The average duration of menstruation is 5 days. They appear with a certain cyclical nature, however, there are frequent cases of small fluctuations when critical days occur a little earlier or later. In this case, it is worth thinking about and looking at your body, because the discharge is easily confused with bleeding, which is a symptom of many dangerous diseases. In this article we will describe how to distinguish menstruation from uterine bleeding.
How to distinguish uterine bleeding from menstruation
Any blood loss, except for that which develops on critical days, can be dangerous for the female body. Uterine bleeding has pathological causes, menstruation is physiological. However, it is not always easy to determine what is before us: bleeding or menstruation.
On critical days a small amount of blood is secreted every day. At the beginning of the cycle, the highlights are bright and fluid, towards the end - dark and thick.
In addition to the blood itself, the menstrual flow contains mucus and particles of dead endometrium. All this gives them a specific flavor that resembles the smell of meat.
Thus, if a woman is interested in how to determine that she has abundant menstruation or bleeding, she must be repelled by the nature of the discharge.
A more precise definition is based on the study of such signs of uterine bleeding, such as duration, cyclicity, and volume of blood loss.
With menstruation, blood from the uterus lasts from 3 to 7 days, depending on the individual characteristics of the female cycle. Monthly over 7 days may be a sign of uterine bleeding. In addition to the duration, their character is different. So, to determine if menstruation or bleeding has occurred, you need to know that:
- With menstruation in the first days, the discharge is insignificant, smearing, and in the following - portion, with pathological bleeding - continuous.
- Discharge on critical days has a strict duration - from 3 to 7 days, uterine bleeding can be a one-time or bother a woman for more than one week. In this case, the blood is excreted in small quantities.
Menstruation have a specific cycle. It usually lasts 28 days, however, fluctuations of 1 week in both directions are also considered normal. Accordingly, vaginal discharge found outside the cycle makes it clear that this is most likely not monthly.
It will be typical if the “menstruation” comes on a day that differs from the expected one week or more.
The main difference from monthly bleeding is the amount of discharge. The physiological phenomenon is the loss of 50 ml of blood per cycle.
Also a variant of the norm is abundant menstruation, in which 80 ml of blood is released on critical days. A single blood loss of 50 ml or a total of more than 100 ml is considered bleeding and requires immediate medical attention.
Well illustrates the features of the allocation of blood, the amount of hygiene products that a woman consumed during the day. As a rule, during menstruation, this number does not exceed 4 (depending on profusion). This suggests that the amount of secretions fit into the physiological framework. When uterine bleeding woman can use more than 10 pads per day.
Thus, it is very important to distinguish between abundant menstruation in a woman and blood loss, which has pathological causes. Otherwise, there is a risk of anemia with iron deficiency.
Answering the question how to distinguish between menstruation and uterine bleeding, one should pay attention to somatic symptoms. During the pathological process in the female body, there are a number of manifestations with which it can be recognized. So, signs of uterine bleeding during menstruation include:
- a significant increase in the volume of discharge,
- the continuous nature of blood loss,
- liquid consistency, bright color of discharge, the absence of mucus, clots and characteristic odor,
- signs of anemia (weakness, drowsiness, pallor of the skin, dizziness, nausea, increased heart rate),
- pain in the groin area before the onset of the proposed menstruation and during intercourse.
The main causes of bleeding
Blood loss is a dangerous phenomenon, especially if it has a pathological nature. Often the reason lies in violations related to the functioning of the female reproductive system, and the symptom in question is a kind of marker that indicates that a malfunction has occurred in the body.
Bleeding can never be ignored. Otherwise, the pathological process will receive time for development, there may be complications that can lead to infertility.
The main causes of uterine bleeding include:
- malignant and benign neoplasms of the female reproductive system,
- abortion due to abortion,
- postpartum bleeding,
- implant bleeding,
- hormonal imbalance
- blood diseases
- infections of the urogenital tract,
- coagulation disorders
- inflammation of the pelvic organs.
Postpartum blood loss
Postpartum discharge is considered a physiological phenomenon that foreshadows the regenerative process in the female body. Such discharge is called lochia. They can continue for two months after the baby is born.
In addition to bleeding bright scarlet color with an unpleasant odor, in which there is no mucus and blood clots, the woman has low-grade fever, general malaise, dizziness, nausea, migraines.
Accompanying the process of conception. Physiologically, this process is determined by the implantation (implantation) of the egg into the endometrium of the uterus. As a result, the integrity of the organ wall is broken, small blood vessels are damaged, from which blood is poured.
Implantational blood loss can be judged if shortly before it unprotected sexual intercourse took place and early signs of pregnancy already appeared. Rapid test for urine hCG is able to confirm or refute this diagnosis.
Symptoms of miscarriage
Considering the question of how to distinguish menstruation from bleeding during pregnancy, you should touch upon such a topic as miscarriage.
