The management of patients with abnormal uterine bleeding requires a logical, rational approach, and an awareness of etiologic factors. A careful history and examination should attempt to answer these questions: (1) Is the bleeding truly from the uterus? (2) Is the bleeding superimposed upon ovulatory cycles or (3) is the bleeding anovulatory? The endometrial biopsy obtained during the bleeding episode, and the basal temperature chart are diagnostically useful. Massive uterine bleeding not due to a complication of pregnancy, neoplasis, or blood dyscrasia, usually responds immediately to curettage, done in operating room or office; follow-up hormonal therapy with progesterone and a progestational agent should control the episode. More chronic forms of abnormal uterine bleeding are approached by identifying and treating the etiologic cause. If the cause is not correctable (e.g., obesity), most patients will respond satisfactorily to the cyclic administration of a progestational agent, or, if indicated, to induction of ovulation.
异常子宫出血患者的管理需要一种合乎逻辑、理性的方法，以及对病因的认识。详细的病史和检查应试图回答以下问题：（1）出血是否真的来自子宫？（2）出血是叠加在排卵周期上，还是（3）出血为无排卵性？在出血期间进行的子宫内膜活检和基础体温图表具有诊断价值。非因妊娠并发症、肿瘤或血液系统疾病导致的大量子宫出血，通常在手术室或诊室进行刮宫后会立即见效；后续使用孕激素和孕激素类药物进行激素治疗应能控制病情。对于更慢性的异常子宫出血形式，应通过识别并治疗病因来处理。如果病因无法纠正（如肥胖），大多数患者对周期性使用孕激素类药物，或在有指征时对诱导排卵的治疗反应良好。
