In the great majority of cases of uterine hemorrhage, the indication for treatment is perfectly clear. A definite anatomic lesion can be demonstrated in one of the pelvic organs, and the removal of such a lesion is the sine qua non for the cure of the abnormal bleeding. For example, the most common of all causes of persistent uterine hemorrhage is incomplete miscarriage, and the spontaneous or operative removal of the retained gestation products is followed by a cessation of the bleeding. In the same way, bleeding due to pelvic neoplasm or to pelvic inflammatory disease necessitates removal of the lesion.
In a much smaller but still not inconsiderable group of cases, however, uterine bleeding may be observed in the entire absence of any demonstrable gross lesions of the pelvic organs. Indeed, extremely profuse hemorrhage may occasionally be observed in children at or near the age of puberty. Far more
EMIL NOVAK. THE TREATMENT OF FUNCTIONAL UTERINE HEMORRHAGE. JAMA. 1926;86(15):1105–1107. doi:10.1001/jama.1926.02670410001001