In the early stages of pregnancy, there are cases of spontaneous interruption. The embryo at this time is a very small number of cells that constantly undergo multiple divisions. This process can often fail. Mutational material does not accumulate due to the mechanism of miscarriage. This is an evolutionary elaborated defensive reaction of the organism, designed to prevent the development of an embryo with genetic abnormalities.
In the early stages of miscarriage is relatively easy. Its manifestations include:
- Pulling pain in the groin, which can give to the lumbar.
- Isolation of blood from the vagina.
In contrast, menstruation discharge with miscarriage have a dark red or brown color. They can be quite large and dense clots.
Miscarriages are often fraught with consequences. Over time, women may develop subfebrile temperature, which is a marker of the inflammatory process in the reproductive organs. When fever should consult a doctor to avoid serious complications.
Self-treatment before admission to the gynecologist
With abundant uterine bleeding, it is necessary to urgently call the ambulance brigade. Prior to her arrival, the following measures can be taken to reduce discharge:
- Lie down in such a way that the legs are higher than the body.
- Provide plenty of drink.
- Attach dry ice to the groin area of the abdomen.
After hospitalization and relevant research and analysis, doctors will decide whether the patient should see a gynecologist. Perhaps a symptom requires the intervention of other specialists.
Often used drugs to reduce blood loss: Tranexam, Vikasol, Ditsinon. Acceptance of each of these drugs requires consultation with a gynecologist, careful reading of the instructions for use and strict adherence to the rules of dosing.
What should guard?
The appearance of any symptoms may indicate the development of bleeding.
- If the release of menstrual blood does not decrease, and in some cases increases several days after the start of menstruation.
- If, after establishing a permanent monthly schedule, they do not come on time, the blood excretion is very abundant and does not have a tendency to subside, while the blood released is red.
- The appearance of bloody discharge from the genital tract after abdominal trauma.
- Abundant secretion of scarlet blood after a long-term absence of menstruation in women of the older age group during menopause.
The causes of uterine bleeding are very numerous, ranging from diseases of the female reproductive system, ending with malfunctions in the blood coagulation system. In various age groups, the frequency of occurrence of various causes varies considerably.
- Blood diseases (for example, thrombocytopenic purpura). Usually, in case of coagulation disorders, there are other signs, such as long-term incessant bleeding from minor wounds (more than 10 minutes), frequent nose bleeds, bruises that appear without cause, and abundant long-term bleeding after tooth extraction. Such symptoms should not go unnoticed. The girl should always consult a doctor and pass the appropriate tests. Violations of the hemostatic system of the blood carry a real threat to the life of a woman. If such signs of "close eyes", then there is a high risk of dying during any operation, childbirth, injuries from the outbreak of bleeding.
- Inflammatory diseases of the reproductive organs .
- Endometriosis . Endometrium foci located outside the uterus during menstruation can lead to heavy bleeding.
- Tumors of the genitals. The neoplasm of considerable size, can grow into nearby vessels, destroying the vascular wall, which causes such a complication as bleeding.
- Vaginal Polyps . Polyps of such localization are most often injured, for example, during sexual intercourse or using tampons, resulting in excessive bleeding.
- Medications . Acceptance of drugs from the group of anticoagulants and antiplatelet agents (blood thinners) during menstrual flow may also cause bleeding.
- Hot bath, shower , visiting the bath, saunas in the first days of menstruation is also a frequent cause of bleeding in women predisposed to them.
- Spontaneous miscarriage . If a woman is pregnant, the discharge of blood from the genital tract may indicate a threatened abortion, premature detachment of the placenta, etc. In any case, the occurrence of bleeding in a pregnant woman requires her hospitalization in a specialized hospital.
- Serious injuries to the abdomen .
- Ectopic pregnancy. A fetal egg implanted in the uterus tube, which increases in size, inevitably leads to rupture of the fallopian tube and the occurrence of bleeding. The discharge of blood from the genital tract, the woman is in extreme pain, ignore, which is not possible. This situation requires emergency hospitalization.
- Taking the drug "Postinor" in order to prevent unwanted pregnancy, if there was unprotected sexual intercourse. Bleeding is a side effect of the drug and in women with uterine bleeding in the past history, “Postinor” can trigger bleeding that requires emergency medical care to stop.
INTERESTING TO KNOW. Even in newborn girls, menstrually similar bleeding from the genital tract occurs. This phenomenon is called a sexual (hormonal) crisis. This condition occurs about 7 days after birth and is manifested by the appearance of a small amount of blood from the vagina of a newborn girl. After a couple of days, the bleeding stops on its own.
This phenomenon is explained by the increased content of the mother’s sex hormones in the baby’s blood, after 9–10 days the hormonal balance levels out and the bleeding does not recur. The condition is adaptive in nature, does not require any therapeutic measures.
Blood excretion may be accompanied by symptoms of mastitis (swelling of the mammary glands) and the separation of a small amount of whitish fluid from the nipples.
