There are two common types of ovulatory uterine bleeding: luteal insufficiency; and incomplete endometrial shedding.
I. Luteal insufficiency.
There is follicular development and ovulation in the menstrual cycle, but the progesterone secretion during the luteal phase is insufficient, or the corpus luteum declines prematurely, resulting in poor endometrial secretion response.
Pathology.
1. poor glandular secretion.
2. insignificant interstitial edema.
3. glandular and interstitial asynchrony phenomenon.
4, various parts of the endometrium show uneven secretory response.
Treatment.
1, promotion of follicular development: clomiphene, HMG-HCG method.
2, luteal function stimulation therapy.
3. luteal function supplementation therapy.
4, Bromocriptan therapy – combined with hyperprolactinemia.
Irregular shedding of the endometrium.
In the menstrual cycle, there is ovulation and the corpus luteum is well developed, but the atrophy process is prolonged, resulting in irregular shedding of the endometrium.
Pathology.
1, endometrium showing secretory reaction can still be seen on the 5th-6th day of menstruation.
2. The pathology shows a mixed type of residual secretory phase endometrium mixed with bleeding necrotic tissue and new growths of endometrium.
Treatment.
1.Progestin therapy.
2.HCG treatment .