From the first menstruation to menopause for a total of more than 30 years, most women experience menstrual disorders with a variety of causes, which are collectively referred to as abnormal uterine bleeding in medical terms. Abnormal uterine bleeding is defined as abnormal bleeding from the uterine cavity that is inconsistent with any one of the normal menstrual cycle frequency, regularity, length of periods, or volume of menstrual bleeding, and has both organic (e.g., endometrial polyps, adenomyosis, fibroids, endometrial malignancy, etc.) and functional (also known as dysfunctional uterine bleeding, menstrual disorders, menstrual disorders, etc.) causes. Today, we will talk about functional abnormal uterine bleeding, or what used to be called dysfunctional uterine bleeding. I. So what exactly is dysfunctional? In fact, it is a dysfunction of the endocrine system that controls menstrual flow. When it comes to this, many people are still confused, especially when doctors recommend taking hormones. To answer this question, we need to trace the root of how menstruation came about…Second, who is in charge of menstruation or not? First, let’s understand the echelon of the endocrine system that controls menstruation. We know that menstruation is caused by the shedding of the endometrium once a month, and the endometrium is led by the ovaries, the female endocrine glands, which are under the command of the hypothalamus-pituitary gland. We also call this echelon the hypothalamic-pituitary-ovarian axis (HPO axis). The hypothalamus-pituitary gland is the commander-in-chief of the body’s endocrine glandular organs, and although we always refer to these two guys at the same time, there is actually a hierarchical relationship between the two. The hypothalamus listens to the brain, receives tasks and communicates them to the pituitary gland. The pituitary gland will assign different tasks to various departments, which are the endocrine glands of the body, such as the pancreas, thyroid, adrenal glands, etc. After receiving the tasks, the endocrine glands will secrete various hormones to ensure the normal functioning of the body. The ovaries are one of these endocrine glands. 1. follicles nurture eggs that gradually mature Estrogen appears to peak when the last menstrual cycle ends and the hypothalamus-pituitary gland begins to gradually release follicle stimulating hormone (FSH) and luteinizing hormone (LH). fsh promotes the gradual maturation of follicles in the ovaries and the production of estrogen. The follicles harbor our eggs, and when they mature they will rupture in response to LH to release a healthy egg and complete ovulation. When the follicle matures, estrogen levels also reach their peak, while stimulating the endometrium to gradually thicken, even reaching about 7~8 mm. 2. Egg expulsion Estrogen and progesterone help the endometrium get ready for conception When estrogen reaches its peak, it reports to the hypothalamus – “the follicle is mature and ready for ovulation It is ready to ovulate~”. After the follicle ruptures and expels the egg, the follicle that has lost the egg forms the corpus luteum by the action of LH. The role of the corpus luteum in our menstrual cycle should not be underestimated, as it secretes large amounts of estrogen and progesterone (i.e. progesterone). Estrogen causes the endometrium to proliferate, while progesterone causes the endometrium to become vasodilated and tissue-rich, thus making the endometrium loose, fat and vascular, with the aim of preparing a comfortable living environment for the fertilized egg.3. Waiting to fall short Only the next cycle can be welcomed If no conception occurs, the corpus luteum slowly shrinks and progesterone and estrogen rapidly decrease. When the endometrium suddenly loses the support of these two sex hormones, continuous contraction of blood vessels occurs and the thickened endometrium peels off due to lack of blood, forming menstruation. At the same time, the concentration of estrogen and progesterone in human blood decreases and the next menstrual cycle is entered.4. Hormone therapy helps restore the normal menstrual cycle Having said that, we can see the important role of hormones and the coordination between hormones in the whole menstrual cycle. If something goes wrong in the hypothalamic-pituitary-ovarian (HPO) axis that leads to ovulation disorders, take the example of adolescent menstrual bleeding: because the cyclical regulation of the hypothalamic-pituitary-ovarian (HPO) axis is not yet stable, the ovaries cannot ovulate, and there is no corpus luteum formation, so there is estrogen but no progesterone. Estrogen keeps the endometrium growing, but without the effect of progesterone, there is no shedding of the large endometrium when the blood vessels contract violently. These endometrium fall off piece by piece in the east and west, so there is a situation where the uterine bleeding drips and the patient’s menstruation always stays away. Since the body has a certain level of estrogen but lacks progesterone, proper supplementation of progesterone can stop the bleeding. Many parents refuse hormone therapy because they are afraid of hormones, but they do not know that long-term persistent gonorrhea may affect the physical development of adolescence, which in turn may affect future fertility.