中国医科大学：《妇产科学》课程教学资源（PPT课件讲稿，英文版）Dysfunctional Uterine Bleeding（DUB）功能失调性子宫出血

Dysfunctional Uterine Bleeding(DUB 功能失调性子宫出血

Dysfunctional Uterine Bleeding (DUB) 功能失调性子宫出血

Definition Dysfunctional uterine bleeding DUB) Abnormal uterine bleeding with no demonstrable organic causes a diagnosis of exclusion

Definition Dysfunctional uterine bleeding (DUB): Abnormal uterine bleeding with no demonstrable organic causes. • A diagnosis of exclusion

Epidemiology about 10% of the outpatients Common at the extremes of reproductive life. but can occur at reproductive age 50%o at near menopause 20% in adolescents 30% at reproductive age

• About 10% of the outpatients • Common at the extremes of reproductive life, but can occur at reproductive age: 50% at near menopause 20% in adolescents 30% at reproductive age Epidemiology

Key Learning points Clinical classification and features of duB Principles of treatment and methods Etiology and mechanism of duB Common diagnostic methods and key points in making the differential diagnosis

• Clinical classification and features of DUB • Principles of treatment and methods • Etiology and mechanism of DUB • Common diagnostic methods and key points in making the differential diagnosis Key Learning Points

Normal menstrual cycle a brief review Menstrual cycle Endometrial cycle Ovarian cycle Hypothalamic-pituitary-ovarian axis

• Menstrual cycle • Endometrial cycle • Ovarian cycle • Hypothalamic-pituitary-ovarian axis Normal menstrual cycle A brief review

Ovarian /Endometrial cycles Follicular Luteal phase hase GOOO8 62 2 Estrogens Progesterone Secretion Menses Proliferation eases O Days 3-5 14 28 3-5

Ovarian /Endometrial cycles

大脑皮层 下丘脑 垂体 H IU/L∴…FSH 100 LH 50}P En μg/L 800 垂体激素40}80 30F60 600 20F40 400 卵巢激素10F20 200 FSH 卵巢周期 @ 图2-7下丘脑垂体卵巢轴在月经周期中的变化

The normal menstrual cycle Menstruation is triggered by a sudden decrease in progesterone and estrogen secretions After menstruation. the increased secretion of estrogen causes cellular growth and the regeneration of the endometrium After ovulation, the secretion of progesterone stops the growth of the endometrium, turning the proliferative phase into the secretory phase If conception does not occur, the corpus luteum(5p regresses causing declines in estrogen and progesterone production, thus the next menstruating begins

The normal menstrual cycle • Menstruation is triggered by a sudden decrease in progesterone and estrogen secretions. • After menstruation, the increased secretion of estrogen causes cellular growth and the regeneration of the endometrium. • After ovulation, the secretion of progesterone stops the growth of the endometrium, turning the proliferative phase into the secretory phase. • If conception does not occur, the corpus luteum (黄体) regresses causing declines in estrogen and progesterone production, thus the next menstruating begins

Classification Anovulatory bleeding(无排卵性DUB) DUB that occurs without ovulation Ovulatory bleeding(排卵性DUB) DUB that involves ovulation

Classification • Anovulatory bleeding (无排卵性DUB) DUB that occurs without ovulation • Ovulatory bleeding (排卵性DUB) DUB that involves ovulation

Anovulatory bleeding

Anovulatory bleeding