A case of irregular uterine bleeding

Summary

• 1. A uterine polypus showing typical glandular hyperplasia combined with hyperplasia of the stroma without any glandular changes is relatively rare, representing as it does (Novak) one per cent. of all cases of metropathia hæmorrhagica.

• 2. This type of endometrial change may be easily missed, both by the operating gynæcologist and the pathologist, unless they are familiar with such a condition.

• 3. The presence of a follicular hæmatoma has been of help to us in homologising metropathia hæmorrhagica as it occurs in the human with the so-called nymphomania that occurs in certain of the lower animals in the absence of copulation.

• 4. The presence of cystic degeneration in the follicle cyst, similar to that which occurs in the corpus luteum, suggests that the mechanism of bleeding in cases of typical metropathia hæmorrhagica is similar to that of normal menstruation.

• 5. The production of premature bleeding in the monkey by the removal of the cystic follicle appears to confirm the suggestion.

The main difference between the two types of bleeding is that in the one case the bleeding is controlled, and in the other it is acyclic or arrhythmic. What is the cause of this arrhythmia? That is another question.