosula, and 30 grams of Astragalus membranaceus. Boil in water, take the juice after removing the residue, and add an appropriate amount of honey to drink. Take twice a day.

　　3. Ginseng Stewed Turtle: Use 1 turtle (with intestines and viscera removed) cleaned and cut into pieces, and 3 grams of ginseng. Place them together in a steaming pot and simmer until the turtle is tender and can be taken.

　　4. Longan and Red Date and Chinese Wolfberry Decoction: Use 30 grams of longan, 20 grams of red date, and 20 grams of Chinese wolfberry. Take the decoction by mouth.

　　5. Sea Cucumber and Turtle Plate Lean Pork Soup: Use 50 grams of sea cucumber, 20 grams of turtle plate, and 50 grams of lean pork. Put the turtle plate in a pot of water and boil for 20 minutes, then add the sea cucumber and lean pork, and cook until done. Season and eat.

　　6. Sea Cucumber and Euryale Seed Soup: Use 30 grams of sea cucumber, 30 grams of Euryale Seed, and 50 grams of lean pork. Boil the sea cucumber and Euryale Seed with pork in water, season with sauce, and serve with meals.

　　7. Burn the hoof of the horse (or cow) to a charcoal powder, take 9 grams each time, 3 times a day, taken with plain salt water. Take for 1-3 days.

　　8. Red Sugar Fungus. Use 120 grams of fungus (soaked), and 60 grams of red sugar. Boil the fungus first, then mix in the red sugar. Take it all at once. Take for 7 days as one course. It is suitable for dysfunctional uterine bleeding.

　　9. Corn Silk Pork Soup. Use 15 to 30 grams of corn silk and 250 grams of pork. Boil the two ingredients together, eat the meat and drink the soup after the meat is cooked. Take one dose a day. It is suitable for dysfunctional uterine bleeding.

　　10. Wu梅 Paste. Use 1500 grams of clean Wu梅. Add 3000 milliliters of water to Wu梅, boil over a charcoal fire until the water evaporates to half, then add water back to the original amount, boil until thick, filter the residue with clean gauze, and store in a bottle. Add sugar to taste when taking, 5 to 10 milliliters for adults each time, diluted with boiling water, taken 3 times a day. It is suitable for dysfunctional uterine bleeding.

　　11. Pork Skin Jelly. Use 1000 grams of pork skin, 250 grams of yellow wine, and 250 grams of red sugar. Cut the pork skin into small pieces, place in a large pot, add an appropriate amount of water, and simmer over low heat until the skin is tender and the juice is thick and sticky. Add the yellow wine and red sugar, mix well, and turn off the heat. Pour into a porcelain bowl, cool, and store for later use. It can be eaten with meals as desired. It has the effects of nourishing yin and blood, and stopping bleeding. It is suitable for excessive menstrual bleeding, dysfunctional uterine bleeding, and all kinds of bleeding.

　　12. Wu梅Red Sugar Soup. Use 15 grams of Wu梅 and 30 to 50 grams of red sugar. Put Wu梅 and red sugar in a pot, add 1.5 bowls of water, and boil until half a bowl remains. Remove the residue and serve warm. It has the effects of nourishing blood and stopping bleeding, and beautifying the skin. It is suitable for women with excessive menstrual bleeding or dysfunctional uterine bleeding.

　　(6) Braised pork skin with red dates. Use 15 to 20 red dates (with seeds removed), and 100 grams of pork skin. Clean the pork skin, cut into small pieces, and clean the red dates, removing the seeds. Place them in a steaming pot with a small amount of water, and steam until the pork skin is tender. It has the effects of strengthening the spleen and blood, enhancing skin luster and elasticity. It is suitable for treating spleen deficiency type metrorrhagia and body weakness.

　　13. Ginger juice rice wine clam soup. 3 to 5 milliliters of ginger juice, 20 to 30 milliliters of rice wine, 150 to 200 grams of clam meat, appropriate amounts of cooking oil and table salt. Clean the clam meat, fry with peanut oil, add rice wine, ginger juice, and a sufficient amount of water, bring to a boil, add table salt for seasoning after the meat is cooked. It has the effects of nourishing yin and blood, clearing heat and detoxifying, and moistening and softening the skin. It is suitable for symptoms such as excessive menstruation and physical weakness.

　　14. Two fresh juice. 500 grams of fresh lotus root and 500 grams of fresh white radish. Clean the ingredients, grind together, wrap in clean gauze to extract the juice, add an appropriate amount of rock sugar and drink. It has the effects of clearing heat and cooling blood, stopping bleeding and consolidating the pulse, and whitening the skin. It is suitable for symptoms such as excessive menstruation.

　　Prescription

　　Ginseng and prepared slices chicken

　　Recipe: 20 grams of prepared slices, 6 grams of ginseng, 100 grams of chicken.

