Treatment Methods for Promoting Ovulation in Patients with Dysfunctional Uterine Bleeding

The treatment of patients with functional uterine bleeding cannot simply stop bleeding. Restoring or establishing normal ovulation and menstruation is the basis for treating anovulatory functional uterine bleeding. After stopping bleeding, ovulation promotion treatment should be carried out. Different patients should adopt corresponding treatment methods according to their condition and requirements.

Manual cycle

To simulate the hormonal changes of a normal menstrual cycle, estrogen is used first, followed by progesterone. After stopping the medication, the endometrial shedding and bleeding stops, and then the medication is repeated for 3 to 5 consecutive cycles. After stopping treatment, measure the basal body temperature. If it is biphasic, it means ovulation has occurred and treatment can be stopped. If it is monophasic, progesterone is used again for 7 to 10 days/month. This therapy is suitable for young girls and girls whose sexual characteristics have not yet matured. After treatment, some children can establish an ovulation cycle.

Progestin therapy

When there is no spontaneous menstruation after artificial cycle treatment and the basal body temperature is monophasic, progesterone is used for 7 to 10 days/month, repeated for 3 to 5 months, and a few girls may have ovulation and menstruation. This method is suitable for older girls with well-developed sexual characteristics.

Using ovulation-stimulating drugs

In theory, ovulation-inducing drugs are a fundamental solution to anovulatory functional uterine bleeding, but these drugs are all replacement therapies that release hormones and menopausal gonadotropins from the gonads. They are effective during treatment, but return to their original state after stopping the drug. If the patient cannot adhere to artificial cycle treatment, or the condition is more stubborn, clomiphene can be used to promote ovulation.

Clomiphene is a synthetic ovulation-inducing drug. 50 mg is taken daily for 5 days in the early menstrual cycle. Ovulation occurs 5 to 10 days later. The ovulation success rate in adult women is 80%. If it is ineffective, increase the dose monthly to 200 mg per day.