– pathological bleeding from the uterus associated with impaired production of sex hormones by the glands internal secretion. There are juvenile bleeding (during puberty), menopausal bleeding (in the stage of extinction of ovarian function), bleeding of the reproductive period. It is expressed by an increase in the amount of blood lost during menstruation or prolongation of the duration of menstruation. May manifest as metrorrhagia - acyclic bleeding. Characterized by alternating periods of amenorrhea (from 6 weeks to 2 or more months) followed by bleeding of varying strength and duration. Leads to the development of anemia.
General information
Dysfunctional uterine bleeding (accepted abbreviation - DUB) is the main manifestation of ovarian dysfunction syndrome. Dysfunctional uterine bleeding is characterized by acyclicity, prolonged delays in menstruation (1.5-6 months) and prolonged blood loss (more than 7 days). There are dysfunctional uterine bleeding of juvenile (12-18 years), reproductive (18-45 years) and menopausal (45-55 years) age periods. Uterine bleeding is one of the most common hormonal pathologies female genital area.
Juvenile dysfunctional uterine bleeding is usually caused by the immaturity of the cyclic function of the hypothalamus-pituitary-ovaries-uterus departments. In childbearing age, common causes of ovarian dysfunction and uterine bleeding are inflammatory processes of the reproductive system, diseases of the endocrine glands, surgical termination of pregnancy, stress, etc., in menopause - dysregulation of the menstrual cycle due to the extinction of hormonal function.
Based on the presence or absence of ovulation, ovulatory and anovulatory uterine bleeding are distinguished, with the latter accounting for about 80%. The clinical picture of uterine bleeding at any age is characterized by prolonged bleeding, appearing after a significant delay in menstruation and accompanied by signs of anemia: pallor, dizziness, weakness, headaches, fatigue, and decreased blood pressure.
DMK development mechanism
Dysfunctional uterine bleeding develops as a result of disruption of hormonal regulation of ovarian function by the hypothalamic-pituitary system. Violation of the secretion of gonadotropic (follicle-stimulating and luteinizing) hormones of the pituitary gland, which stimulate follicle maturation and ovulation, leads to disruptions in folliculogenesis and menstrual function. In this case, the follicle in the ovary either does not mature (follicular atresia) or matures, but without ovulation (follicle persistence), and, therefore, the corpus luteum does not form. In both cases, the body is in a state of hyperestrogenism, that is, the uterus is influenced by estrogen, since in the absence of the corpus luteum, progesterone is not produced. The uterine cycle is disrupted: there is a long-term, excessive growth of the endometrium (hyperplasia), and then its rejection, which is accompanied by heavy and prolonged uterine bleeding.
The duration and intensity of uterine bleeding are influenced by hemostasis factors (platelet aggregation, fibrinolytic activity and vascular spasticity), which are disrupted in DUB. Uterine bleeding may stop on its own after an indefinitely long time, but, as a rule, it occurs again, so the main therapeutic goal is to prevent the recurrence of DUB. In addition, hyperestrogenism during dysfunctional uterine bleeding is a risk factor for the development of adenocarcinoma, uterine fibroids, fibrocystic mastopathy, endometriosis, and breast cancer.
Juvenile DMK
Causes
In the juvenile (pubertal) period, uterine bleeding occurs more often than other gynecological pathologies - in almost 20% of cases. Violation of the formation of hormonal regulation at this age is facilitated by physical and mental trauma, poor living conditions, overwork, hypovitaminosis, dysfunction of the adrenal cortex and/or thyroid gland. Childhood infections (chicken pox, measles, mumps, whooping cough, rubella), acute respiratory infections, chronic tonsillitis, complicated pregnancy and childbirth in the mother, etc. also play a provoking role in the development of juvenile uterine bleeding.
Diagnostics
When diagnosing juvenile uterine bleeding, the following are taken into account:
- anamnesis data (date of menarche, last menstruation and onset of bleeding)
- development of secondary sexual characteristics, physical development, bone age
- hemoglobin level and blood clotting factors ( general analysis blood, platelets, coagulogram, prothrombin index, clotting time and bleeding time)
- indicators of hormone levels (prolactin, LH, FSH, estrogen, progesterone, cortisol, testosterone, T3, TSH, T4) in blood serum
- expert opinion: consultation with a gynecologist, endocrinologist, neurologist, ophthalmologist
- indicators of basal temperature in the period between menstruation (a single-phase menstrual cycle is characterized by a monotonous basal temperature)
- condition of the endometrium and ovaries based on ultrasound data of the pelvic organs (using rectal sensor in virgins or vaginal - in girls who are sexually active). An echogram of the ovaries with juvenile uterine bleeding shows an increase in the volume of the ovaries during the intermenstrual period
- the state of the regulatory hypothalamic-pituitary system according to radiography of the skull with a sella turcica projection, echoencephalography, EEG, CT or MRI of the brain (to exclude tumor lesions of the pituitary gland)
- Ultrasound of the thyroid and adrenal glands with Dopplerometry
- Ultrasound monitoring of ovulation (for the purpose of visualizing atresia or persistence of the follicle, mature follicle, ovulation, formation of the corpus luteum)
Treatment
The primary task in the treatment of uterine bleeding is to carry out hemostatic measures. Further treatment tactics are aimed at preventing repeated uterine bleeding and normalizing the menstrual cycle. Modern gynecology has in its arsenal several ways to stop dysfunctional uterine bleeding, both conservative and surgical. The choice of hemostatic therapy method is determined general condition patient and the amount of blood loss. For anemia medium degree(with hemoglobin above 100 g/l), symptomatic hemostatic (menadione, etamsylate, ascorutin, aminocaproic acid) and uterine contracting (oxytocin) drugs are used.
If non-hormonal hemostasis is ineffective, progesterone drugs (ethinyl estradiol, ethinyl estradiol, levonorgestrel, norethisterone) are prescribed. Bloody discharge usually stops 5-6 days after stopping the medication. Heavy and prolonged uterine bleeding leading to a progressive deterioration of the condition (severe anemia with Hb less than 70 g/l, weakness, dizziness, fainting) are an indication for hysteroscopy with separate diagnostic curettage and pathomorphological examination of the scraping. A contraindication to curettage of the uterine cavity is a blood clotting disorder.
In parallel with hemostasis, antianemic therapy is carried out: iron supplements, folic acid, vitamin B12, vitamin C, vitamin B6, vitamin P, transfusion of red blood cells and fresh frozen plasma. Further prevention of uterine bleeding includes taking progestin drugs in low doses (gestodene, desogestrel, norgestimate in combination with ethinyl estradiol; dydrogesterone, norethisterone). In the prevention of uterine bleeding, general hardening, sanitation of chronic infectious foci and proper nutrition. Adequate measures for the prevention and treatment of juvenile uterine bleeding restore the cyclic functioning of all parts of the reproductive system.
