Irregular shedding of the endometrium

　　Pathophysiology:

　　The corpus luteum generally atrophies after 14 days of survival, and the endometrium sheds and menstruates due to the lack of support from estrogen and progesterone.

　　Irregular shedding of the endometrium is caused by the dysfunction of the hypothalamus-pituitary-ovary axis, leading to incomplete atrophy of the corpus luteum. The endometrium is continuously affected by progesterone, so it cannot shed completely on schedule. Normally, by the 3rd to 4th day of the normal menstrual period, the secretory endometrium has completely shed, replaced by the regenerating proliferative endometrium. However, in cases of irregular shedding of the endometrium, the endometrium showing secretory reaction can still be seen on the 5th to 6th day of the menstrual period. Due to the longer menstrual period, the endometrium loses water, the stroma becomes dense, the glands shrink, and the acini become plum blossom-like or star-shaped.

　　The endometrium shows a mixed type, that is, the residual secretory endometrium, necrotic and hemorrhagic tissue, and newly proliferating endometrium coexist and mix together.

　　Irregular shedding of the endometrium may lead to endometritis and anemia. Endometritis is an inflammatory change in the endometrial structure caused by various reasons. The uterine cavity has good drainage conditions and periodic endometrial shedding, which makes inflammation rarely have a long stay in the endometrium. However, if the treatment of acute inflammation is not thorough, or if there is a frequent source of infection, it can recur. Chronic endometritis is the most common cause of miscarriage.

　　On the 3rd to 4th day of normal menstruation, the secretory endometrium has completely shed, replaced by the regenerating proliferative endometrium. However, when the corpus luteum does not atrophy completely, the endometrium showing secretory reaction can still be seen on the 5th to 6th day of menstruation. Some areas of the endometrium still have bleeding, while others have new proliferative endometrium appearing. Irregular shedding of the endometrium is characterized by normal menstrual interval, but prolonged menstrual period, lasting 9-10 days, with abundant bleeding.

　　1. To relieve mental stress, you can engage in some whole-body exercises, such as swimming, running, once or twice a week, for 30 minutes each time.

　　2. Eat more dishes that have a pressure-relieving effect, such as bananas, cabbage, potatoes, shrimps, chocolate, ham, corn, tomatoes, etc.

　　3. During the period, prevent cold and dampness, avoid rain, wading, swimming, drinking cold drinks, etc., especially prevent the lower body from getting cold, and pay attention to keeping warm.

　　4. It is not advisable to add foods such as scallions, beans, pumpkins, garlic, ginger, chestnuts, oranges, etc. to the diet; in addition, vinegar, soy sauce, vegetable oils, chili, pepper, and other spices, as well as braised beef, chicken broth, and other soups, have a certain effect on menstrual irregularities caused by this situation.

　　1. Routine blood tests, hormone level detection, coagulation function, platelet adhesion function and aggregation function test, measure BT, and make内膜 or blood progesterone determination at the appropriate time.

　　2. Hysteroscopy, laparoscopy, B-ultrasound, uterine artery angiography examination.

　　Determining whether the dysfunctional uterine bleeding with ovulation is based on clinical manifestations and relevant examinations, and measuring the blood progesterone concentration 5-9 days before the menstrual period.

　　The dietary requirements for patients with irregular shedding of the endometrium generally include: 1. Pay attention to diet and rest, be concerned about physiological hygiene, and also pay attention to emotional harmony, be concerned about mental hygiene.

　　2. Reasonable diet, taboo spicy and刺激性 food.

　　1. Progesterone:Starting 10-14 days before the next menstrual period, take 10mg of medroxyprogesterone daily by mouth. For those with fertility requirements, intramuscular injection of progesterone or oral natural micronized progesterone. Its function is to regulate the feedback function of the hypothalamus-pituitary-ovary axis, so that the corpus luteum atrophies in time, and the endometrium is shed completely in time.

　　2. Chorionic gonadotropin:The usage is the same as luteal insufficiency, HCG has the effect of promoting luteal function.