Sexual crisis is not common, only in 9-7% of newborn girls.
How to treat?
Uterine bleeding, regardless of the causes, should be treated within the walls of a specialized hospital, but in no case at home.
If a woman has lost a significant amount of blood, a platelet or red blood cell transfusion may be prescribed, as well as fresh frozen plasma.
They are prescribed, such as, Ditsinon, Tranexam, Vikasol (not a first aid tool, since it acts only after 18-12 hours), Oxytocin (causes the uterus to contract, which helps to stop uterine bleeding).
After stopping bleeding, post-hemorrhagic anemia is corrected with iron preparations.
In severe cases, surgical bleeding is carried out by curettage of the uterus. If such a measure fails, extirpation (removal) of the uterus is performed. This procedure is done in extremely difficult cases when the use of other methods is not effective.
Before the arrival of the ambulance
- Take a horizontal position with raised upside down.
- On the lower abdomen put a bubble with cold water wrapped in cloth. Attach on
15-10 minutes, then a 5 minute break and reapply for 10-15 minutes. This is done before the arrival of the ambulance.
Uterine bleeding - This is any outflow of blood from the uterine cavity, with the exception of menstrual and patrimonial bleeding. Uterine bleeding as a symptom may accompany many gynecological and extragenital pathologies, or it may be an independent disease.
There is an abnormal uterine bleeding without age adjustment in any of the periods of life. In approximately 3% of newborn girls, in the first days of extrauterine life, bloody discharge from the genital tract of a physiological nature often appears, it consists of dark, uncoiled blood, mucus and stops on its own after one or two days. Uterine bleeding that occurs in older women almost always indicates a serious pathology.
The largest group is uterine bleeding due to menstrual dysfunction, or dysfunctional uterine bleeding. They are not associated with anatomical abnormalities, they can occur with a certain periodicity (cyclical) or have an acyclic character.
Among dysfunctional uterine bleeding leading juvenile (adolescent). Juvenile uterine bleeding is diagnosed in girls during active puberty, their cause is associated with imperfect work and the immaturity of the endocrine and hypothalamic-pituitary system.
Uterine bleeding in its origin can be attributed to complicated pregnancy, childbirth or the postpartum period. It is also sometimes provoked, complicated by abortion, tumors of the genital sphere.
Diseases of the circulatory system, pathology of the heart and / or blood vessels and endocrine diseases are often present among the causes of uterine bleeding in women with good gynecological health.
Among the causes of uterine bleeding there are also less serious factors: stress, overwork, change in the climatic zone of residence, a sharp weight loss (especially by artificial means). Incorrect use of hormonal contraceptive drugs can also provoke uterine bleeding.
The clinical picture of abnormal uterine bleeding is simple and obvious. Characterized by the appearance of bleeding from the genital tract of varying intensity and duration, which is not menstruation and is not associated with physiological birth. Intensive abnormal uterine bleeding provokes the clinic of anemia, and sometimes it can lead to serious consequences: distortion of the cardiovascular system and hemorrhagic shock.
A huge variety of causes of uterine bleeding requires a consistent diagnostic search that includes a large list of studies. As a rule, diagnosis is carried out in stages, when, by an exception method, diagnostic measures are carried out until the minute when there is no reliable reason for the bleeding.
Stop uterine bleeding is made according to its cause, and certainly taking into account the patient's condition. В экстренных ситуациях, когда сильнейшее маточное кровотечение сопряжено с угрозой жизни, проводится терапия в рамках реанимационных мероприятий, а после восстановления должного самочувствия больной начинается поиск причины кровотечения, вырабатывается дальнейшая терапевтическая тактика.
Causes of uterine bleeding
Uterine bleeding etiologically has a close relationship with age, the nature of the hormonal function of the ovaries, as well as the somatic health of women.
Uterine bleeding of the neonatal period is associated with a “sex crisis” - the process of adaptation of a born girl to an “independent” life. After childbirth, a significant amount of maternal hormones remains in the girl's body, which decreases sharply after childbirth. The peak of hormonal decline occurs at the end of the first week of life, at the same time, the baby may experience bloody vaginal discharge. They correlate with the norm, they pass independently within a maximum of two days and do not require outside intervention.
Juvenile uterine bleeding often occurs in the first two years after the onset of the first menstruation. Their appearance is associated with imperfect regulation of menstrual function or with the consequences of the pathological course of pregnancy and childbirth.
In women who have overcome puberty, uterine bleeding can have the following causes:
1. Pathology of pregnancy. Uterine hemorrhage in the early (up to 12 weeks) terms is caused by miscarriage, "frozen" pregnancy, vesicular drift. In the later periods (after 12 weeks), uterine bleeding can provoke the placenta if it is improperly attached (presumptive) to the uterine wall, or if it begins to exfoliate before the prescribed period.
In pregnant women, uterine bleeding is not always associated with the unfavorable state of the fetus or the threat of premature birth. Sometimes they appear due to the presence of erosion on the cervix, a cervical polyp or a banal mucosal injury.