DMC of the reproductive period
Causes
During the reproductive period, dysfunctional uterine bleeding accounts for 4-5% of cases of all gynecological diseases. Factors that cause ovarian dysfunction and uterine bleeding are neuropsychic reactions (stress, fatigue), climate change, occupational hazards, infections and intoxications, abortions, and some drugs that cause primary disorders at the level of the hypothalamic-pituitary system. Disturbances in the ovaries are caused by infectious and inflammatory processes that contribute to thickening of the ovarian capsule and a decrease in the sensitivity of ovarian tissue to gonadotropins.
Diagnostics
When diagnosing uterine bleeding, organic pathology of the genitals (tumors, endometriosis, traumatic injuries, spontaneous abortion, ectopic pregnancy, etc.), diseases of the hematopoietic organs, liver, endocrine glands, heart and blood vessels. In addition to general clinical methods for diagnosing uterine bleeding (history taking, gynecological examination), hysteroscopy and separate diagnostic curettage endometrium with histological examination of the material. Further diagnostic measures the same as for juvenile uterine bleeding.
Treatment
Therapeutic tactics for uterine bleeding of the reproductive period are determined by the histological results of the scrapings taken. If recurrent bleeding occurs, hormonal and non-hormonal hemostasis is performed. In the future, to correct the identified dysfunction, it is prescribed hormonal treatment, helping to regulate menstrual function and prevent recurrence of uterine bleeding.
Nonspecific treatment of uterine bleeding includes normalization of the neuropsychic state, treatment of all background diseases, removal of intoxication. This is facilitated by psychotherapeutic techniques, vitamins, sedatives. For anemia, iron supplements are prescribed. Uterine bleeding of reproductive age may occur repeatedly due to incorrectly chosen hormone therapy or a specific reason.
DMC of menopause
Causes
Premenopausal uterine bleeding occurs in 15% of cases of gynecological pathology in menopausal women. With age, the amount of gonadotropins secreted by the pituitary gland decreases, their release becomes irregular, which causes disruption of the ovarian cycle (folliculogenesis, ovulation, development of the corpus luteum). Progesterone deficiency leads to the development of hyperestrogenism and hyperplastic growth of the endometrium. Menopausal uterine bleeding in 30% develops against the background of menopausal syndrome.
Diagnostics
Features of the diagnosis of menopausal uterine bleeding lie in the need to differentiate them from menstruation, which at this age becomes irregular and occurs as metrorrhagia. To exclude the pathology that caused uterine bleeding, it is better to perform hysteroscopy twice: before and after diagnostic curettage.
After curettage, examination of the uterine cavity can reveal areas of endometriosis, small submucous fibroids, and uterine polyps. In rare cases, the cause of uterine bleeding is a hormonally active ovarian tumor. Ultrasound, nuclear magnetic or computed tomography can identify this pathology. Methods for diagnosing uterine bleeding are common to their different types and are determined by the doctor individually.
Treatment
Therapy for dysfunctional uterine bleeding during menopause is aimed at suppressing hormonal and menstrual functions, i.e., inducing menopause. Stopping bleeding during uterine bleeding during menopause is done exclusively surgically - through therapeutic and diagnostic curettage and hysteroscopy. Waiting tactics and conservative hemostasis (especially hormonal) are erroneous. Sometimes cryodestruction of the endometrium or surgical removal of the uterus is performed - supravaginal amputation of the uterus, hysterectomy.
Prevention of DMK
Prevention of dysfunctional uterine bleeding should begin at the stage intrauterine development fetus, i.e. during pregnancy. In children's and adolescence It is important to pay attention to general strengthening and general health measures, prevention or timely treatment of diseases, especially the reproductive system, and prevention of abortion.
If dysfunction and uterine bleeding do develop, then further measures should be aimed at restoring the regularity of the menstrual cycle and preventing recurrent bleeding. For this purpose, the prescription of oral estrogen-progestin contraceptives is indicated according to the scheme: the first 3 cycles - from 5 to 25 days, the next 3 cycles - from 16 to 25 days of menstrual-like bleeding. Pure gestagenic drugs (Norkolut, Duphaston) are prescribed for uterine bleeding from the 16th to 25th day of the menstrual cycle for 4 to 6 months.
The use of hormonal contraceptives not only reduces the frequency of abortions and the occurrence of hormonal imbalance, but also prevents the subsequent development of anovulatory form of infertility, endometrial adenocarcinoma, cancerous tumors mammary glands. Patients with dysfunctional uterine bleeding should be monitored by a gynecologist.
Normally, in a woman of reproductive age, uterine bleeding depends on the phase of the cycle and occurs once a month at approximately the same time. When blood is released during the intermenstrual period, this indicates functional changes in the body; more often the process is pathological. What are the causes of bleeding after menstruation and what to do in this situation?
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What types of bleeding are there?
Bloody discharge from the uterus that occurs in women regardless of the phase of the cycle is called generalized medical term, metrorrhagia. Pathology may occur:
- at puberty;
- during the reproductive period;
- with the onset of menopause;
- in postmenopause.
Bleeding after menstruation is a signal that reproductive system women are not all right. There are many reasons for the appearance of blood. This could be gynecological problems or hormonal imbalance. The occurrence of pathology is influenced by age, physiological characteristics of the body, disease of the genital organs and related health problems. Acyclic uterine bleeding in women can be ovulatory or anovulatory.
Ovulatory
The appearance of blood is associated with a disruption in the production of hormones that affect ovulation and control the menstrual cycle. Bleeding can also be caused by a change in the sensitivity of the endometrium due to the inflammatory process; the condition is mainly characteristic of reproductive age. This type manifestations are characterized by spotting discharge with a brown tint, but there are also cases with heavy discharge. Blood usually appears during ovulation, before menstruation, sometimes a few days after the previous menstruation.
Why do my periods come? ahead of schedule- is it dangerous?
Anovulatory
Bleeding differs in duration and release of a larger amount of blood, appearing periodically. The pause between them can last several months. The dysfunctional state is caused by endocrine disorders, poor nutrition, intoxication, developmental defects internal organs, often detected in adolescence and before menopause.
Follicles in the ovary appear, mature and grow, but the formation of the corpus luteum (ovulation) does not occur. The situation may develop in two scenarios:
- Follicle persistence. The egg matures, but the follicle does not rupture; it exists in this form for a long time. Actively produces estrogen, which leads to the proliferation of endometrial cells. After some time, the follicle undergoes reverse development.
- Artresia of the follicle. Several eggs appear in the ovary, but they do not mature, but regress. During this period, the growth of the following follicles begins, which also do not complete the formation stage. The eggs form cysts and the woman develops infertility.
Blood after menstruation can appear up to twice a year and does not require therapeutic activities. If the phenomenon bothers you frequently, there are most likely violations present, so it is necessary to undergo an examination. The pathology contributes to a decrease in hemoglobin, causing weakness, tachycardia, dizziness and pallor of the skin.
