We know that most adolescent girls have immature functions of the hypothalamic-pituitary-ovarian axis and often experience irregular menstruation. If the symptoms are mild, they can be treated without urgency and the patient will recover slowly with age. However, if drenching bleeding or heavy bleeding occurs, and the duration of menstruation is significantly prolonged for more than 10 days or even up to 2 months individually, it may lead to varying degrees of anemia in the patient, and then medical intervention is required.
1. Stopping bleeding without menstrual regulation will definitely recur. Active follow-up and timely consultation are required
Patients need to go through hemostasis and menstrual regulation for 3 to 6 months of treatment. During this period many patients do not adhere to the end of treatment, moreover, they do not follow up with the hospital on time, resulting in the recurrence of the disease. Why is this? Because stopping the bleeding alone does not cure the anovulatory state, and if left alone, recurrent anovulatory bleeding will occur. Parents should not think that stopping the bleeding is the cure, but should actively follow up and see the doctor in time to adjust the menstrual cycle and prevent recurrence. As the patient ages, the reproductive endocrine axis will stabilize and mature, and the risk of gonorrhea will be reduced.
2.Must return to the hospital for follow-up after 3~6 months of treatment
Let’s talk about how to properly follow up during the treatment process for patients with adolescent gonorrhea. As mentioned in the previous article, the treatment of menstrual bleeding should be adhered to for at least 3~6 cycles (i.e. 3~6 months), during which the patient should take menstrual regulating drugs strictly according to the doctor’s prescription. If the menstrual regulation is effective (normal cycle: 28-30 days; normal menstrual volume: 20 ml < 80 ml; normal number of menstrual days < 10 days), then insisting on the medication does not require a hospital visit.
After 3~6 months of menstrual regulation treatment, the medication should be stopped under the guidance of the doctor to see if the normal menstrual cycle can be restored, so it is important to follow up at the hospital at the end of the menstrual regulation treatment.
3. Stopping the medication in the middle of the treatment may aggravate the disease
If you still experience excessive menstruation, dripping, or mid-menstrual bleeding during the adjustment period, go to the hospital in time to find out the cause, and remember not to interrupt the treatment without authorization. Patients and their parents should be reminded that they should insist on taking the medication at the beginning of each cycle until the end. Giving up the medication in the middle of the cycle will cause sudden changes in the hormone level in the body, which will only aggravate the disease.
At the follow-up visit of such patients, the doctor will do some tests to clarify the reasons for the poor efficacy.
(1) Complete blood count: to determine the presence of anemia and thrombocytopenia.
(2) Coagulation tests: to exclude coagulation disorders.
(3) Urine pregnancy test or blood beta-HCG test: to determine if pregnancy is present (stay alert).
(4) pelvic ultrasound on day 12 of the menstrual cycle: to find out the thickness and echo of the endometrium in order to clarify the presence of occupying uterine cavity lesions and other organic lesions of the reproductive tract, etc.
(5) Blood hormone test 2~5 days after menstruation: measure progesterone level to determine whether there is ovulation and luteal function; measure thyroid hormone to determine whether there is abnormal thyroid function; measure prolactin and other endocrine hormone levels for differential diagnosis with other diseases.
(6) Diagnostic scraping or hysteroscopic scraping: for adolescent girls, scraping is not easily performed unless endometrial lesions are excluded. It is suitable for patients with massive bleeding that needs to be stopped immediately by medication or suspected endometrial lesions.
4.Information to be provided to the doctor during the follow-up consultation
It is recommended that patients with gonorrhea should develop a good record keeping habit.
(1) Changes in menstruation during treatment.
(2) Basal body temperature (see “Don’t neglect to record basal body temperature in gonorrhea treatment” for specific measurement methods).
(3) Medication intake. Since the course of menstrual regulation medication is long, and sometimes it needs to be combined with other medications, patients often miss or take medications. Therefore, patients often miss or take more than one pill, so it is good to record each pill to avoid the problem of confusing medication. You can use the “medication diary” of the cell phone client, so your doctor can understand your medication situation remotely.
(4) Mental condition: such as whether there has been a quarrel or recent study and work pressure, whether there is strenuous exercise, etc.
Finally, we remind you not to believe in various “tonic” and health products, eat less cold and stimulating food during menstruation, and pay attention to relaxation, reduce tension, anxiety and fear, which is very helpful to the recovery of gongbao.