Hypothyroidism misdiagnosed as gonorrhea, nearly cut off the uterus

  Meritorious hemorrhage is a very common gynecologic complication, but many patients do not pay enough attention to it. The following is a brief description of functional hemorrhage and its differential diagnosis.  Dysfunctional uterine bleeding, or gonorrhea for short, is abnormal uterine bleeding due to dysfunction of the hypothalamic-pituitary-ovarian axis. It is divided into two main categories: anovulatory and ovulatory uterine bleeding. The former accounts for 70-80% of cases and is seen in women in puberty and menopausal transition; the latter accounts for 20-30% of cases and is seen in women of reproductive age.  There are many causes of uterine bleeding, and only when other organic lesions are excluded can the diagnosis of uterine bleeding be made.  Common organic lesions include: 1. tumors of reproductive organs, such as endometrial cancer, cervical cancer, uterine fibroids, ovarian tumors, trophoblastic tumors (such as choriocarcinoma), etc.; 2. abnormal pregnancy or pregnancy complications, such as ectopic pregnancy, gravida, miscarriage, poor uterine recovery, placental residue, placental polyps, etc.; 3. irregular uterine bleeding caused by improper use of intrauterine device or sex hormone drugs; 4. Systemic diseases, such as hypo- or hyperthyroidism, blood disorders, hypo-hepatic and renal function, etc.  5. Reproductive tract injury.  Treatment of uterine bleeding includes: 1. Drugs: including estrogen, progestin, androgen, contraceptives, combined sex hormones, etc. Drug treatment is the main treatment method for gonorrhea. After the treatment of hemostasis, adjustment of menstrual cycle and ovulation promotion, gonorrhea can often be better controlled.  2.Surgery: ① Diagnostic scraping, which has the effect of both rapid hemostasis and clear endometrial pathological diagnosis, is a very effective diagnosis and treatment method, but most patients refuse to use it for fear of pain.  ②Endometrial resection, which is performed under hysteroscopy using electrocoagulation, thermotherapy and laser to stop bleeding by coagulation or necrosis of endometrial tissue.  ③Hysterectomy, which is suitable for those who have failed to be treated by drugs or other methods, is rarely used in clinical practice.  The focus of prevention and treatment of uterine bleeding is on diagnosis, and the focus of diagnosis is on excluding other diseases. Only after other pathological causes of uterine bleeding have been excluded, can the diagnosis of meritorious bleeding be made.