Causes of blood
When there is bleeding during the intermenstrual period due to hormonal imbalance, it seems that your period has started again. But this is due to fluctuations in estrogen levels, to which the uterus reacts by rejecting blood. The causes of bleeding can be different, and they depend on the age of the fair sex.
Juvenile
This type is typical of young girls during the formation of the menstrual cycle, when menstruation has just begun. The condition occurs in the first two or three years after the onset of menstruation. As a rule, the duration of intermenstrual bleeding is a week or more, usually the symptoms are characterized by intensity. Often occur in adolescents due to:
- poor nutrition;
- stress;
- vitamin deficiency
Due to active blood loss, the girls suffer from anemia. dizziness and weakness.
Reproductive age
The ability to conceive means a woman’s youth, the ability to give birth to a child. The main causes of bleeding occurring in women of reproductive age:
- 1. If your period is over and blood appears again, first of all you should make sure that it is not an ectopic pregnancy (the egg has been fertilized and is developing outside the uterus). At first, the symptoms are no different from usual signs pregnancy, but you should be alerted first by aching and then severe, shooting pains in the lower abdomen. With the enlargement of the embryo painful sensations so bright that they end in loss of consciousness. The condition is extremely dangerous; if surgery is not performed in time, the woman may die.
- 2. With hypothyroidism, a lack of thyroid hormones has a negative effect on the sexual sphere. Menstruation may begin late, blood appears outside the cycle. At this time, the woman experiences irritability, increased fatigue, and weight loss.
- 3. If fertilization has occurred and blood appears after menstruation a week later, the bleeding is called implantation bleeding and is explained by the implantation of the egg into the wall of the uterus. When the discharge is insignificant and lasts no more than two days, there is no reason to worry, you need to do a test and visit a gynecologist.
- 4. Sometimes the condition is accompanied by nagging pain in the lower abdomen, dizziness, there may be a threat of miscarriage, urgent measures are required to preserve the fetus, so a trip to the doctor should not be delayed. When yellowish streaks of the membranes join the bloody discharge, most likely, embryo rejection has already occurred.
- 5. Happens, arises early ovulation on the 10th day of the cycle, therefore, due to a failure, menstruation occurs two weeks after the previous ones. The phenomenon requires diagnosis to prevent recurrence.
- 6. Taking contraceptives sometimes causes side effect, like the acyclic appearance of blood. The discharge, as a rule, is scanty; the reaction is observed during the period of adaptation of the body to taking hormones in the first six months. The situation is considered normal and does not require treatment, but when it manifests itself for a long time, pain occurs, here you need to consult a doctor. If the drug is discontinued on your own, increased blood loss is possible.
- 7. The intrauterine device can injure the endometrium, as a result the woman discovers blood on her underwear.
- 8. Abortion is a huge stress for female body, causes hormonal chaos, until the system is restored, it is not surprising that menstruation came ten days earlier. This may also indicate an inflammatory process in the uterus or ovaries caused by curettage.
- 9. Too active sex sometimes leads to injury to the vaginal wall, which can cause blood to appear in the absence of menstruation.
- 10. Nervous tension, drinking alcohol, smoking are factors that cause hormonal disorders leading to metrorrhagia. Heavy physical work can also cause bleeding.
Premenopause
During the period of decline of childbearing functions in hormonal system women are changing. The body adjusts to reduce the production of hormones that affect the maturation of follicles. Therefore, from 40 to 55 years of age, a premenopausal woman may have menstruation irregularly, with varying frequencies.
If fibroids are present in the uterus, the formation provokes severe bleeding. It happens that your period begins, it goes on for a long time and intensely, without stopping. With severe menopausal symptoms, women suffer from increased blood pressure, hot flashes and psychological disorders.
When the cyclical menstruation ended, thepostmenopause, and the blood appears again, the symptom indicates the possible development of an oncological process in the cervix, in the organ itself or in the ovaries.
Diseases
Bleeding after menstruation is also caused by diseases of the genital organs:
- Endometriosis is a common reason when blood may not come on time. Discharge begins immediately after menstruation; the diffuse form typically appears approximately 10 days after menstruation. The condition is often accompanied by pain and a feeling of fullness in the lower abdomen.
- Menstruation a week after menstruation indicates endometrial hyperplasia - the disease is associated with an increase in volume and thickening of the layer lining the uterus. When compared with menstruation, the discharge of blood is scanty, sometimes just spotting, in some cases abundant, with clots.
- Infectious diseases of the vagina, sometimes, are asymptomatic; the processes occurring inside lead to inflammation in the uterus. Therefore, a woman experiences discharge during a period when she should not have her period.
- Ectopia, when cuboidal epithelium is located on the vaginal area of the cervix. The disease is characterized by minor contact bleeding, for example, after intimacy or examination by a gynecologist.
- The appearance of blood a week after the end of menstruation is caused by growths that form on the cervix or in the uterine cavity, they are called polyps. The reason for their formation is IUDs, abortions, infectious processes, hormonal disorders.
- With fibroids, metrorrhagia is accompanied by aching pain in the lower back and abdomen. Sometimes the manifestations are so strong that the gaskets have to be changed very often.
- During development malignant processes in the uterus, bleeding can begin on any day outside of menstruation.
The female body is a complex structure, all systems in it work harmoniously and interconnected, problems in any area affect reproductive functions. Menstrual-like bleeding is sometimes caused by diseases that seem to be unrelated to the reproductive system, for example, cirrhosis of the liver or chronic diseases of the ENT organs, a tumor in the brain, and bleeding disorders. Therefore, if you bleed after menstruation, you should definitely look for the cause of the discharge.
Sometimes the appearance of blood from urethra confused with vaginal bleeding, since the organs are located nearby. If discharge appears from the urethra, this indicates inflammation in the ureters, kidneys or bladder. The condition is usually accompanied by fever, lower back pain or discomfort when urinating, and frequent release of small portions of urine.
Diagnostics
What to do if you are worried about bleeding after menstruation? There is only one answer: urgently go to the gynecologist. It is impossible to make a diagnosis yourself, so it is better to trust a specialist. After all, the appearance of uterine blood after menstruation has ended is sometimes a symptom of a serious illness, on which not only the future health, but also the life of a woman depends. The doctor will conduct necessary examination and prescribe treatment measures.
To find out the causes of intermenstrual bleeding, the gynecologist prescribes comprehensive examination, usually using the following procedures:
- Blood test: research general values gives an idea of the state of the body, reveals anemia and the presence of inflammation. Biochemical analysis informs about the operation of individual systems. Blood is taken to determine the concentration of hormones - a method that determines the functioning of the endocrine system.
- Hysteroscopy helps to detect pathology visually when gynecological examination using optical equipment.
- Ultrasound of the uterus and surrounding space makes it possible to identify diseases of the organ at any stage of development.
- Examination of the smear under a microscope reveals an infectious infection.
