FUNCTIONAL UTERINE BLEEDING

The term "functional" includes those bleeding abnormalities that are not due to local lesions in the generative tract such as carcinoma, myoma, endometrial polyp, or pregnancy complications. The majority of these functional bleeding problems will be found to be due to disturbances in the normal pituitary-ovarian-endometrial hormonal relationships. The most commonly encountered hormonal disturbance is that which results in anovulatory bleeding. Although the exact hormonal stimulus that initiates ovulation is not well understood the best evidence indicates that no one hormone is responsible. It is likely that ovulation occurs when an optimal ratio has been reached between the secretion of F.S.H. (follicle-stimulating hormone) and L.H. (luteinizing hormone). It is reasonable to assume that in anovulatory cycles an imbalance between the secretion and these two hormones exists. It is unlikely that either hormone is completely absent, for estrogen effect in the endometrium is readily apparent, and available evidence indicates that secretion