　　Preparation: Cut the chicken into pieces, slice the ginseng, and steam with the prepared slices for 1 hour, add a little salt.

　　Benefits: Warm the kidneys, consolidate the pulse, tonify the qi and control bleeding.

　　Usage: Serve with meals.

　　Angelica sinensis and raw earth braised mutton

　　Recipe: 500 grams of mutton, 15 grams of Angelica sinensis, 15 grams of raw earth, 10 grams of dried ginger.

　　Preparation: Cut the mutton into pieces, put it in a pot, add Angelica sinensis, raw earth, dried ginger, soy sauce, sugar, cooking wine, etc., and cook the mutton through low heat until tender.

　　Benefits: Warm the kidneys, consolidate the pulse, regulate menstruation and stop bleeding.

　　Usage: Serve with meals and eat in portions.

　　Boiled scallop

　　Recipe: 250 grams of fresh scallop meat, 500 milliliters of meat soup.

　　Preparation: Boil the meat soup, add the scallop meat, bring to a boil, then season with salt and monosodium glutamate.

　　Benefits: Nourish yin and blood, cool heat and stop uterine bleeding.

　　Usage: Eat the meat and drink the soup.

　　Turtle Cordyceps soup

　　Recipe: 1 turtle (about 500 grams), 20 grams of Cordyceps sinensis, 50 grams of lotus root.

　　Preparation: Cut the turtle into pieces, remove the head and internal organs, and cook with Cordyceps sinensis and lotus root in a pot, add an appropriate amount of water, simmer over low heat for 1 hour, add seasonings.

　　Benefits: Nourish yin and cool heat, consolidate the pulse and stop bleeding.

　　Usage: Drink the soup and eat the meat.

　　Rubia cordifolia turtle soup

　　Recipe: 1 turtle, 30 grams of Haliotis diversicolor, 20 grams of Rubia cordifolia.

　　Preparation: Boil the turtle in boiling water, remove the shell and internal organs, clean, cut into small pieces, and cook with Haliotis diversicolor and Rubia cordifolia in a pot, add an appropriate amount of water, bring to a boil with high heat, then simmer over low heat for 3 hours, season with salt to taste.

　　Benefits: Nourish yin and cool blood, regulate menstruation and stop bleeding.

　　Usage: Consume as desired.

　　Stewed black-bone chicken with cuttlefish

　　Recipe: 250 grams of cuttlefish, 1 turtle, 1 black-bone chicken.

　　Preparation: Remove the bones from the cuttlefish, remove the shell, claws, and internal organs from the turtle, blanch in boiling water to remove the black skin, remove the feathers and clean the internal organs of the black-bone chicken, then cook together in a pot with an appropriate amount of water, bring to a boil with high heat, then simmer over low heat for 1 hour until tender, season with salt to taste.

　　Benefits: Nourish yin and blood, resolve blood stasis and regulate menstruation.

　　Usage: Eat with meals as needed.

　　Longan and lotus seed porridge

　　Recipe: 20 grams of dried longan meat, 15 grams of lotus seed meat, 6 red dates, 30 grams of glutinous rice.

　　The preparation: Remove the kernel from the red dates, and cook with glutinous rice, longan meat, and lotus seed meat together in a pot, add an appropriate amount of water, bring to a boil over high heat, then simmer over low heat until soft, and add sugar to taste.

　　Effects: Strengthen the spleen and Qi, nourish blood and stop bleeding.

　　Usage: Take one dose per day, can be eaten regularly.

　　Cuttlebone stewed chicken

　　Ingredients: 30 grams of cuttlebone, 100 grams of chicken.

　　The preparation: Cut the chicken into pieces, crush the cuttlebone into bean-sized pieces, put the chicken and cuttlebone in an earthen pot, add water and seasonings, and simmer over low heat for 2 hours.

　　Effects: Strengthen the spleen and Qi, nourish blood and control blood.

　　Usage: Eat with meals, remove the cuttlebone when eating. Take one dose per day, 5 days as one course.

　　Ginseng and Astragalus pigeon soup

　　Ingredients: 5 grams of American ginseng, 15 grams of Astragalus, 1 pigeon.

　　The preparation: Remove the feathers and internal organs of the pigeon, stuff with ginseng slices and Astragalus, add an appropriate amount of water, steam over low heat for 1 hour, and season with a little salt.

　　Effects: Strengthen the spleen and Qi, elevate the Yang and control blood.

　　Usage: Eat with meals.

　　Ginseng and cimicifuga porridge Ingredients: 6 grams of ginseng, 3 grams of cimicifuga, 30 grams of glutinous rice. Preparation: Boil the first two ingredients to extract the juice and cook with glutinous rice to make porridge. Effects: Tonify the Qi and control blood, elevate the Yang and fill the deficiency. Usage: Take one dose per day, take for one week consecutively.