- Colposcopy is performed for a detailed examination of the vaginal cavity and cervix when multiple magnification. If anomalies are detected, the doctor simultaneously performs a biopsy of the material for laboratory testing.
- Histological analysis is taken from the uterus, its cervix and cervical canal to identify oncology.
You should not refuse a thorough and comprehensive examination; if the doctor prescribes all measures at once, it means that he has reasons for this. Based on the diagnostic results, treatment will be carried out.
Therapy methods
Treatment of bleeding is based on the origins of the problem, the individual characteristics of the female body and the age of the patient. There are two directions in gynecological practice:
- 1. Conservative therapy.
- To treat bleeding caused by hormonal imbalances, estrogen-progestogen drugs are prescribed to stop the bleeding and normalize the cycle.
- Measures also include taking hemostatic (hemostatic) agents or drugs that enhance the contractile activity of the myometrium (uterotonics).
- When diagnosing infectious or inflammatory processes, antibiotics, immunomodulators, and physiotherapy are prescribed locally and systemically.
- 2. Surgical intervention. Used for growing fibroids and polyps. If a malignant tumor is detected, the oncologist will continue treatment.
In parallel with stopping the bleeding, measures are required to prevent relapses. A complex of vitamins is prescribed and anemia is treated. It is necessary to adjust the diet; to replenish blood loss, it is recommended to eat red meat and beef liver.
Folk remedies
Recipes based on infusions and decoctions of medicinal herbs are used in gynecological practice to stop bleeding, but only after the recommendation of a gynecologist. Self-treatment may make the situation worse because the woman does not know why the bleeding is occurring.
Of the herbs that stop uterine bleeding, the most commonly used are decoctions prepared on the basis of:
- Shepherd's purse and nettle. The effectiveness of plants is based on their blood thickening properties due to their high vitamin K content.
- Yarrow. Eating the herb contracts the muscles of the uterus, which also reduces bleeding.
- Horsetail. The aerial part has an astringent and anti-inflammatory effect.
- St. John's wort. Medicinal herb regulates the menstrual cycle, but use it with caution, in some cases the opposite effect occurs, blood may flow more heavily.
Infusions of medicinal herbs are biologically filled active substances, microelements, help fight inflammation, support the immune system. Therefore they can be used for treatment gynecological problems, as an additional treatment, but only as prescribed by a gynecologist.
Prevention
In order to avoid relapses, it is important for a woman to maintain her health after a course of treatment to follow the doctor’s recommendations; she must adhere to the following rules:
- visit a gynecologist regularly, at least once every six months;
- if incomprehensible symptoms appear (menstruation did not arrive on time), consult a doctor immediately;
- avoid intimacy with people you don’t know well; it is preferable to have a permanent sexual partner;
- use contraceptives to prevent unwanted pregnancy;
Uterine bleeding includes bleeding from the uterus that varies in nature and cause.. Similar symptom testifies about hormonal imbalances in the body, the presence serious gynecological or other pathology.
And even with minor bleeding This issue cannot be ignored. The consequences can be quite dire.
Symptoms of uterine bleeding
Discharge from uterine bleeding can be as follows: insignificant, smearing, so and quite intense. In the latter case, the woman feels malaise, weakness, drowsiness, increased fatigue, dizziness, palpitations, nausea, darkening of the eyes, and headache. Decrease in circulating blood volume (CBV) leads to hypoxia of the brain and other organs, which is manifested by a drop in pressure, increased heart rate, pallor of the skin and mucous membranes, shortness of breath, sweating, fainting. If you notice these symptoms, you should not hesitate. In case of significant blood loss, feeling unwell or pregnant, it is better to call a doctor rather than go to the hospital yourself. The sooner you start treatment, the higher the chance of avoiding possible consequences.
There are cases when uterine bleeding is disguised as normal menstruation. Measures should be taken when:
Prolonged periods (more than a week),
- intense discharge (more abundant than usual),
- frequent periods that disrupt the usual schedule,
- accompanied by intense pain in the lower abdomen, lumbar department, sacrum, perineum, rectum.
Causes and types of uterine bleeding
There are several main types of uterine bleeding.
1 . Dysfunctional bleeding occurs due to a malfunction of the organs that control the menstrual cycle and related processes. This is caused by various reasons. These include :
Hormonal disorders (including during menopause),
- blood pathology,
- excessive,
- gynecological diseases (endometriosis, tumors, including fibroids, etc.),
- installed intrauterine device,
- infection of the female genital organs,
- chronic or acute stress, overwork,
- acclimatization, hypothermia,
- excess weight, strict diet,
- side effect of medications, starting or stopping contraceptives drugs,
- invasive gynecological manipulation.
To the group of dysfunctional uterine bleeding includes those that occur V menopause period, as well as those occurring in girls at the initial stage of puberty.
Distinctive feature dysfunctional bleeding is that it is often painless.
Uterine bleeding, which occurs in the middle of the menstrual cycle, occurs in about a third of women. As a rule, they have a spotting character, small duration(up to three days) and are not associated with any diseases. This phenomenon is due changes hormonal levels .
Uterine bleeding in young girls can be caused by mental or physical stress, poor diet, viral disease, dysfunction of the genital organs, or hormonal imbalance. It should be emphasized that you need to take the problem seriously, even if you managed to eliminate the blood loss on your own.
2. Obstetric bleeding is associated with pregnancy and childbirth. They can occur at various stages of pregnancy, during labor or after childbirth. Pregnant women may experience very light discharge without accompanied deterioration in health. Even in this case, you should immediately contact a gynecologist. The condition can worsen sharply and have serious consequences. Extremely severe, massive bleeding can occur with placental abruption or uterine rupture.
Spontaneous miscarriage is also a cause of uterine bleeding. This can also happen in the early stages, when a woman does not even suspect she is pregnant. Abortion procedure, including medicinal, is also accompanied by bleeding.
3. The development of tumors leads to uterine bleeding due to destruction of the layers of the uterine wall, damage to blood vessels. Wherein neoplasm may have like benign character, so be it malignant. It should be remembered that the earlier the disease is detected, the easier it is to fight it and the greater the chances of getting rid of it completely.
4 . Trauma to the abdomen or surrounding areas may also cause uterine bleeding Internal bleeding poses a particular danger. In this case, discharge from the genital tract may be minimal or absent altogether. In this case, the signs of blood loss indicated earlier appear in the abdominal area at the same time there are intense concerns painful sensations, symptoms of peritoneal irritation are determined (Kulenkampf's symptom).
Sometimes bloody discharge from the genital tract occurs after intimacy. Reason occurrence of such bleeding may be:
Mechanical damage as a result of too active or rough actions,
- existing inflammatory process in the genitals,
- diseases of the genital tract leading to wall damage vagina or uterus (polyps, erosion, tumor),
- while taking certain medications, contraceptives,
- miscarriage, ectopic pregnancy,
- blood diseases.
In some cases, the spotting may be the partner's blood. This can happen, for example, when the frenulum of the penis ruptures during sexual intercourse.
