Treatment of ovulatory dysfunctional hemorrhage The treatment of ovulatory dysfunctional hemorrhage can be divided into the treatment of excessive menstruation and the treatment of bleeding between menstrual cycles. (a) Treatment of excessive menstruation The main treatment is oral hemostatic drugs such as Tocopherol, placement of levonorgestrel intrauterine extended-release system, or oral contraceptive pills; endometrial removal, hysterectomy, or uterine artery embolization may be considered for those who have not responded to the drug treatment. (ii) Treatment of intermenstrual bleeding The guideline describes: For the treatment of intermenstrual bleeding (intermenstrual bleeding), it is recommended that the patient should be observed for 1~2 cycles, basal body temperature should be measured, the type of bleeding should be clarified, and organic pathology should be ruled out before intervention. 1.Periovulatory bleeding: stop bleeding symptomatically. 2.Premenstrual bleeding: supplementation of progesterone or hCG before bleeding, application of clomiphene in early follicular phase to promote ovulation in order to improve follicular development and luteal function. 3. Long menstrual period: small dose of estrogen on the 5th to 7th day of the cycle to help repair, or clomiphene to promote normal follicular development, or progesterone to promote endothelial shedding in the luteal phase of the previous cycle. 4., oral contraceptives: especially for patients with contraceptive needs. Oral contraceptives are usually used cyclically for 3 cycles, with a discretionary extension to 6 cycles for those with recurrent disease. The potential risks of applying oral contraceptives should be noted, and should not be applied to women with high risk factors for thrombophilia, cardiovascular and cerebrovascular diseases, and women over 40 years of age who smoke. Interpretation: Bleeding between menstrual cycles is usually not heavy, so there is no need to treat it urgently and blindly. Therapeutic measures should be taken after a clear diagnosis is made. The guidelines recommend observation for 1 to 2 cycles, along with measurement of basal body temperature, which, if biphasic, suggests ovulation. Bleeding due to organic diseases such as fibroids, endometrial polyps, adenomyosis, and intrauterine devices need to be excluded. For peri-ovulatory bleeding, if it occurs infrequently and the amount of blood is very small, it can be left untreated clinically or treated symptomatically with hemostatic drugs. For premenstrual bleeding or long menstrual period, progesterone supplementation during luteal phase is generally used to shorten the duration of bleeding, or oral contraceptive pills. If the above treatments are unsatisfactory, ovulation stimulants, estrogen and HCG may be considered to treat premenstrual bleeding or prolonged menstrual periods. The efficacy of treatment for dysmenorrhea should be finally assessed after long-term follow-up. If the etiology is not corrected, recurrence may occur soon after hormone withdrawal. About half of women of childbearing age can get pregnant and give birth after ovulation, but after delivery, most of the patients still have no ovulation, and their menstruation is sometimes or persistently irregular, and individual patients may develop atypical hyperplasia of the endothelium or adenocarcinoma, and even the patients whose menstruation has returned to normal are also prone to relapse. The condition of patients with ovulatory dysfunctional hemorrhage fluctuates naturally and can be treated and observed intermittently except for organic diseases.