Menstruation is periodic uterine bleeding that occurs when the endometrium responds to sex hormones from the ovaries. On one hand, ovarian sex hormones affect the development of the endometrium; on the other hand, they regulate the activity of the hypothalamus and pituitary gland through positive and negative feedback (i.e., stimulation and inhibition). Under normal circumstances, the hypothalamus, pituitary gland, and ovaries interact and restrict each other to maintain a dynamic balance, which is the main regulatory mechanism of the menstrual cycle, known as the hypothalamic-pituitary-ovarian axis. The activity of this axis is also controlled by the cerebral cortex. Therefore, a disorder in any link from the cerebral cortex to the ovaries can disrupt this balance, leading to ovarian dysfunction, which in turn affects the endometrium and causes dysfunctional uterine bleeding.
Adolescent dysfunctional uterine bleeding is mostly caused by the delayed maturation of the central nervous system in the hypothalamus that manages the synthesis and release of pituitary gonadotropins. As a result, the hypothalamic-pituitary-ovarian axis fails to function normally. Ovulation in the ovaries is impaired: follicles develop in the ovaries and can secrete estrogen but fail to mature. The level of estrogen in the blood fluctuates with the growth and atrophy of the follicles. When the estrogen level is high, the endometrium proliferates; when the estrogen level is low, the endometrium loses support, leading to necrosis, exfoliation, and bleeding.
Therefore, adolescent dysfunctional uterine bleeding is often characterized by irregular menstrual cycles, varying durations of menstrual periods, and fluctuating menstrual flow. Sometimes there is heavy bleeding; sometimes there is a short period of amenorrhea followed by uncontrollable bleeding; sometimes irregular bleeding starts directly; in some cases, the cycle is relatively regular, but the menstrual flow increases and the menstrual period is prolonged. If the bleeding is heavy, lasts for a long time, or recurs repeatedly, it will inevitably cause anemia. Therefore, prompt treatment is essential.
The treatment principles are to correct anemia, supplement nutrition, and ensure appropriate rest; use sex hormones to stop bleeding under the guidance of a doctor, then induce ovulation and regulate the menstrual cycle. After the condition is controlled, it is necessary to pay attention to exercise to enhance physical fitness and health, avoid overfatigue and mental stimulation, and pay attention to menstrual hygiene to prevent recurrence.
Adolescence is a critical period for the development and maturation of the female reproductive system, and any abnormal uterine bleeding during this period should not be ignored. Many adolescent girls and their parents may mistakenly regard irregular bleeding as a normal phenomenon of puberty, which delays the best treatment time and even leads to severe anemia, affecting physical development and daily life. In addition to the physiological factors mentioned above, factors such as excessive study pressure, irregular work and rest, and poor diet can also induce or aggravate adolescent dysfunctional uterine bleeding. Therefore, it is crucial for adolescents to maintain a healthy lifestyle, and parents should pay close attention to their children's physical changes and seek medical advice in a timely manner when abnormalities are found.