Increased menstrual flow, spotting and bleeding before and after menstruation, and even anemia as a result are common symptoms in patients with adenomyosis, but there are other factors that can cause uterine bleeding in addition to the uterine bleeding that adenomyosis can cause. Regular uterine bleeding – menstruation – is a sign of a woman’s health, starting from puberty and continuing through menopause. There is also the birth of a child, the process of stripping away new life, which also causes bleeding. But in life, we will encounter strange and bizarre bleeding phenomenon, so we are at a loss, panic What is the “secret” of uterine bleeding? 1, the uterus and endometrium The factors that cause uterine bleeding in the uterus and endometrium include: abnormalities in the structure and function of small spiral arteries and microcirculatory vascular beds, abnormalities in local coagulation mechanisms, endometrial steroid receptor and lysosomal dysfunction, and dysregulation of PGI2 secretion. 2.Functional bleeding Functional uterine bleeding is mainly manifested as abnormal uterine bleeding, which can be excessive, too little, too frequent, or irregular, or postmenopausal bleeding, etc. In women with abnormal bleeding, about 75% are caused by hormonal disorders affecting the regulation of the reproductive system. These hormones are produced by the hypothalamus and pituitary gland and are common in women of reproductive age. 3, systemic factors Systemic factors that cause uterine bleeding include malnutrition, adverse mental trauma, stress hormones, endocrine and metabolic disorders, such as iron deficiency, anemia, blood disorders, bleeding disorders and diabetes mellitus. 4, medical factors including steroidal contraceptives, intrauterine devices interfere with the normal HPOU axis function. Certain drugs for systemic diseases can affect normal menstrual function via neuroendocrine machine transfer. How to treat uterine bleeding? 1.The treatment should distinguish between ovulatory and non-ovulatory types, and make corresponding plans according to the patient’s age, duration of the disease, the amount of bleeding, the relationship with the last bleeding time, the difference of the patient’s physique, and the requirement for fertility. 2. For acute bleeding, scraping is a rapid and effective method to stop bleeding, while scraping out the endometrium for pathological examination can help in diagnosis. However, for adolescent and unmarried patients, scraping is generally not performed. 3, for menopausal bleeding patients, can not simply be considered as benign disorders due to endocrine disorders, but should be routinely scraped endometrial specimens to exclude malignant lesions. Clinical data show that those who suffer from functional bleeding before menopause have a higher incidence of endometrial cancer later. 4. Treatment can be carried out in stages. For young and middle-aged patients, the goal is to achieve restoration of ovulation, while for menopausal women, after hemostasis, the focus is on adjusting the cycle, reducing bleeding and preventing recurrence, without restoring ovulation. For those who have ovulation in their reproductive age and wish to have children, they should be encouraged to have a sound luteal function.