Corniţescu F I, Tănase Florentina, Simionescu Cristiana, Iliescu D
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania.
Rom J Morphol Embryol. 2011;52(3):759-65.
With the decline of ovarian hormonal function, from the fifth decade of life, women enter the menopause transition, during which bleeding becomes irregular in duration and time of occurrence. Secondary to ovarian dysfunction, developmental and maturation endometrial anomalies occur, which are clinically translated by abnormal uterine bleeding, which in many cases at this age can be caused by organic lesions (fibroma, polyps, endometritis, endometrial hyperplasia, adenomyosis, etc.). The retrospective study included a total of 256 patients with abnormal uterine bleeding in menopause transition. Statistics showed that the incidence of these types of bleeding increases with age (64.5%) and parity (30.5%), with symptoms consisting mostly in different clinical forms of abnormal uterine bleeding (62.1%), and leiomyomas prevailing at histopathological examination (49.6%). Progesterone replacement therapy was the first therapeutic choice for correcting these types of bleeding. Progesterone therapy is useful not only for therapeutic purposes to amend the bleeding, but also as a precaution against the development of endometrial carcinoma. Progestogens cancel the proliferative and mitogenic effect of estrogens, even when administered in sequential regimen 10-12 days per month.
随着卵巢激素功能的衰退，从50岁起，女性进入围绝经期过渡阶段，在此期间，出血的持续时间和发生时间变得不规律。继发于卵巢功能障碍，会出现发育和成熟方面的子宫内膜异常，临床上表现为异常子宫出血，在这个年龄段，许多情况下这种出血可能由器质性病变（纤维瘤、息肉、子宫内膜炎、子宫内膜增生、子宫腺肌病等）引起。这项回顾性研究共纳入了256例围绝经期过渡阶段异常子宫出血的患者。统计显示，这些类型出血的发生率随年龄（64.5%）和产次（30.5%）增加，症状主要表现为不同临床形式的异常子宫出血（62.1%），组织病理学检查中子宫肌瘤最为常见（49.6%）。孕激素替代疗法是纠正这些类型出血的首选治疗方法。孕激素疗法不仅对治疗出血有用，而且可作为预防子宫内膜癌发生的措施。即使每月按序贯方案给药10 - 12天，孕激素也能消除雌激素的增殖和促有丝分裂作用。
