Dysfunctional+Uterine+Bleeding

//Western Diagnosis// Abnormal Uterine Bleeding excess duration of menses
 * Menorrhagia**

excess amount of menses
 * Hypermenorrhea**

too frequent menstruation
 * Polymenorrhea**

intermenstrual bleeding
 * Metrorrhagia**

bleeding >6 months after last menstrual period at menopause
 * Postmenopausal bleeding**

Etiology
1. organic cause in 25% 2. remainder usually functional abN in hypothalamic-pituitaryovarian axis ---dysfunctional uterine bleeding ---50% in women >45 yrs old ---20% in adolescents 3. abN clotting disorders 4. complications of pg ---ectopic pg ---placenta previa ---endometritis 5. endometriosis 6. trauma 7. vaginal lesions 8. cervical CA 9. some benign cervical lesions 10. endometrial hyperplasia ---in anovulatory women ---unopposed E or xs exogenous E ---irregular, incomplete endometrial sloughing 11. adenomyosis ---invasion of endometrium into myometriuim ---menorrhagia, metrorrhagia 12. leiomyomas (uterine fibroids) ---in 40% of women by age 40 ---sx in only a small percentage ---any type of bleeding abN 13. functional ovarian cysts ---common ---50% women present with some type of menstrual irregularity ---if >5 cm adnexal mass for >1 month, surgery to rule out neoplasm: ultrasound 14. contraceptives: bc pills, IUD 15. thyroid dysfunction: oligomenorrhea, amenorrhea, menorrhagia 16. postmenopausal: rule out malignancy

Treatment
1. find cause 2. be careful of anemia

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==================================================================== //TCM Pathology// =Dysfunctional Uterine Bleeding=

Formula 1
Shu Di Huang (12g.), Shan Yao (12g.), Huang Jing (9g.), Yin Yang Huo (12g.), Bai Ji Tian (12g.), Shan Zhu Yu (9g.), Bu Gu Zhi (12g.) Modifications: Internal heat: + Zhi Mu (12g.), Hua g Bai (12g.), Huang Qin (12g.) Qi deficiency: + Dang Shen (12g.), Bai Zhu (9g.), Pao Jiang (3g.) Yang deficiency: + Fu Zi (9g.), Rou Gui (3g.), Lu Jiao Jiao (3g.)

Formula 2
Dang Shen (12g.), Bai Zhu (9g.), Shu Di Huang (12g.), E Jiao (9g.), Bai Shao (12g.), Xian He Cao (15g.), Yin Yang Huo (12g.), Ce Bai Ye (12g.), Di Yu (12g.), Qiao Cao Gen (12g.), Hai Piao Xiao (12g.), Huai Hua Mi (12g.)

Acupuncture
It is appropriate to induce ovulation in young patients: SP-6, CV-4, CV-3, Zi Gong