Menstruation refers specifically to the vaginal bleeding that occurs after ovulation by the ovaries due to lack of hormonal support and subsequent shedding of the endometrium due to lack of conception and lack of gestational corpus luteum support. Therefore, not all vaginal bleeding is menstruation. Only vaginal bleeding that meets these two basic conditions can be called menstruation. Any other form of vaginal bleeding is considered “abnormal vaginal bleeding” or “abnormal uterine bleeding” and not “menstruation”. “Abnormal uterine bleeding” Abnormal uterine bleeding related to pregnancy – including pre-eclampsia, ectopic pregnancy, low placenta, placenta praevia, placenta abruptio, and gravida – can be the cause of abnormal uterine bleeding. There are two types of abnormal uterine bleeding that are not related to pregnancy. Bleeding caused by organic lesions of the uterus, including cervical cancer, submucosal fibroids, endometrial polyps, endometrial cancer, and hyperplasia of the endometrium. Abnormal uterine bleeding without organic lesions of the reproductive system and not related to pregnancy, which used to be called “dysfunctional uterine bleeding” or “gonorrhea” for short, including menstrual disorders caused by various hypothalamic, pituitary and ovarian dysfunctions, such as puberty It includes menstrual disorders caused by various hypothalamic, pituitary and ovarian dysfunctions, such as puberty, menopause and frequent menstruation. What are the manifestations of abnormal uterine bleeding? In short, abnormal uterine bleeding should be suspected whenever the amount or duration of bleeding is different from the usual menstruation. The first thing that should be suspected is pregnancy-related bleeding, because pregnancy-related bleeding often has serious consequences, but it is easy to detect and can be completely ruled out as long as the HCG is negative. Many people think that they can’t be pregnant because they are taking measures; that’s not necessarily true, as any contraceptive measure can fail. Other people say that they have not had intercourse for two months, and their last menstrual period was normal, so it is impossible to be pregnant; however, they do not know that the last “menstrual period” may not be menstrual, but abnormal uterine bleeding similar to menstruation. We often encounter these situations in the clinic. Sometimes, when patients are asked to take a pregnancy test, they are even scolded, “What kind of doctor is that? Whether you believe it or not, after the HCG test, often many people who think they cannot be pregnant are confirmed to have ectopic pregnancy. Ectopic pregnancy is a very odd condition in obstetrics and gynecology, which can present in various odd ways or without any symptoms, even most ectopic pregnancies have no history of menopause, some just have abdominal pain or only vaginal bleeding, a topic we can discuss separately. In addition, we often talk about “heavy menstruation”, “frequent menstruation”, “menstrual disorders “, “ovulatory bleeding”, “incomplete menstruation” …… are all forms of abnormal uterine bleeding. Menstruation must be vaginal “bleeding”! This statement seems to be nonsense, but I have to emphasize that the key point is the word “bleeding”, mainly to warn those who have excessive menstruation not to naively think “it’s just menstruation, it’s no big deal”. Blood”, “blood”, “bloody”, “gory”, “bloody”, the reason why so many gory words are piled up is The blood that comes from the vagina is the same as the blood that comes from the body when it is injured, and it comes from the blood vessels, from the heart. Some people say that menstruation is “detoxification” and that it is good for women to “detoxify” every month, so it is right to flow out. But you should know that this “poison”, more than the discharge is possible to die. I once saw a high school student, adolescent gonorrhea, each time the menstrual period is heavy bleeding, come when already pale, weak, the bleeding for more than ten days, her mother took to see a Chinese doctor, a week of Chinese medicine, but the blood has not stopped, gurgling to flow ah! (Not that Chinese medicine is bad, but in this problem node, Western medicine is really better than Chinese medicine.) When asked why she didn’t come earlier, her mother said with a bewildered look on her face, “I thought it was my period!” Because of these words, her daughter’s life was almost killed. After the patient was admitted to the hospital, the bleeding was stopped in a few hours with endocrine treatment, and she recovered quickly with a blood transfusion. This is why too much “menstruation” can be fatal.