2. Pathological birth. Extensive birth injuries, delayed particles of the placenta in the uterus giving birth, impaired uterine wall tone (atony and hypotension) initiate uterine bleeding in women who gave birth.
3. Complicated abortion. Severe uterine bleeding may occur after a mechanical injury to the uterine wall. Also, post-abortion bleeding is provoked by not removed parts of the fetus and / or fetal membranes.
- Oncological gynecological pathology.
Dysfunctional uterine bleeding
Dysfunctional are considered uterine bleeding associated with impaired regulatory functions of the pituitary and hypothalamus, when in the absence of diseases of the uterus and appendages, hormonal dysfunction appears, changing the menstrual cycle. Since the greatest number of hormonal fluctuations falls on young (14–18 years) and premenopausal (18–45 years) age, the greatest number of dysfunctional uterine bleeding is registered among patients of these age groups.
Dysfunctional uterine bleeding is not uncommon and is diagnosed in almost every fifth patient who has contacted the gynecologist.
Normally, the menstrual cycle consists of two equivalent phases, separated by an ovulation period - the release of a ripe egg cell beyond the limits of the ovary. Ovulation occurs in the middle of the cycle. After the egg leaves the ovary, in the place where it matured, a yellow body forms.
In the first menstrual phase, estrogens dominate, in the second they are occupied by progestin gestagens (progesterone).
Dysfunctional hemorrhages are caused by the disruption of the hormone secretion rhythm, as well as by the change in the number of sex steroids.
The clinic of dysfunctional bleeding is closely related to the presence or absence of ovulation, so they are divided into:
- ovulatory (ovulation is) characteristic of the reproductive age,
- Anovulatory (without ovulation), often found in young girls and menopausal women.
At the heart of all dysfunctional bleeding is a violation of the menstrual cycle. It can have the following forms:
- “abnormal” copious menstruation (regular or irregular), lasting longer than a week,
- menstruation with a small (less than 20 days) or large (more than 35 days) interval,
- absence of menstruation for more than six months, provided there is no pregnancy, lactation and menopause.
In the absence of ovulation, menstruation becomes irregular, with long delays. Usually, after a delay of one month and a half or two months, there is heavy bleeding that lasts longer than a week. Uterine bleeding with clots may occur. A large amount of blood that accumulates in the uterine cavity, does not have time to evacuate in a timely manner and forms clots - fragments of coagulated blood. The presence of blood clots may also indicate a violation of the coagulation system or a decrease in uterine wall tone (for example, after childbirth or abortion).
Regularly repeated significant blood loss often leads to concomitant anemia.
Therapy for dysfunctional uterine bleeding involves a detailed diagnosis of their cause. It is necessary to determine in which of the links of the hormonal regulation violations occurred in order to properly compensate for them.
Treatment of uterine bleeding
The choice of treatment for uterine bleeding always implies a detailed study of their cause.
Postpartum uterine bleeding due to a delay in parts of the placenta or fetal membranes cannot be stopped without a revision of the uterine cavity. After giving birth, the uterus retains its large size, and the cervix has not yet returned to its original size and freely misses the hand. With the observance of all the rules of antiseptics, a manual examination of the uterine cavity is performed in order to find the "culprit" of the bleeding. The detected fragment of the afterbirth or membranes is removed, and then infectious complications are prevented.
Bleeding after abortion, due to the delay of parts of the fetus, is stopped by scraping the uterine cavity.
Juvenile uterine bleeding is treated in several stages. Initially, the bleeding is stopped. If the bleeding is moderate, and the patient's condition is not disturbed, symptomatic hemostasis is resorted to. Long and abundant juvenile bleeding with the presence of a secondary one requires the use of hormones. Also, hormonal hemostasis is used if bleeding continues after symptomatic treatment. The choice of a hormonal agent is always individual, because it depends on the specific clinical situation. Usually preference is given to gestagens or a combination of estrogen with gestagens.
Even the most effective hemostasis cannot rule out a recurrence of juvenile uterine bleeding, therefore the next therapeutic step is anti-relapse therapy aimed at eliminating the true cause of the bleeding - hormonal dysfunction. With the help of hormonal preparations, the normal menstrual cycle inherent in a particular patient is recreated. As a rule, anti-relapse treatment continues for three months.
Dysfunctional uterine bleeding of the reproductive period is also treated in stages:
Stage I Stopping bleeding.
1. Symptomatic hemostasis. It includes means to reduce the musculature of the uterus, as well as preparations of hemostatic action.
2. Surgical hemostasis. Scraping uterine cavity. The method leads among menopausal women due to increased risk of development.
3. Hormonal hemostasis. It is justified only for young women who have not realized the reproductive function of women who do not have indications of endometrial pathology in the history.
Stage II. Recreation of the normal menstrual cycle and relapse prevention.