It should be understood that prolonged or intense uterine bleeding can lead to anemia, the development of such a life-threatening condition as hemorrhagic shock and have other negative consequences, including death. Uterine bleeding is sometimes the first and only symptom of serious illnesses that require immediate medical attention.
Diagnosis and treatment of uterine bleeding
In case of uterine bleeding, first of all, it is necessary to replenish the blood volume, ensure reliable hemostasis, correct complications. And, of course, you should undergo an examination in order to identify the cause of the uterine bleeding and its subsequent elimination. The gynecologist will conduct an examination and will collect material for research. You will need to do a blood test and evaluate psychological woman's condition. Perhaps the doctor will prescribe an ultrasound or biopsy. In some cases, you will have to go through a procedure of mechanical cleansing of the uterus. If there was psychological factor, sedatives may be prescribed. It happens that it is not possible to avoid surgical intervention, possibly multiple ones.
Diagnosis and treatment should only be carried out by a doctor. No self-medication! The bleeding could be caused by a complex of different reasons. To effectively solve the problem and prevent relapse, they all must be eliminated. The duration of treatment depends on the cause of the bleeding and the amount of blood loss.
Uterine bleeding can occur in women of any age. In the juvenile period, as well as postmenopause, any vaginal discharge blood tests are pathological in nature, therefore they are a reason for mandatory visit to the doctor.
In women of reproductive age, the pathology can be functional: menstruation and obstetric bleeding.
TO pathological manifestations blood includes all other bloody discharge from the genitals, which can occur both during menstruation and during the “dry” period of the cycle.
How to distinguish simple menstruation from bleeding? And what medications can accompany the treatment of the disease? Let's figure it out.
Causes that awaken the disease
The causes of abnormal uterine bleeding can be:
- hormonal imbalance;
- inflammatory, structural and other gynecological disorders;
- extragenital, that is, diseases not related to the genital organs, for example, liver damage or blood clotting disorders;
- disturbances during pregnancy and spontaneous abortion.
In most cases, the appearance of a disorder is preceded by hormonal state, at which during anovulatory cycle the corpus luteum does not develop.
The most common cause of sexual ailments is hormonal imbalance.
As a result, in the second phase of the menstrual cycle, an insufficient amount of progesterone is produced, while estradiol, on the contrary, is produced in excess.
Under the influence of a large amount of the latter, the endometrium grows rapidly and becomes so dense that the blood vessels are no longer able to nourish it. As a result, the endometrium dies and begins to leave the uterine cavity, accompanied by blood..
In the early stages of pregnancy, bleeding may occur during spontaneous abortion. In rare cases, it accompanies an ectopic pregnancy. In the second or third trimester, this can occur due to rupture, placenta previa or polyposis, or hydatidiform mole.
The disease can be caused by changes in the structure of the genital organs: endometriosis, malignant formations, endometrial and cervical polyps, submucous myoma or the birth of a node, hyperplasia, as well as damage to the vagina, cervix or uterine body, foreign body in the vagina, cervicitis, atrophic vaginitis.
Dysfunctional bleeding may indicate the presence functional cysts, polycystic ovary syndrome.
Bleeding can be a consequence of hypothyroidism or hyperprolactemia, as well as certain liver diseases and decreased blood clotting; it can be a side effect after taking certain medications, as well as contraceptive hormonal drugs.
Classification
Bleeding can occur in women of all ages, even girls. Depending on the age of the patient, they can be divided into the following types.
Bleeding in newborns
In the first week of life, due to a sharp change in hormonal levels, girls sometimes experience vaginal discharge of various types, including bloody ones. They are scanty in nature, last only a few days, and do not require treatment.
During puberty
Occurs in girls aged 11–18 years due to hormonal changes in the body, a violation of the psycho-emotional state or various diseases genital area.
During reproductive age
They can be either physiological, that is, menstrual or obstetric, or abnormal.
Menopause
Associated with diseases of the genital organs and hormonal imbalances.
Dysfunctional bleeding (ovulatory and anovulatory)
It is much more common compared to other types of uterine bleeding.
Occurs at any age against the background of malfunctions of the pituitary gland, hypothalamus, adrenal glands or ovaries and subsequent hormonal imbalance.
Dysfunctional bleeding is much more common compared to other types
Quite often, the causes of bleeding are stress, mental or physical fatigue, climate change, as well as endocrine diseases and inflammation of the genital organs (appendages, uterus, ovaries).
Ovulatory bleeding occur mainly in women of reproductive age. Accompanied by spotting and spotting before and after menstruation, as well as in the middle of the cycle. May accompany infertility and miscarriage.
Anovulatory bleeding appear after a delay in menstruation and differ in their duration (7 days or more, sometimes up to several months). They can be moderate or abundant, but due to the duration they almost always lead to anemia.
Juvenile
Bleeding in girls during puberty is called juvenile bleeding. Most common cause their appearance is ovarian dysfunction due to chronic infections, severe physical exertion, poor nutrition, rapid growth and stress. Juveniles are characterized by seasonality and anovulatory, that is, absence of ovulation.
During menopause
During premenopause, gradual decline occurs reproductive functions and significant hormonal changes.
As a consequence, frequent blood loss occurs, which often turns out to be signs of serious diseases of a benign (uterine leiomyoma, polyps) or malignant nature. During the postmenopausal period, bleeding is the first signal about the development of the disease and serious reason consult a doctor.
During pregnancy
Any discharge of blood from the genital organs of a pregnant woman, except obstetric (associated with childbirth) or implantation (occurring on the 7th day after fertilization of the egg during its implantation into the endometrium), is a pathology. In the early stages of pregnancy, blood loss can occur when there is a threat of miscarriage, an abortion in progress, or a terminated pregnancy. ectopic pregnancy.
From the middle of the second trimester, vaginal bleeding can be associated with previa, placental abruption, and uterine rupture. Any of these cases is extremely dangerous for the health of the fetus and the expectant mother and sometimes requires an emergency caesarean section.
Breakthrough
Occurs when taking hormonal hormones contraception, are scanty and short-lived and are a sign of adaptation to the drug. Most often, when breakthrough bleeding occurs, the dosage of the drug is revised: first increased, and after the symptoms disappear, decreased again.
A uterus damaged by an intrauterine device can also bleed. In this case, the spiral is removed as quickly as possible.
Profuse
Most dangerous species uterine blood loss. It is severe bleeding, somewhat reminiscent of menstrual bleeding in nature. It can occur both during menstruation and during the “dry” period of the menstrual cycle.
Due to severe blood loss, the profuse appearance may a short time cause anemia and become a serious threat to the patient’s life. Does not stop with drug therapy, is cured by separate curettage.
The strongest flows of blood from the uterus occur with injuries to the genital organs, as well as in the presence of submucosal myomatous nodes. Treatment is carried out in a hospital setting and often requires surgical intervention.
What symptoms can be used to distinguish menstruation (including heavy menstruation) from bleeding?
