Impact on the cervix with dysfunctional uterine bleeding

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Hemostatic effect after the third session was observed in 65%, and after the fifth electrostimulation - even 18%. Thus, the total hemostatic effect in the treatment of dysfunctional uterine bleeding, developed in connection with anovulatory processes, amounted to 83%. This figure is slightly less than those who have led Lichtwitz, Rouane-Crepeaux, Bordier (1957), which is explained by the relatively small material, which had listed the authors.
In accordance with the accepted technique in cases when it was not possible to obtain a complete hemostasis, there was a scraping mucous membrane of the uterus. Analysis of negative results revealed the possible causes, as a result of which the desired effect was not achieved. All such patients was 165 persons, of which 74 were in reproductive age and 91 in menopausal. Thus, the failure rate in the treatment of women in menopausal period relative to the original number (720) amounted to 12,7, while among women of reproductive age (208) it was $ 30,6. This difference in the success allows us to consider these results are not accidental. In addition to some reasons, which would be reported below, in the group of women of reproductive age were available according to the data of the anamnesis is very significant, in our view, detail: more than half of these patients had a prolonged menstrual function, which began in the pubertal period. In addition, drew my attention to a small number of pregnancies in all patients treated, and a large number of primary infertile marriages. All this allows to assume that in a group of women of reproductive age had a significant and lasting change the function of the hypothalamic-pituitary system, when the method of electro-stimulation could not give proper effect. Curettage of the uterus, produced in 165 patients, revealed the following data (table. 7).

In cases of detection of structural changes (adenocarcinoma, polyposis, submucous fibroids) the absence of the effect of electrical stimulation is clear; the presence of secretory changes too (in the light of the understanding of the essence of reflex) is a reflection of such function of the ovary, which shall not be manifested the effect of excitation of cervico-hypothalamic-pituitary reflex.
Considerable interest in this respect are patients diagnosed with atrophic, mixed and hyperplastic endometrium. These colpocytology revealed that a significant number of patients had III and III-IV reaction, and 5 women - III-II reaction and only 7 took place IV the reaction. Counting karyopyknotic index showed that only 11 people he was over 60, and the rest was lower. Therefore, indirect data testified that the vast majority of women who have not reached the hemostatic effect was low saturation of the organism estrogenic hormones. The opportunity when anovulatory processes low level of estrogen is confirmed by studies A. F. Dobrotino (1968), which found that full correlation between the state of the endometrium and estrogen levels when anovulation may not be: a low level of estrogen may be glandular-cystic glandular hyperplasia of the endometrium. Apparently, proceeding from these facts, we must assume that the initiation of cervico-hypothalamic-pituitary reflex is possible only with a high level of estrogen.
Long-term results in terms of 6 months to 2 years are traced at 540 patients; 470 of them were in menopausal and 70 in the reproductive periods. Stable therapeutic effect in the absence of bleeding was observed in 365 patients (73%); among women of menopausal age he was at 320 and reproductive at 45. The character of further menstrual function among women of the first group was manifested regular menstruation 35% upon detection of 15% of two-phase cycles; irregular, infrequent menstruation - 40%; experiencing menopause - 25%. In the second group among 33 women was two-phase of the menstrual cycle, 8 - phase, 3 - irregular menstruation without the tendency to bleeding, and one patient 34 years came amenorrhea.
To illustrate, here's own observation.