1. Vitamin therapy: folic acid, vitamins E, B, C.
2. Homeopathic medicines that regulate menstrual function: Remens, Mastodinon and the like.
3. Hormone therapy. The medicine is chosen according to the patient's age and the nature of the hormonal dysfunction.
Stage III. Restoration of the ability to reproduce.
Conducted among young women planning pregnancy. Ovulation stimulating agents are used.
During menopause, dysfunctional uterine bleeding also implies a phased therapy. First, at the first stage, surgical hemostasis (curettage) is often performed. Subsequent hormonal treatment is aimed at suppressing ovarian activity and the formation of atrophic changes in the endometrium.
How to stop uterine bleeding
Any abnormal uterine bleeding should be eliminated with a qualified technician. However, women do not always seek help, preferring to cope with non-intensive bleeding on their own.
Indeed, sometimes the bleeding is very successfully stopped by the woman herself. But, since hemostasis is only the first stage of therapy, without subsequent adequate treatment, uterine bleeding can not only recur, but also return accompanied by more serious symptoms.
If a woman knows about the cause of uterine bleeding and is sure that there is no serious reason behind it, it is possible to try to stop it yourself.
Infusions and decoctions of herbs cause a good hemostatic effect. They are used not only as monotherapy, but also as part of a complex treatment, enhancing its effect and shortening the treatment time.
Clinically proven pronounced hemostatic effect of nettle, shepherd's bag, yarrow, burnet.
Women who have already experienced episodes of uterine bleeding in the past and know their cause, use well-known and "proven" drugs. Dicine with uterine bleeding is perhaps the most popular hemostatic agent. It affects the vascular wall, reduces its permeability and restores the normal mechanism of blood coagulation. Ditsinon is used in uterine bleeding in pill or injection form.
Tranexam for uterine bleeding is also very effective. It enhances blood clotting processes and thereby stops the bleeding. An additional effect of the drug is its anti-allergic and anti-inflammatory effect. Tranexam is used for uterine bleeding of a dysfunctional nature, with heavy menstruation.
When choosing a drug and a method for its administration, it should be remembered that even the most innocuous medication has adverse side effects and contraindications, therefore, when starting a self-liquidation of uterine bleeding, a woman risks harming her health.
Even if uterine bleeding is stopped, a visit to the doctor is necessary to determine its exact cause and subsequent anti-relapse treatment.
Independent hemostatic measures can also be carried out in the presence of an emergency situation while waiting for an ambulance car, when there is a lot of uterine bleeding, severe pain and feeling unwell. In order to reduce negative symptoms, it is necessary to lie down on a hard surface, slightly raising the legs, put something very cold on the stomach - a “bubble” with ice, any bag of frozen food, a container filled with very cold water (for example, a bottle). You can also attach ice (for example, ice cubes in the package). Pre-cold should be wrapped with a cloth to avoid contact frostbite. It is also necessary to replenish the fluid lost by the body during bleeding. It should drink more water, sweet tea or herbal decoctions.
If uterine bleeding is associated with a hormonal contraceptive, you should inform your doctor and get recommendations about its replacement. It should be remembered that abrupt withdrawal of hormonal contraceptive can cause uterine bleeding or strengthen the existing one.
Preparations for uterine bleeding
To eliminate uterine bleeding, drugs of different pharmaceutical groups are used:
1. Means that enhance contractions of the uterine muscles (Oxytocin, Methylergomentrin, Ergotamine, and the like). From phytopreparations used tincture of water pepper, shepherd's bag extract.
Reinforced uterine contractions quickly evacuate the contents of the uterus and spasm bleeding vessels, causing their obstruction.
2. Antihemorrhagic and hemostatic drugs. Accelerate the blood clotting time, restore the normal tone of the wall of small vessels and narrow their lumen. The most popular are Ditsinon, Calcium chloride 10%, Calcium gluconate 10%, Vikasol, Ascorbic acid, Tranexam.
3. Hormonal hemostatic agents. Perhaps the most extensive drug group. A significant list of available hormonal drugs allows you to choose the necessary combination of hormones in the composition of the drug in order to eliminate hormonal failure and stop uterine bleeding in women belonging to different age categories.
Juvenile uterine bleeding is stopped with the help of gestagens (Duphaston, Norkolut, Utrogestan), combined drugs (Non-ovlon, Microgene).
Dysfunctional uterine bleeding of the reproductive period is eliminated using monophasic hormonal contraceptives (Microgenon, Marvelon, Femoden), gestagens (progesterone derivatives) or estrogens (Estradiol, Sinestrol).
Dysfunctional bleeding of the premenopausal period is stopped with the help of gestagens (Norcolut, Orgametril, Progesterone derivatives) and antigonadotropic drugs (Danazol, Gestrinone).
Postmenopausal uterine bleeding undergoes surgical treatment.