　　Black fungus steamed chicken

　　Ingredients: 30 grams of black fungus, 200 grams of chicken.

　　The preparation: Soak black fungus in water, wash and set aside; cut the chicken into small pieces, add salt, soy sauce, cornstarch, sugar, and monosodium glutamate, marinate for 20 minutes, then mix with black fungus and steam over low heat.

　　Effects: Remove blood stasis and stop bleeding.

　　Usage: Eat with meals as needed.

　　Hawthorn and brown sugar water

　　Ingredients: 30 grams of hawthorn, 20 grams of brown sugar, 20 grams of motherwort.

　　The preparation: Put hawthorn, motherwort into a pot, add an appropriate amount of water, boil to extract the juice, add brown sugar, and continue to boil until the brown sugar is completely dissolved.

　　Effects: Activate blood circulation and remove blood stasis.

　　Usage: Take one dose per day, divided into two servings.

　　Sanqi lotus root and egg porridge

　　Ingredients: Fresh lotus root, 5 grams of Sanqi powder, 1 egg.

　　The preparation: Clean and chop the lotus root, squeeze a small cup of juice with a gauze, add a little water to boil, mix the Sanqi powder with the egg, pour it into the lotus root juice to make a porridge, and season with salt and lard.

　　Effects: Dissolve blood stasis and stop bleeding.

　　Usage: The above is a single dose, take twice a day.

　　Motherwort cooked egg

　　Ingredients: 60 grams of motherwort, 2 eggs.

　　The preparation: Boil the motherwort and eggs together until cooked, remove the shell of the egg, and boil for a while longer.

　　Effects: Activate blood circulation and regulate menstruation.

　　Usage: Take one dose per day, divided into two servings.

　　Fresh lotus root and side柏 leaves juice

　　Ingredients: 500 grams of fresh lotus root, 100 grams of raw side柏 leaves, 15 grams of honey.

　　The preparation: Wash the lotus root with joints, squeeze the juice; muddle and squeeze the juice of side柏 leaves. Mix the two juices, add honey to mix evenly, place them in a steaming bowl, and simmer over low heat for 5 minutes.

　　Effects: Clear heat and cool blood, dissipate blood stasis and stop bleeding.

　　Usage: Drink as desired.

　　Water chestnut and mao gen juice

　　Ingredients: 500 grams of water chestnuts, 500 grams of fresh mao gen.

　　The preparation: Peel and squeeze the juice of water chestnuts, wash and cut the fresh mao gen into small segments, and squeeze the juice. Mix the two juices, place them in a steaming bowl, and simmer over low heat for 5 minutes.

　　Effect: Clear heat, cool blood, and stop bleeding.

　　Usage: Drink as desired.

　　Celery and lotus root soup

　　Formula: Fresh celery 150 grams, fresh lotus root 150 grams, cooking oil 250 grams

　　Preparation: Cut celery into pieces, cut lotus root into slices. Heat oil in a pot, stir-fry celery and lotus root slices for a moment, then add 500 milliliters of water, and boil it.

　　Effect: Clear heat, cool blood, remove blood stasis, and stop bleeding.

　　Usage: Take one dose per day, divided into two servings. 7 days is one course.

　　Dandelion instant drink

　　Formula: Fresh dandelion 2500 grams, sugar 500 grams

　　Preparation: Cut the fresh dandelion into pieces, boil it for 1 hour over medium heat, remove the residue and take the juice, concentrate it over low heat into a syrup. Wait until it is warm, add sugar, absorb the medicine, cool it down, dry it, and then grind it into powder and pack it into bottles.

　　Effect: Clear heat, cool blood, and stop bleeding.

　　Usage: Take 10 grams each time, pour boiling water, take it warm, three times a day.

　　Shepherd's purse and horse-tail grass soup

　　Formula: Shepherd's purse 100 grams, horse-tail grass 100 grams

　　Preparation: Boil shepherd's purse and horse-tail grass with an appropriate amount of water, add salt, vinegar, and sesame oil for seasoning.

　　Effect: Clear heat, cool blood, and stop bleeding.

　　Usage: Drink soup and eat vegetables.

　　Dietary taboos for functional uterine hemorrhage

　　It is advisable

　　(1) It is advisable to eat nutritious and easily digestible foods, and eat more iron-rich foods: such as animal internal organs, black-bone chicken, black fungus, longan meat, spinach, and the like fresh vegetables and fruits.

　　(2) For those with属实 heat, it is advisable to eat more fresh vegetables, fruits, and low-fat foods, including milk, soy milk, eggs, lean meat, liver soup, shepherd's purse, black-bone chicken, persimmon cake, lotus root powder, horse-tail grass, watermelon juice, pear, water chestnut, hawthorn, crucian carp, black fungus, leek, etc.