Almost any bleeding in the middle of the menstrual cycle are uterine bleeding and serve as a reason for immediate consultation with a doctor. Bleeding that occurs during menstruation should be learned to be distinguished from menstrual bleeding.
Such bleeding is characterized by:
- increased discharge and the need to change the pad in less than 2 hours;
- change in the duration of discharge: in contrast to normal menstruation bleeding may last less than 3 or more than 7 days;
- violation of the regularity of discharge: if “menstruation” comes more often than after 21 days, or less often than after 35;
- any bleeding after sexual intercourse;
- bleeding in girls under 10–11 years of age or in women who have reached postmenopause.
What to do if heavy bleeding begins?
Any suspicions are a reason for a mandatory visit to a gynecologist. If heavy bleeding occurs, you should call an ambulance.
Any suspicion of the onset of uterine bleeding is a reason for a mandatory visit to the gynecologist
While waiting for the doctor to arrive, you need to lie down, remove the pillow from under your head and place it under your feet, raise your pelvis (place a cushion of a towel).
You can apply cold to the lower abdomen. Before the doctor arrives, you need to move less and not eat or drink anything.
How does the treatment proceed?
First of all, treatment is aimed at stopping the blood and replenishing it. Next, the cause of the disease is eliminated and relapses are prevented.
Stopping bleeding in in case of emergency requires surgical intervention - separate diagnostic curettage, which allows not only to stop the bleeding, but also to determine the cause of its occurrence.
Curettage is performed in most cases in menopausal women, less often in women of reproductive age, and almost never in girls. Hormonal hemostasis is also used to stop it: oral contraceptives are prescribed in large doses.
Hemostatic agents
Most often used in the composition symptomatic therapy the following drugs:
- ethamsylate;
- vikasol;
- dicinone;
- aminocapriic acid;
- calcium preparations.
In such cases, agents that contract the uterus also have a hemostatic effect:
- hyphotocin;
- oxytocin;
- pituitrin and others.
The menopause begins unnoticed and over time
The menopausal period begins unnoticed and over time, the woman’s quality of life begins to deteriorate, find out so that you can respond in time and not trigger the syndrome. The uterus is the main reproductive organ of a woman, susceptible to many diseases, read the classifications of hyperplasia and what it is in the dedicated this disease. The causes of mastopathy described in the article can be eliminated without the intervention of doctors.
Drugs used for uterine bleeding in women
To immediately stop blood loss, oral contraceptives Mercilon, Rigevidon, Non-ovlon, Marvelon and others are prescribed.
During symptomatic therapy the following is prescribed:
- hemostatic;
- drugs that contract the uterus;
- for anemia - iron supplements (fenuls, maltofer) or blood components (erythrocyte mass, frozen plasma);
- vascular strengthening and a complex of vitamins: ascorutin, folic and ascorbic acid, pyridoxine, cyanocobalamin.
After stopping the bleeding, relapses are prevented and the cause of the disease is eliminated.
Proven folk recipes for this disease
IN complex therapy When treating uterine bleeding, folk remedies are often used.
Prepare a decoction of 1 tbsp. l. dry leaves and 1 tbsp. water, boil for 10 minutes. Take a tablespoon every 3-4 hours.
Nettle tea
Orange
The peels of 6-7 oranges are poured into 1.5 liters of boiling water and boiled to 0.5 liters. The decoction is taken three times a day, 4 tbsp. l.
Uterine bleeding should not be confused with natural monthly blood loss associated with rejection of the functional layer of the endometrium. When they speak abstractly about uterine bleeding (there is also a term - profuse bleeding), they mean abnormal bleeding in women due to gynecological problems.
Unexpected (or without obvious reasons) bleeding from the uterus poses a great danger to a woman (no matter what age she is). In this regard, gynecologists exclude the so-called symptomatic treatment, since eliminating the bleeding itself (that is, the consequence of some process) is a temporary measure that only aggravates the further growth of the cause of bleeding.
The causes of bleeding in women can be very different and often the symptoms are very vague. In a good way, before “believing” in the established diagnosis, it would be necessary to undergo examination in two or three independent laboratories.
Uterine bleeding is a manifestation of gynecological diseases, extragenital pathology, and can also be an independent disease.
The age at which this phenomenon may occur may vary - from the neonatal period to postmenopause.
Structure of the uterus
The uterus is a hollow smooth muscle organ of the female reproductive system, which consists of three parts:
- Bottom – top part uterus.
- The body is cone-shaped, ends with an isthmus at the bottom, leading to the cervix.
- Cervix - includes the isthmus, cervical canal and vaginal part.
The weight of such an organ in girls and nulliparous women is about 50 g.
The structure of the uterus is such that it includes three layers:
- Perimetry – outer layer uterus, which goes into the wall abdominal cavity.
- The myometrium is the middle, densest layer, which consists of muscles and a large number of vessels.
- The endometrium is the inner lining of the uterine cavity to which the fertilized egg is attached. The endometrium, in turn, is divided into two layers:
- Basal (main).
- The functional layer is the one that undergoes monthly rejection in the absence of a fertilized egg.
For reference! The rejection of the functional layer of the endometrium, accompanied by bleeding from the uterus, is called menstruation.
Menstrual cycle
For the normal functioning of the female reproductive system, the participation of not only the genital organs, but also the entire organism as a whole is necessary. 
This process is characterized by stages, where a change in one link leads to disruption of the activity of the entire organism.
Normally, the regulation of the menstrual cycle is determined by the following processes:
- The activity of the uterus is the main organ of the female reproductive system, which is controlled by higher structures of the body.
- Functioning of the ovaries - this paired organ is an endocrine gland that produces progesterone, estrogens and androgens. The most significant role in the first phase of the cycle is occupied by estrogen hormones, and in the second - progesterone. But despite the importance of organs such as the ovaries, they are also regulated by other organs and systems.
- Control by the pituitary gland - this part of the brain controls the production of hormones, without which a woman, in principle, cannot be a woman in the full sense of the word:
- Luteinizing hormone (LH) - it is the peak levels of this hormone that ensure the full process of ovulation in the ovaries, which involves the release of an egg.
- Follicle stimulating hormone (FSH) – when the leading one matures, dominant follicle controls its maturation in full.
- The influence of the hypothalamus - the coordinated activity of the hypothalamus takes control of the clear cyclical flow of hormones into the blood. Substances that control this process are “statins”, which reduce the formation of hormonal substances and “liberins”, the main function of which is to stimulate the pituitary gland. In this way, normal production and levels of hormones important for women are constantly maintained.
- The influence of the cerebral hemispheres - it is from here that the necessary impulses are distributed to all the controlling structures of the female reproductive system. Even the slightest stress, for example, can lead to a failure of menstruation, because the entire regulation of the menstrual cycle is completely disrupted.