The health of a woman’s genital sphere affects her general condition, reproductive function and psychological mood. Almost every woman at one time or another experienced uterine bleeding. Although bleeding from the vagina can occur for a lot of completely harmless reasons, sometimes it signals problems with childbirth and poses a threat to the health of the woman herself.
Menstrual bleeding: blood loss rates
Monthly menstruation (physiological rejection of the endometrium of the uterus, accompanied by bleeding) is the norm. Usually, the first menstrual bleeding occurs in 11-16 years. However, due to the acceleration of the younger generation and the early puberty, these periods vary.
Important! Regular menstruation, which began at 8 years and earlier, as well as their absence after 16 years, signals hormonal pathology and requires professional examination.
The process of rejection of the endometrium (menstruation) lasts 3-7 days and is repeated after 21-28-35 days. During one menstruation, a girl / woman loses 50-80 ml of blood, and the rejected endometrium enters this volume. Actually blood is lost only about 1 tbsp. spoons. More intensive menstrual bleeding with clots gradually lead to the development of anemia.
Regular menstruation is stopped during pregnancy, after childbirth and for some time during breastfeeding. Gradually, menstruation subsides (the production of sex hormones stops) at 45-55 years. In the postmenopausal period there is no bleeding of the endometrium.
Important! On the 7th day after fertilization and in the early stages, a pregnant woman may experience 1-2 day scanty excretions. Usually their beginning coincides with the estimated period of menstruation. Due to a lack of progesterone and pose a threat to pregnancy.
Types of bleeding from the uterus
According to physiological periods of sexual functioning, blood outflows from the uterus are distinguished:
- juvenile - the stage of sexual formation of the body (up to 18 years),
- reproductive - childbearing age,
- menopausal - in menopause.
By the nature of the pathological bleeding are considered:
- menorrhagia - long (8 days or more) and abundant menstrual rejection (more than 80 ml),
- metrorrhagia - single, often meager bleeding in the intermenstrual interval,
- polymenorrhea - menstrual rejection with intermenstrual intervals shorter than 21 days,
- menometrorrhagy - irregularly arising prolonged bleeding from the uterus.
Symptoms of uterine bleeding
- menstruation for more than 8 days or unplanned bleeding,
- nagging pain, localization - in the lower abdomen, in the lower back,
- menstrual rejection is more abundant than usual (blood loss reaches 120 ml), with large blood clots (hygienic tampons and pads are rapidly getting wet) or scanty, long-lasting,
- pale skin
- dizziness, possible fainting,
- nausea, vomiting possible,
- rapid pulse, decrease in pressure,
- a blood test reveals anemia.
Characteristic signs of uterine bleeding:
- Dysfunctional bleeding is painless.
- The normal duration of bleeding after childbirth is up to 2 months.
- Prolonged, profuse bleeding after an abortion indicates the presence in the uterus of fetal tissue residues or inflammation.
- Small bleeding after copulation is not dangerous, but I demand clarification of the reason.
- Breakthrough bleeding due to hormonal contraception requires a dose change or withdrawal of the drug.
- With polyps in the uterus, menstruation is painful, small lumps and clots come out with blood.
- The fibroid inside the uterus is manifested by particularly heavy bleeding.
- Ectopic pregnancy provokes bleeding for 4 weeks., Accompanied by severe abdominal pain.
- Кровотечения при климаксе часто связаны с онкологией.
- Внутреннее кровотечение сопровождается всеми общими симптомами (обмороки, слабость, анемия и т. д.) за исключением внешнего кровотечения. Обязательна неотложная помощь.
To determine the cause of uterine bleeding is carried out:
- consultation of the gynecologist, endocrinologist, oncologist,
- blood tests (general, biochemistry, sex hormones and thyroid gland),
- Ultrasound of the uterus, thyroid gland,
- X-ray of the Turkish saddle (brain), rheoencephalogram,
- vaginoscopy, posterior posterior vaginal fornix is possible,
- cervical biopsy,
What to do when uterine bleeding?
The first thing to do is call an ambulance. This is especially true for pregnant women and those cases where the condition worsens very quickly. It is necessary to call an ambulance as soon as possible, because every minute can be decisive.
Secondly, they will independently consult a doctor, because only a specialist will be able to give an adequate assessment, assessing the condition of a woman and find out the reason.
You can not: put warm warmer, douche, take warm baths, use drugs, reducing the uterus.
