The normal menstrual cycle is 24-35 days, the period lasts 2-7 days, and the volume of one period is 20-60 ml. Any abnormal uterine bleeding that does not meet the above criteria is considered abnormal uterine bleeding. Abnormal uterine bleeding can be caused by abnormal endometrial shedding and bleeding due to endocrine dysfunction (also called dysfunctional uterine bleeding, referred to as gongbao, or abnormal menstruation) or by uterine pathology, such as endometrial cancer, endometrial polyps, endometrial inflammation, etc. In the case of meritorious bleeding due to dysfunction of the neuroendocrine system, other organic lesions must be excluded, such as bleeding caused by lesions of the urinary tract, rectum, anus, cervix and vagina. Meritorious bleeding is divided into two categories: anovulatory and ovulatory. Generally speaking, each menstrual period is marked by the discharge of a mature egg from the ovary. In practice, however, some women have menstruation but fail to ovulate normally, while others have ovulation but have intermenstrual vaginal bleeding or dripping vaginal bleeding around the time of menstruation. The clinical manifestations of abnormal menstruation vary, and the following conditions are common: I. Anovulatory menstruation: Anovulatory menstruation refers to the condition in which the ovaries secrete only estrogen, not progesterone, the basal body temperature is monophasic, and the endometrium only changes during the proliferative phase, but when estrogen drops to a certain level or when estrogen is insufficient to maintain the endometrium to continue proliferation, the endometrium will also shed and menstruation will occur. Anovulatory menstruation takes different forms. The more common form is irregular vaginal bleeding, which means that there is no regularity in the interval of bleeding, the number of days it lasts, or the amount of blood. Sometimes there are months between periods (sporadic periods); sometimes there is bleeding every few days (irregular periods); sometimes there are less than 21 days between periods (frequent periods). Each bleeding may be a few days or a few months long; the amount of blood may be a little drip bleeding or a lot of bleeding with great intensity, and the latter often causes dizziness, dizziness, weakness and other symptoms of anemia due to too much bleeding. The latter often causes dizziness, dizziness, weakness and other anemia symptoms due to excessive bleeding. The above situation is mostly seen in adolescents and menopausal transition patients. Pseudo-ovulatory” menstruation: In some cases, the developing follicle can form the corpus luteum even though it has not ovulated. Pseudo-ovulation” in women refers to a condition called “luteinized unruptured follicle (LUF)” syndrome. In women with this condition, although the corpus luteum is produced during the menstrual cycle, the follicles do not disappear or even continue to grow 48 hours after the peak of LH formation, and no eggs are naturally expelled. However, indirect monitoring indicators of ovulation, such as basal body temperature, cervical mucus and endometrial changes during menstrual cycle, are no different from those of women with normal ovulation, thus creating an illusion of ovulation, hence the term “pseudo-ovulation”. Recent studies suggest that the ovulatory orifice of the developing follicle can epithelialize and repair so quickly that it is difficult to determine whether ovulation has occurred. Even with daily ultrasound, post-ovulatory follicular collapse can easily be overlooked, or a blood-filled corpus luteum can be mistaken for a continuously growing LUF follicle. Thus, the diagnosis of LUF cannot be made easily. However, the diagnosis of “pseudo-ovulation” is often encountered in patients with signs of ovulation but delayed menstruation and non-redundant cysts in one ovary. The follicles are mature but not ovulated, and the estrogen in the follicular fluid does not drain into the peritoneal cavity due to follicular rupture, so that the estrogen in the blood circulation does not drop significantly due to ovulation, and the effect of estrogen on the hypothalamus and pituitary does not change rapidly from positive to negative feedback, resulting in a prolonged follicular phase with luteal atrophy and delayed menstruation or dripping bleeding before and after menstruation. The etiology of LUF is still unclear and is generally thought to be related to mental stress, emotional anxiety, pelvic inflammatory disease, endometriosis, endocrine disorders, and drug abuse. Currently, the diagnosis of pseudo-ovulation can be confirmed by continuous ultrasound monitoring, laparoscopy and posterior vaginal fornix aspiration, combined with clinical manifestations. (a) Extra-ovulatory menstruation: Some couples who use safe period contraception may still conceive unexpectedly even if they strictly master the requirements and regulations and avoid the 10-day fertile period 6 days before and 3 days after ovulation. This is due to the fact that ovulation in women is governed by neurological and endocrine factors. When there is excessive mental excitement, changes in the living environment or changes in the state of health, ovarian ovulation can be affected, resulting in accelerated follicular development and shortening of the follicular phase, resulting in early ovulation during the non-ovulatory period, or extra ovulation. The extra ovulation, if not conceived, will result in early menstruation. (ii) Delayed ovulatory menstruation: In some women, the number of days of pregnancy is significantly less than the number of days of menopause, and in other women, they come to the clinic with fear of pregnancy during menstruation, but after examination, pregnancy is ruled out, the endometrium has a certain thickness, and the application of progestin to perform pharmacological scraping is ineffective, and menstruation comes on its own 10 days after stopping the medication. In both cases, the follicular