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