It is an abnormal uterine bleeding caused by the malfunction of the neuroendocrine mechanism regulating reproduction without the presence of organic lesions in the body and internal and external reproductive organs. It can be divided into two types: anovulatory and ovulatory. About 85% of cases are anovulatory. It can occur at any age between menarche and menopause, with 50% of patients occurring in premenopause, 30% in reproductive age and 20% in adolescence. The anovulatory type of gonorrhea belongs to the category of collapse in TCM, while the ovulatory type of gonorrhea is similar to premenstruation, excessive menstruation, prolonged menstruation and intermenstrual bleeding in TCM, and can be cross-referenced. Classification, clinical manifestations and treatment of dysfunctional bleeding (1) Causes: There are many causes of dysfunctional bleeding, including internal and external factors, such as excessive mental stress, fear, sorrow, sudden environmental and climatic changes, as well as systemic diseases, malnutrition, anemia and metabolic disorders, which can affect the hypothalamic-pituitary-ovarian axis through the cerebral cortex and central nervous system. The mutual regulation of the hypothalamic-pituitary-ovarian axis can be affected by the cerebral cortex and central nervous system, and ultimately, the occurrence of anovulation. The anovulatory type of eclampsia mostly occurs in adolescent and perimenopausal women and is caused by unrestricted endometrial proliferation due to single estrogen stimulation without progesterone antagonism. (2) Clinical manifestations and auxiliary diagnosis: The most common clinical symptom is irregular uterine bleeding. It is characterized by menstrual disorders, with periods of varying length, bleeding that is sometimes more or less frequent, or even heavy bleeding. Or there is menopause for several weeks or months first, then irregular bleeding occurs, and the blood volume is often high and cannot stop by itself. Sometimes the bleeding starts as irregular vaginal bleeding. There is no obvious lower abdominal pain, and most of them are accompanied by different degrees of anemia. There should be no obvious organic lesions in the gynecological examination; the auxiliary examination is mainly to exclude vaginal bleeding caused by genital tumor, inflammation or systemic diseases. Ultrasound, MRI, hysteroscopy, or diagnostic scraping, basal body temperature (BBT) measurement, etc. can be chosen according to the condition. (3) Treatment: ①General treatment: Patients are mostly anemic, so they should enhance nutrition and improve their general condition. Iron, vitamin C and protein can be supplemented, and blood transfusion is required for severe anemia. Pay attention to rest, prevent infection, and use coagulants appropriately to reduce bleeding. Chinese medicine treatment: this disease is a common gynecological disease, but also a difficult and critical disease, belongs to the category of “leakage” in Chinese medicine, and its common causes include spleen deficiency, kidney deficiency, blood heat and blood stasis. According to the principle of “treating the symptoms when it is urgent and treating the root cause when it is slow” in Chinese medicine, when the bleeding is heavy, the symptoms should be treated first and the bleeding should be stopped to prevent syncope; when the bleeding is low and the condition is stable, according to the evidence of the disease, the spleen should be strengthened, the kidney should be tonified, the blood should be cooled and the blood stasis should be eliminated; after the bleeding is stopped, the evidence-based treatment should be carried out according to the etiology of the disease to restore the old one, so as to adjust the menstrual cycle and establish ovulation function (for those who have fertility) to prevent recurrence. After the blood has stopped, the treatment will be directed at the cause and mechanism of the disease to restore the old one. ③Western medicine treatment: mainly endocrine hormone treatment, different methods are chosen for different patients. There are three aspects: hemostasis, adjustment of menstrual cycle and restoration of ovulation function in infertile patients after cycle control. 2. Ovulation-type functional hemorrhage (1) Etiology: Ovulation-type functional hemorrhage mostly occurs in women in their reproductive years. Although ovulation occurs in the ovaries, it is caused by follicular dysplasia or hypothalamic pituitary insufficiency, resulting in abnormal luteal function after ovulation. There are two common types: luteal insufficiency and irregular shedding of endometrium. (2) Clinical manifestations and auxiliary diagnosis: luteal insufficiency mostly manifests as early menstrual cycle, some manifest as excessive menstrual flow or ovulatory bleeding, some have normal cycle but prolonged follicular phase and shortened luteal phase, resulting in infertility or miscarriage in patients; irregular endometrial shedding mostly manifests as normal menstrual interval but prolonged menstrual period up to 9 to 10 days and heavy menstrual flow. If the gynecological examination is normal, BBT is biphasic, but the rise is slow and small after ovulation, and the maintenance time is only 9 to 10 days, the endometrium shows poor secretory response as luteal insufficiency; if BBT is biphasic, but falls slowly, and the endometrium of secretory response is still seen in the diagnosis and scraping on the 5th to 6th day of menstruation, and it coexists with the endometrium of bleeding phase and proliferative phase, the endometrium is irregularly shed. (3) Treatment: ①Chinese herbal medicine treatment: the disease can be combined with Chinese medicine “premenstruation”, “excessive menstruation”, “prolonged menstruation”, “intermenstrual bleeding” treatment. The treatment of “bleeding between menstrual periods” can be inter-referenced with the treatment of “Pre-menstruation”, “excessive menstruation”, “prolonged menstruation” and “bleeding between menstrual periods” in Chinese medicine. Under the premise of evidence-based treatment, we can treat both the symptoms and the root cause to achieve the purpose of stopping bleeding and adjusting menstrual cycle. ②Western medicine treatment: mainly includes follicle development promotion therapy, luteal function stimulation and replacement therapy, commonly used drugs such as CC, HCG and progesterone. 3. Prevention and regulation of dysfunctional bleeding (1) Diet should not be too much fat, sweet, greasy, cold, spicy and dry products, so as not to damage the spleen and stomach, or produce heat and burn blood. (2) regulate the mood, keep the mood relaxed, avoid worry and depression, damage to the liver and spleen, or the seven emotions too extreme, five will turn into fire, punching any heat, and cause premenstruation. (3) appropriate labor and relaxation, menstruation should not be overworked and strenuous exercise, so as not to damage the spleen, resulting in the lack of power to regulate and cause the disease. (4) Abstain from intercourse and birth control, avoid having too many children (including abortion), too often, and having intercourse during menstruation and puerperium, otherwise it is easy to damage the rhythm and deplete the essence and blood, leading to menstrual disorders. (5) Menorrhagia can be prevented by paying attention to menstrual hygiene, avoiding or reducing uterine surgery as much as possible; early treatment of menstrual diseases with bleeding tendency such as excessive menstruation, prolonged menstruation and pre-menstruation to prevent the development of menorrhagia. Once menorrhagia occurs, it must be cured early and exercise must be strengthened to prevent recurrence. The first thing to do is to take care of personal hygiene to prevent infection, the second thing is to adjust the diet to increase nutrition, and the second thing is to adapt labor and relaxation to smooth the mood.