It is known that the intensity and duration of menstruation is individual for each woman. There are often cases when a woman or girl mistakes heavy periods for bleeding. To avoid this, you need to know the criteria for normal, healthy menstruation:
- The duration of menstruation should not be more than 7 days.
- Menstrual blood should not contain large and abundant blood clots.
- The volume of blood lost is no more than 80 ml.
- Preservation of the cyclicity of menstruation (from 21 to 35 days is normal).
Attention. Despite these criteria, it is necessary to pay attention first of all to the amount of blood released, since about 20% of cases turn out to be bleeding, leading to chronic anemia.
Classification
- Bleeding in newborns.
- Uterine bleeding before puberty.
- Juvenile - typical for adolescent girls, which begins from the first menstruation until the age of 18.
- Reproductive – characteristic of women from 18 years of age to menopause.
- Menopausal – can occur in women during menopause.
- Bleeding from the uterus during pregnancy:
- First trimester – up to 12 weeks.
- Second trimester - from 13 to 26 weeks.
- Third trimester - from 27 to 40 weeks.
- Postpartum uterine bleeding:
- In the early postpartum period - up to 2 hours after birth.
- In the late postpartum period - within 42 days after birth.
Depending on the cause of uterine bleeding, there are:
- Dysfunctional:
- Ovulatory – associated with menstruation. They are characterized by an increase in the volume and duration of bleeding.
- Anovulatory - occurs between menstrual bleeding. Most often develop after menstruation.
- Organic.
- Iatrogenic.
Uterine bleeding. Causes
The causes of uterine bleeding in women are very diverse. To make it easier to understand this issue, they are divided into into two large groups:
- Bleeding caused by dysfunction of the female reproductive system (genital).
- Bleeding caused by diseases of other organs and systems (nongenital, extragenital).
In the development of such a process as extragenital uterine bleeding, the reasons will be as follows:
- Diseases of the blood and hematopoietic system - hemophilia, hemorrhagic vasculitis, deficiency of vitamins involved in blood clotting).
- Infectious diseases (flu, sepsis, etc.).
- Cirrhosis of the liver.
- Atherosclerosis.
- Arterial hypertension.
- Hypofunction of the thyroid gland.
The causes of genital bleeding may be associated with pregnancy or develop outside of pregnancy:
- Those related to pregnancy:
- Disturbed pregnancy.
- Bubble drift.
- Chorionepithelioma.
- Placet presentation.
- Premature placental abruption.
- Scars on the uterus.
- Destruction of cervical tissue.
- Low location of the placenta.
- Uterine rupture.
- Injuries.
- Endometritis.
- Retention of parts of the placenta.
- Uterine fibroids.
- Reasons not related to pregnancy:
- Neoplasms.
- Ovarian cysts.
- Ovarian ruptures.
- Infections and inflammations of the female genital organs.
- Cervical erosion.
- Cervicitis and endocervicosis.
- Vaginitis.
- Endometritis.
Uterine bleeding. Symptoms and types
- Menorrhagia (hypermenorrhea) – menstruation lasting more than 7 days and volume more than 80 ml with preserved regularity.
- Metrorrhagia – bloody, not copious discharge, characterized by irregularity. More typical for the middle of the cycle.
- Menometrorrhagia is irregular but prolonged bleeding.
- Polymenorrhea - such menstruation appears more often than after 21 days.
Important! A frequent concomitant symptom of prolonged uterine bleeding is iron deficiency anemia, which occurs due to a decrease in the level of hemoglobin in the blood.
Uterine bleeding in newborns
They are scanty bloody vaginal discharge, which most often occurs in the first week of life in newborn girls. The reason for this condition is a sharp and rapid change in hormonal levels.
Such conditions do not require treatment and go away on their own, so drug intervention to stop bleeding is not necessary.
Bleeding from the uterus before puberty
Rarely registered. The main cause of this pathology is hormone-positive ovarian tumors, which constantly produce a large number of hormones.
For reference. This condition is regarded as false-positive puberty.
Juvenile uterine bleeding
The most common cause of uterine bleeding in the juvenile period is a malfunction of the ovaries, which manifests itself 
changes in hormonal levels:
- The synthesis of progesterone by the ovaries is disrupted.
- Excessive levels of progesterone appear in the body.
- The level of FSH increases and the level of LH decreases, which leads to the fact that the process of ovulation does not occur (such bleeding is called anovulatronic).
- Due to pathology of the thyroid gland and adrenal glands, impaired hormone production also develops.
In addition to the development of juvenile bleeding, prolonged chronic infections, frequent hypothermia, stress, psychological trauma, excessive physical activity, poor nutrition.
Less commonly, conditions such as tuberculosis, tumors and developmental abnormalities of the cervix, uterine body and ovaries, impaired blood clotting, leukemia, and pituitary tumors can cause such blood loss.
Juvenile uterine bleeding is characterized by seasonality, since the disease most often occurs or worsens in autumn and spring.
Treatment in such cases is necessary in a hospital setting with the prescription of bed rest, the use of vikasol, dicinone, aminocaproic acid, and cold heating pad applications to stop bleeding. Vitamins, iron-based preparations to eliminate anemia, uterine contractions (oxytocin), ascorutin and physiotherapeutic manipulations are also indicated.
Important! Treatment is individual in each case. With correctly prescribed therapy, recovery occurs in almost 90% of cases within 12 months. normal cycle and uterine bleeding stops.
If the indicated curative measures do not have the desired effect, they resort to hormone therapy. IN life-threatening situations, diagnostic curettage is performed.
Bleeding during the reproductive period
Important! According to statistics, every third woman of reproductive age has experienced uterine bleeding at least once in her life.
The causes of uterine bleeding during reproductive age are as follows:
- Changes in hormone concentrations.
- Endometriosis.
- Adenomyosis.
- Pathology of the blood coagulation system.
- Endometrial hyperplasia (this pathology is indicated in the case of endometrial thickening of 14 mm or more).
- Polyps in the uterine cavity.
- Submucosal myomatous nodes.
- Intrauterine devices.
- Complete/incomplete spontaneous abortion.
- Ectopic pregnancy.
Regardless of the cause, one of the leading symptoms is uterine bleeding. If there is a hormonal imbalance, correction is necessary using progesterone-based drugs (Duphaston). If hormonal imbalance is not diagnosed, then hemostatic agents must be used. medications to stop uterine bleeding.
In addition, for example, if endometrial hyperplasia is detected, it is required surgery using diagnostic curettage from the uterine cavity. The same applies to uterine fibroids, ectopic pregnancy and spontaneous abortion, where surgery cannot be avoided.
Important! Treatment of uterine bleeding in women of reproductive age has the main goal of preserving her reproductive function.
Uterine bleeding during menopause
In women who are in such a period with the development of uterine bleeding of even the most minimal severity, first 
the queue must be eliminated oncological diseases, since this is a very dangerous clinical symptom.
The reason for this is:
- Changes in hormonal levels.
- Endometrial hyperplasia.
- Uterine fibroids of submucosal localization.