　　(3) Those with spleen and kidney deficiency should eat more astringent and nourishing foods: mung bean, jujube, pork stomach, yam, lychee, white fungus, black fungus, black, yellow croaker, leek, coix seed, pork kidney.

　　(4) It is good to tonify the heart and spleen with rice, millet, wheat, mung bean, yam, sesame, lotus seed, jujube, longan, etc.; and to tonify the liver and kidney with millet, wheat, yam, sesame, chestnut, walnut, etc. For heat syndrome, it is advisable to choose millet, wheat, red bean, mung bean; for cold syndrome, it is advisable to choose rice, sorghum, mung bean, dried fruit. Birds and animals have strong tonifying power, and those with deficiency syndrome should eat them, and those with实证 are not taboo. Especially pork, beef, chicken meat, milk, eggs, etc. are neutral in nature and can be eaten regardless of cold or heat. Water buffalo meat is especially suitable for blood tonification and hemostasis.

　　(5) Fruits are light and not likely to cause blood leakage, and most of them have the function of tonifying the body, such as sugarcane, apple, cherry, fig, banana, grape, persimmon, and the like. Corn can tonify the spleen, and mulberry can tonify the liver and kidney. When the bleeding lasts for a long time and is continuous, add plum vinegar and hawthorn to stop bleeding.

　　Taboo

　　1. Belonging to deficiency with a cold bias, it is necessary to choose food that is warm in nature among the tonifying products, but not excessively hot. Avoid spicy, mustard, ginger, cassia, and the like. For those with实证, heat syndrome, it is even more taboo to use warm and hot products.

　　2. Lamb, dog meat, and sparrow meat are warm in nature, so they should be used with caution in patients with heat syndrome.

　　3. Avoid ginger, pepper, garlic, and the like during abundant bleeding.

　　General treatment

　　1. Improve the general condition and correct anemia.

　　2. Avoid overexertion during the hemorrhagic period and pay attention to rest.

　　3. For those with prolonged bleeding time, anti-inflammatory treatment can be given.

　　4. Appropriate use of hemostatic drugs.

　　Curettage Treatment

　　For patients with recurrent bleeding or heavy bleeding, and for those with conservative treatment failure and cannot rule out endometrial lesions, fractional curettage can be performed, which can stop bleeding quickly and make an accurate diagnosis.

　　Hormonal Treatment

　　1. For young women with anovulatory menorrhagia, the main treatment is to stop bleeding and restore ovulatory function.

　　For women with heavy bleeding leading to anemia, the method of promoting endometrial growth and repair should be adopted, i.e., estrogen treatment, with the addition of progesterone in the last 3-5 days, and the endometrium is completely shed and bleeding stops after discontinuation of medication for 3-7 days. For patients with poor response to estrogen treatment alone, combined use of estrogen and progesterone preparations can also be considered. For patients with intermittent vaginal bleeding, the method of progesterone-induced endometrial shedding can be used to make the endometrium shed completely and then regrow to stop bleeding, also known as pharmacological curettage. To prevent recurrence of symptoms after discontinuation of medication, continued estrogen-progesterone sequential therapy, i.e., artificial cycle, or short-acting oral contraceptives for 2-3 cycles, can be used to stimulate and wait for the maturation of the hypothalamus-pituitary-ovary axis.

　　2. For women with anovulatory menorrhagia who have fertility requirements, clomiphene can be used to induce ovulation if the vaginal estrogen level is significantly affected.

　　For young women without fertility requirements, the main treatment is to adjust the menstrual cycle, which can include: (1) Oral short-acting contraceptives: Suitable for women without fertility requirements. It regulates the menstrual cycle and also has the effects of contraception or treatment of hyperandrogenism, etc. (2) Consecutive estrogen-progesterone therapy: Suitable for adolescents and women of childbearing age.

　　3. Menopausal anovulatory menorrhagia: The aim is to regulate the cycle, reduce bleeding, and induce menopause. Treatment is based on pathological diagnosis after fractional curettage, and for benign changes such as proliferative endometrium, endometrial hyperplasia, etc., large-dose progesterone cycle treatment can be used until 3-6 cycles before discontinuation and observation.

　　4. Menorrhagia with ovulatory dysfunction generally has mild symptoms and good treatment effects.

　　(1) For women with incomplete luteal function, progesterone can be added for 7-10 days 8-12 days before the period, usually treated for 3 courses.

　　(2) Short-acting oral contraceptives, taken from the first day of the menstrual period, 1 tablet per day, for 22 days in a row, and treated for 3 courses.

　　(3) For women with menorrhagia during the ovulatory period, a small amount of estrogen such as ethinyl estradiol 0.005-0.01mg/d can be administered on the 10th day of the menstrual cycle, for 10 days in a row, and treated for 3 courses.