phase is long and ovulation is delayed. In the former case, ovulation is conceived after the calculated ovulation period, so the number of days of pregnancy is less than the number of days of menopause; in the latter case, ovulation occurs when progestogen is applied during menstruation, or progestogen is applied during the luteal formation period after delayed ovulation and is still at the peak of progestogen secretion after stopping the drug, so progestogen withdrawal is ineffective. (iii) “Pseudomenstruation”: Pseudomenstruation generally has the following conditions: 1. Ovulatory bleeding: In some women, vaginal bleeding occurs in the middle of menstruation, that is, during ovulation, which is called periovulatory bleeding, also known as intermenstrual bleeding. The bleeding during ovulation is very little, some of it is only coffee-colored discharge, and it usually stops on its own in 2 to 3 days, with the longest period not exceeding 7 days. There are three possibilities for ovulatory bleeding: (1) after the mature follicle ruptures and expels the egg, the level of estrogen in the blood circulation drops sharply, which may be so low that individuals cannot maintain the growth of the endometrium, causing the superficial layer of the endometrium to locally collapse and shed, resulting in breakthrough bleeding in small amounts; (2) during the pre-ovulatory period, the mature follicle secretes more estrogen, causing the endometrium to be congested with blood and causing red blood cells to leak out; (3) after ovulation, the blood-containing follicular fluid is sent to the body cavity of the uterus through the peristalsis of the fallopian tube and then flows out through the cervix via the vagina. 2. Early bleeding in intrauterine pregnancy: after fertilization of the ovum, the synthesis and secretion of estrogen and progesterone by the corpus luteum of pregnancy is insufficient, and the level of estrogen and progesterone in the blood circulation is low, which cannot maintain the growth of the endometrium for a while, causing local breakthrough short-term small amount of bleeding in the surface layer of the endometrium, with the same symptoms as ovulatory bleeding, which usually stops on its own in 2-3 days. 3, ectopic pregnancy bleeding: in ectopic pregnancy, the blood supply to the fertilized egg is insufficient, the embryo and chorionic villi are poorly developed, the chorionic gonadotropin secretion is insufficient, and the ovarian corpus luteum secretes low levels of estrogen and progesterone, which cannot maintain the growth of the endometrium, causing a small amount of local breakthrough bleeding in the surface layer of the endometrium and accompanied by a hidden pain in the abdomen. Patients often mistakenly believe that the onset of menstruation is delayed. In such patients, doctors should think of this disease to avoid the serious consequences of internal bleeding shock and life-threatening. Premature miscarriage: “Menstruation” as scheduled, or postponed, small amount, dark red or bloody leucorrhea, often mistaken for delayed menstruation, but then accompanied by paroxysmal lower abdominal pain or lumbosacral pain, the symptoms worsen to develop into inevitable miscarriage. (iv) Premenstrual dripping bleeding: It usually manifests as premenstrual dripping bleeding or shortened menstrual cycle (<21 days). Sometimes the menstrual cycle is within the normal range, but the follicular phase is prolonged and the luteal phase is shortened, so that the patient is less likely to conceive or miscarry in early pregnancy. Basal body temperature is biphasic, but the high temperature is <11 days. Its caused by hypothalamic-pituitary-ovarian axis regulation dysfunction and other reasons resulting in slow follicular development and insufficient estrogen secretion, which leads to poor endometrial proliferation; or poor luteal development after ovulation and insufficient progesterone secretion, which causes poor endometrial secretion response, insufficient luteal function and shortened luteal phase of the uterus, which causes endometrial secretion The response is lagging behind (≥2 days), resulting in early shedding and bleeding of the endometrium. Others have normal ovulation and normal luteal secretion function, but the maintenance time is short and the endometrial secretion response is insufficient, resulting in early menstrual shedding and bleeding. (E) Postmenstrual dripping bleeding: The symptoms are normal menstrual cycle, but postmenstrual dripping bleeding, prolonged menstrual period to 9-10 days or even longer, and high bleeding volume. The basal body temperature is biphasic, but decreases slowly. Diagnostic scraping on the 5th to 6th day of the menstrual cycle still reveals a secretory-responsive endometrium. The endometrium is continuously affected by estrogen and progesterone, so that the endometrium cannot be shed completely as scheduled. (6) Excessive menstrual flow and low menstrual flow: The total blood loss during a normal menstrual period is 20-60 ml, lasting 2-8 days, mostly 4-6 days. Generally there are no special symptoms during menstruation, some women have symptoms of gastrointestinal disorders such as lower abdomen and lumbosacral vague pain, thin stools, individual headache and emotional instability. If the menstrual volume is more than 80ml, the menstrual volume is too much (menstruation with large blood clots, long-term may have dizziness and facial pallor and other anemia symptoms), should go to the hospital to check to exclude uterine fibroids, endometrial polyps, uterine myometriosis, endometrial cancer and menstrual blood system diseases. Low menstrual flow should exclude pregnancy, premature ovarian failure, thyroid disorders, etc. Most of the women who visit the clinic complaining of low menstrual flow, when asked carefully and found that her menstrual flow, each time soaked through at least one sanitary napkin, which means that her menstrual flow is not bad, no need to panic.