- Precancerous degeneration and endometrial cancer.
- The “forgotten” intrauterine device.
Important! According to clinical studies, in approximately 70% of cases malignant neoplasms endometrium in women during menopause are manifested by uterine bleeding.
The most important thing in determining further treatment tactics is diagnostic curettage with extraction of a biopsy sample and its diagnosis.
Detection submucous fibroids involves performing hysteroresectoscopy with removal of the node/nodes. If the size of the nodes is large, then removal of the uterus and appendages is indicated.
If the cervix bleeds, the reasons for this, according to research, often lie in its precancerous degeneration, which requires a biopsy and determination of further tactics for managing the patient.
The presence of a coil installed more than 5 years ago is an indication for its removal followed by anti-inflammatory therapy.
Important! Even if the old IUD is successfully removed, it is necessary to ensure the integrity of the uterine walls.
If uterine bleeding leads to the development of anemia, which happens quite often, it is necessary to prescribe iron supplements.
Dysfunctional bleeding
Failure of the control system can be caused by the following pathological processes:
- Acute and chronic diseases of the genital organs.
- Pathology of the endocrine system.
- Stress.
- Mental and physical fatigue.
- Climate change.
- Abortions (including spontaneous ones).
Important! Dysfunctional uterine bleeding with ovarian dysfunction is one of the most common causes of infertility.
The most optimal treatment method in such cases is hormonal therapy.
Uterine bleeding not associated with pathology of the reproductive system
Such bleeding is also called extragenital, the causes of which are diseases of organs and systems not related to the woman’s genital area.
A distinctive feature of this is the combination of uterine bleeding with nosebleeds, increased bleeding of the gums, prolongation of bleeding time from cuts and scratches, and the appearance of bruises with minor contusions.
In such cases, the underlying disease is treated first.
Iatrogenic bleeding
This type of blood loss occurs due to the use of contraceptives, wearing IUDs and taking medications that cause blood thinning.
Bleeding during pregnancy
- Chorionic detachment, placenta.
- Pathology of the blood coagulation system.
- HELLP syndrome.
- Threatened abortions.
- Uterine rupture.
Important! Bleeding during pregnancy is the most common cause of death in obstetric practice.
The most important principles of treatment of this pathology are:
- Placental abruption requires the prescription of Duphaston, a hemostatic drug. In case of severe bleeding, urgent surgery is necessary.
- Blood clotting disorders are eliminated by the administration of drugs that affect the hemostasis system, red blood cells, platelets, and fresh frozen plasma.
- Uterine rupture is the most severe and dangerous reason bleeding, often leading to death. In this case, only emergency surgery can save the woman’s life.
Postpartum uterine bleeding
Various reasons can lead to such conditions:
- Ruptures of the cervix during childbirth.
- Placenta accretion to the inner wall of the uterus or retention of its parts.
- Postpartum uterine hypotension.
- Blood clotting disorder.
- Premature suture dehiscence after cesarean section.
For treatment heavy bleeding There is not much time left after childbirth, since large blood loss can quickly lead to the woman’s death.
Important. To stop bleeding it is necessary intravenous administration oxytocin, hemostatic drugs, saline solutions, colloidal agents, .
In some cases, manual inspection of the uterine cavity is used to identify the presence of remnants of membranes and parts of the placenta.
In severe cases, surgery is necessary.
First aid
In order to provide first aid to a woman in a timely manner, it is necessary to know the main signs of uterine bleeding, which 
called profuse bleeding:
- Strong, copious discharge of blood over a short period of time.
- Increasing weakness.
- Dizziness.
- Pronounced pallor.
- Fall in blood pressure.
- Tachycardia.
- Drowsiness, lethargy.
Even if at least one of the above symptoms is detected, emergency medical attention is necessary.
Important! Profuse uterine bleeding is an extremely dangerous condition for a woman. If assistance is not provided in a timely manner in difficult situations, a woman can extremely quickly (within a few minutes) develop hemorrhagic shock and death.
If uterine bleeding occurs at home, you must first call emergency specialized care.
Before her arrival, it is necessary to carry out the following manipulations to stop uterine bleeding:
- Place the woman in a horizontal position with her legs raised up (place them on a high pillow).
- Constantly apply cold to the lower abdomen.
- Control arterial pressure and heart rate.
- Transport by ambulance to any nearest medical facility.
In intensive care conditions it is carried out infusion therapy in accordance with vital signs women.
Important! One of the most effective measures aimed at saving the life of a woman with profuse uterine bleeding is curettage, which allows you to remove bleeding areas of the endometrium, ensure powerful vasoconstriction of the uterine vessels and contraction of the uterus.
Profuse bleeding is a very dangerous condition. Life may depend on the correctness and timeliness of actions.
Attention! In case of profuse uterine bleeding, it is strictly forbidden to do the following:
- Apply heat to the lower abdominal area.
- Take a warm bath or shower.
- Use medications at your own discretion.
- Carry out douching and rinsing.
- Take warm baths.
Diagnostics
For juvenile uterine bleeding, the following measures must be taken:
- Determine the start and end date of the last initial menstruation and the date of the initial menstruation that progressed to bleeding.
- Do .
- Donate blood for estrogen, prolactin, cortisol, progesterone.
- Donate blood for thyroid hormones - T3, T4, TSH.
- Determine your basal temperature between periods.
- Do an ultrasound of the pelvic organs, adrenal glands, and thyroid gland.
- Conduct ultrasonic testing ovulation process.
- Take an x-ray of the skull.
- CT, MRI of the brain.
Uterine bleeding in women of reproductive age requires:
- Gynecological examination.
- Exceptions for ectopic pregnancy.
- Hysteroscopy.
- Ultrasound of the pelvic and abdominal organs.
About 30% of all uterine bleeding occurs during menopause. In such cases, first of all, it is necessary to exclude regular menstruation, since as menopause occurs, ovarian function is depleted, which leads to irregular menstruation.
In order to exclude a pathological process, hysteroscopy is indicated. Curettage is also recommended to confirm endometriosis.
Attention. To diagnose polyps of the uterine cavity and its walls, fibroids, curettage is required.
If oncological processes are suspected, an MRI or CT scan is necessary.
Uterine bleeding. Treatment
The goal of treating uterine bleeding is its elimination, replenishment of blood loss, identification and treatment of the cause, as well as prevention. Any uterine bleeding requires immediate treatment, since it is dangerous to leave a woman in this condition without proper treatment.
Diagnostic curettage in many cases is an effective treatment method, as it allows not only to stop bleeding, but also to identify its cause.
Important! For juvenile bleeding that is not life-threatening, curettage is not indicated.
Also effective way stopping bleeding is hormonal hemostasis, in which large dosages of hormones are prescribed.
As symptomatic treatment hemostatic drugs (dicinone, vikasol), drugs for uterine contraction (oxytocin), blood components, iron supplements, vasoconstrictors, and vitamin therapy are used.
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