How to stop uterine bleeding:
- Comply with bed rest. Legs should be kept in a raised position, for example, by placing a cushion or pillow under them. This will allow the blood to function in vital organs (kidneys, liver, brain). With significant blood loss - reduce the risk of fainting, severe complications,
- Chill on lower abdomen. It can be an ice pack wrapped in cloth to prevent frostbite, or a heating pad filled with cold water. Ice hold for 10-15 minutes, then make a 5-minute break. Repeat the procedure for 1-2 hours. The cold constricts the vessels, thereby reducing bleeding,
- Replenish the water balance of the body. If it is not possible to put a dropper, plenty of drinks will help, for example, sweet tea, rosehip tea, water, etc. Water in this case will compensate for the loss of fluid that has come out with the blood. Glucose feeds tissues and, most importantly, brain nerve cells,
- Medicines. They should be taken only after consulting a doctor or in an emergency case: Ditsinon (0.25 g inside 4 p / d), Calcium Gluconate (1 tab. 4 p / d), Aminocaproic acid (30 ml 5 p / d), Vikasol (0,015 g 3 r / d), tincture of nettle or water pepper (100 ml 3 r / d). The above means increase the activity of the muscles of the uterus, but during pregnancy they are not recommended.
Measures taken in the hospital
Some hemostatic agents used in uterine bleeding have already been listed above, for example, Aminocaproic acid, Ditsinon. However, in a medical institution they are administered either intravenously or intramuscularly. At home, these procedures are not performed. Everything must be done under the supervision of doctors and medical staff.
To stop blood loss, hormonal preparations can be used, for example, combined oral contraceptives (monophasic) or gestogen. This method is suitable for nulliparous young women who are not at risk of developing tumors in the endometrium.
Also, hormonal drugs are used in the case when the woman was curetted for diagnostic purposes less than 3 months ago, and at the same time she did not have a pathology in the endometrium.
The second option is hemostatic drugs. In addition to the above, Tranexam is used, as well as Ascorutin for strengthening the walls of blood vessels, and for the tone of the uterus Ergothal and Oxytocin.
Methods of surgical bleeding are also used. The main one and the most effective is the cervical canal. It is held for women of reproductive age and during menopause.
For the same purposes, prescribe cold treatment, or cryodestruction. Using liquid nitrogen destroy the upper modified layer of the uterus. This procedure has no contraindications and gives a lasting positive result.
Ablation is the removal of the endometrium with a laser, loop, ball electrode, or electromagnetic energy. The procedure is performed only for women who are not interested in having children in the future.
The complex is used and symptomatic treatment. It is necessary to eliminate the adverse effects caused by large blood loss. For example, a woman may be given infusion therapy.
In the vast majority of cases, it is not complete without drugs for the treatment of anemia. If the anemia is very severe, they are administered intramuscularly, in other cases, the funds are taken orally.
When the cause of uterine bleeding are stresses, poor lifestyle, emotional turmoil, you may need treatment with sedatives. Take care of yourself and be healthy!
Every woman should pay special attention to her menstrual cycle, because this is an important indicator of reproductive health. And unfortunately, quite often it proceeds with various deviations. Thus, a common complaint is considered monthly in the middle of the cycle. How to interpret them and what to look for the cause of such a state are topical issues that require an adequate solution. But the answers lie only in the plane of medical qualifications.
Before considering any irregularities in the menstrual cycle, it is important to understand how it works and what caused the periodic changes in the female body. The main regulators of reproductive function are hormones of the pituitary (follicle-stimulating, luteinizing) and ovaries (estrogens, progesterone). The former stimulate the production of the latter, maintaining their necessary concentration in the blood.
The menstrual cycle normally has a duration of 21 to 34 days. On average, women expect the next discharge 28 days, that is, almost a month. After their completion, the first phase of the cycle begins: the follicle matures in the ovary, the plasma concentration of estradiol gradually increases, and the endometrium heals (proliferates). At about 14 days - just in the middle of the cycle - ovulation occurs, marked by the release of the egg from the dominant follicle. After that, it forms a corpus luteum, which produces progesterone, which formed the basis of the second phase (lutein). Under the influence of the hormone, the endometrium swells, secretes mucus and prepares to receive a fertilized egg. And, without waiting for the implantation of the embryo, rejected again during the next menstruation.
Causes of deviations
Based on the physiology of the process itself, menstruations cannot begin in the middle of the cycle, because at this time the endometrium should already fully recover and prepare for the transition from the proliferative to the secretory phase. The only thing that should not cause concern is a scant, low-level discharge. This phenomenon is called ovulatory bleeding and can occur in many women. It is associated with increased sensitivity of the uterus to hormonal influences, but should not occur continuously and last more than 3 days. Otherwise, you have to look for another cause of menstrual dysfunction.
In modern life there are many stress factors that can not but affect women's health. It is very easy to shake hormonal balance in the body, especially when exposed to the following factors:
- Physical overwork.
- Emotional stress.
- Irrational food (including "progressive" diets).
- The use of drugs (oral contraceptives, antidepressants).
- Change of climatic zones.
- Overheating and hypothermia.
- Chemical intoxication.
- Ionizing radiation.
In addition, there are other states where hormonal changes are formed due to pathological processes in the gynecological field, as well as in other systems. Therefore, women with an irregular cycle should be examined for:
- Inflammatory diseases (adnexitis, endometritis, colpitis).
- Polycystic ovary.
- Tumor processes (fibroids and uterine polyps).
