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Abstract

Bleeding disorders

Bleeding disorders are a daily challenge in gynecological practice. Obtaining a detailed history of the bleeding disorder and a thorough clinical examination can often indicate the underlying pathology. Morphological changes as well as functional (mainly hormonal) dysfunctions have to be taken into consideration and differentiated by clinical examination and laboratory analysis. It is essential to localize the hormonal dysfunction at the pituitary-ovarial axis and to differentiate primary from secondary ovarian insufficiency. Pathogenesis and differential diagnosis are presented and discussed in detail.Treatment of bleeding disorders can be directed against the underlying cause or towards the relief of symptoms. Either surgical or medical causative treatment aims to re-establish a normal bleeding pattern. Symptomatic treatment is possible by the use of sexual steroids,with which the menstrual cycle can be controlled and directed at specific points or completely suppressed.

Katrin Schaudig, Anneliese Schwenkhagen

Reviewer: Gabriele Gossing, Berlin
und Hans-Joachim Ahrendt,Magdeburg

Gynakol Geburtsmed Gynakol Endokrinol 2007;3(3):4-17