- Anomalies of the structure of the uterus (inflection of the body, two-leggedness, etc.).
- Severe diseases of the liver, kidneys, heart.
It should be noted that menstruation may begin earlier due to the reduction of the cycle itself and the displacement of ovulation during hypermenstrual syndrome. Such bleeding also occurs due to the use of intrauterine contraceptives, after certain diagnostic and therapeutic procedures (curettage, cervix conization, etc.).
The cause of bleeding in the middle of the cycle is often hidden in such acute conditions as ovarian apoplexy or spontaneous abortion. They should not be overlooked, since there is a high risk of undesirable consequences. And there are quite physiological explanations of menstrual bleeding - in adolescence and menopause. Therefore, the question of their origin is quite capacious and complex, requiring a qualified approach to differential diagnosis.
Intermenstrual bleeding can occur due to the negative influence of external and internal factors. But there are quite physiological cases.
To understand what caused the mid-cycle discharge, similar to the monthly, you need to create a complete picture of what is happening. Primary diagnosis begins with a survey, the result of which is expressed in complaints, i.e., subjective symptoms. And objective signs can be identified during the examination and physical examination. This is exactly what the doctor at the reception is doing.
In addition to the nature of the bleeding itself, it is imperative to find out if there are any more symptoms. They can provide important information and guide you along the right diagnostic path. Therefore, not only gynecological, but also general clinical examination of the patient. And it would not hurt to understand what signs are accompanied by the most common and most dangerous states related to intermenstrual bleeding.
Fibromyomas are detected in many women, but not all of them immediately begin to show themselves. It all depends on the location and size of the tumor. If the fibroma is located in the submucosal layer, then bleeding during ovulation is not uncommon. Moreover, it can appear at almost any time (acyclic). Menometroragii are accompanied by other signs:
- Feeling of heaviness and pressure in the uterus.
- Spastic abdominal pain.
When the tumor reaches a large size, it begins to squeeze the surrounding organs. In such cases, there is frequent urination, constipation, back pain and perineum. Fibroma is not a serious obstacle to pregnancy, but can significantly complicate its course.
Infectious-inflammatory process in the genital organs invariably leads to menstrual dysfunction. And this is most pronounced with endometritis, when the menstrual substrate itself is affected - the mucous membrane of the uterus. It cannot heal adequately and periodically corrects, including in the middle of the cycle. But there are other signs suggesting a diagnosis:
- Aching pain in the abdomen.
- Vaginal discharge (dull, with an unpleasant smell).
- Temperature rise.
On palpation of the abdomen, the uterus is painful, slightly enlarged and has a soft texture. If the inflammatory process is not stopped in time, the infection can spread to the circulatory tissue (parametritis) and the peritoneum (peritonitis). There are also chronic endometritis, which create difficulties for the implantation of the ovum and carrying the child.
If the period began somewhere in the middle of the cycle, then you should think about the phenomenon of hypermenstrual syndrome. It can appear in various pathologies, not necessarily only gynecological, and is characterized by the following features:
These medical terms refer to an increase in the frequency, duration and volume of menses, respectively. With a significant reduction in the cycle, the impression may be created that the period comes in the middle, but ovulation also shifts over time.
Frequent menstrual periods with hypermenstrual syndrome - evidence of the reduction of the female cycle.
During ovulation, some women may have ovarian hemorrhage. This is an acute situation that requires immediate diagnosis and the same rapid treatment. These symptoms help to suggest apoplexy:
- Intense pain in the lower abdomen (on the one hand).
- Slight bleeding in the middle of the cycle.
- General weakness.
Palpation of the abdomen marked tension of the abdominal muscles, a sharp pain on the side of apoplexy. Vaginal discharge may not be, but much more serious internal bleeding, which can cause hemorrhagic shock.
In the early period, a woman may not know that she is pregnant, but this does not insure against obstetric pathology. And the discharge, taken by her for intermenstrual bleeding with an extended cycle, can speak about a spontaneous abortion that has begun. Then other signs will appear:
- Spastic pains in the lower abdomen and in the sacral area.
- Frequent urination.
- Urging to stool.
The fetal egg, as a rule, leaves completely, but its separate parts can remain in a cavity of a uterus. In such cases, the risk of bleeding, infection, DIC increases.
Along with the clinical examination, additional diagnosis is required to clarify the nature of menstrual dysfunction and its origin. Methods prescribed by a doctor are defined in the standards of care and may include the following laboratory and instrumental procedures:
- Complete blood count (red blood cells, white blood cells, platelets, ESR).
- Blood biochemistry (hormones, acute phase indicators, antibodies to infections, coagulogram, etc.).
- Analysis of vaginal discharge.
- Ultrasound of the pelvic organs.
And when it becomes clearly known what led to the appearance of intermenstrual bleeding, treatment should be started. The doctor will determine the most effective tactics that will take into account the individual characteristics of the woman and restore her menstrual function.