Uterine bleeding with menopause is a discharge of bloody nature from the vaginal area, having different degrees of intensity, which are formed along with the extinction of reproductive functionality, accompanied by the cessation of the menstrual cycle. Uterine bleeding during menopause may have a different duration, frequency, amount of blood lost, and the nature of the course (that is, with or without blood clots). They can also be dysfunctional or organic.
Read more about uterine bleeding.
Bleeding with menopause and its causes are established according to the following types of examinations:
- gynecological examination,
- ultrasound procedure,
- biopsy or RDV (separate diagnostic curettage), in which part of the surface layer of the endometrium is removed to study and make an accurate diagnosis,
- histological analysis.
Treatment of bleeding during menopause depends on the true cause of its occurrence. A conservative method of treatment with medication or surgical intervention can be chosen.
The occurrence of dysfunctional uterine bleeding in the menopausal period is characterized as an unexpected onset of bleeding from the vaginal area, which can occur at any stage of menopause: in premenopause, in menopause, or in menopause.
Abundant bleeding is one of the most frequent reasons why mature women who have reached the age of 45-50 are hospitalized in the gynecology. The factors contributing to the occurrence of such pathological manifestations, in most cases, depend on the stage of menopause.
According to statistics, bleeding in menopause in a quarter of all cases is combined with pathology such as fibroids. Up to 20% of cases of bleeding with endometriosis, and up to 10% with the development of polyps in the endometrial layer, were also recorded.
Regardless of the profusion of blood flow, as well as its duration and level of blood lost, dysfunctional uterine bleeding must be necessarily taken under the strict control of a qualified gynecological specialist. This is due to the fact that all the cunning and danger of such manifestations is that they can occur not only along with the development of hormonal changes in the body or benign neoplasm in the uterine cavity, but also to become evidence of the development of a malignant neoplasm.
Causes of bleeding in different phases of menopause
In the installation process of the true causes contributing to the formation of dysfunctional uterine bleeding, the main role belongs to the time period of the menopausal period, during which non-characteristic bleeding from the vaginal area began. The whole climacteric period is divided into 3 main phases of the flow:
- premenopauseduring which there is a change in the menstrual cycle, and pregnancy is still possible,
- menopausecoming along with the last menstrual cycle
- postmenopauseduring the development of which, a complete cessation of the reproductive functionality of the female body and atrophy of the ovaries is noted.
Uterine bleeding in menopause can occur throughout any period of time. Therefore, when making a diagnosis, the specialist takes into account the phase of development of the menopausal period.
Bleeding during menopause can be caused by the action of the following factors or causes:
- Violation of the functionality of the reproductive system. Even if the female reproductive system of the organs was in one hundred percent working capacity, this factor should not be discarded, since the uterus with the cervix, the endometrial layer, and the ovaries can contribute to the formation of bleeding.
- Hormonal restructuring of the body. Climax, includes inherent processes of change in metabolism, with a focus on reduction. But during the development of each phase of the climacteric period, hormonal disruptions may occur, accompanied by jumps in the production of sex hormones, which leads to a response to the blood reaction of the reproductive system of organs.
- The use of drugs. In menopause, to reduce the manifestation of the menopausal syndrome, specialists can prescribe the use of hormone-containing drugs, to which a similar reaction of the body can follow.
- The presence of pathological processes in varying degrees of existence, not associated with the reproductive organs.
Types of bleeding
Dysfunctional uterine bleeding in menopause can vary in the number of losses, the degree of duration and associated symptoms. All DMK are divided into:
- menorrhagic dischargecharacterized by a weekly duration, abundant intensity and cyclical nature of the flow,
- metrorrhagic bleeding, characterized by the appearance of bloody discharge with small volumes of discharge of blood and mucous discharge. Have a chaotic nature of the flow, can occur at any time
- menorrhagic discharge, characterized by a combination of the characteristic signs of previous types of bleeding and rather frequent formation, with a large amount of blood loss,
- polymenorrhagia - This menstrual bloody discharge, appearing cyclically, every 3 weeks.
All considered types of MQD refer to the general characteristics of the presented pathological condition of women. To make an accurate diagnosis, it is necessary to accurately determine the true cause of the pathology, which determines the development of a subsequent scheme of medical therapy.
Uterine bleeding in premenopausal
The pre-menopausal period in a woman’s life is different in that the body already has hormonal changes. Reproductive organs (ovaries) are still functioning, but their level of efficiency decreases markedly. This leads to the fact that bleeding can have the absolute unpredictability of its nature of manifestation and development.
It is very important to observe all their features. Appeal to specialists gynecological profile is needed if the following points appear:
- High profusion of discharge, manifested by frequent change of gaskets, more than 1 time in 2.5-3 hours.
- The presence of clots, lumps and fabric fibers on the surface of the strip.
- The appearance of postcoital discharge, in other words, after sexual contact with a partner.
- High incidence of hemorrhage, formed every 21 days and shorter time intervals.
- The absence of menstruation more than 2.5-3 months.
The first stage of development of the climacteric period is also marked by a pattern of development peculiar to it. Metrorrhagic hemorrhages appear in the majority of representatives of the beautiful half of humanity. A small amount of menstruation does not indicate a decrease in the volume of reproductive organs. It can be caused by the development of polyps in the uterine cavity, which during active growth contribute to the separation of the epithelial layer with bloody secretions.
Also, such a bleeding can be caused by the development of a tumor of different nature, which, along with the formation of a bleeding phenomenon, can also cause painful symptoms in the lower abdomen.
The emergence of menometer in the pre-menopausal period can cause a complete decline in physical activity, the cause of which will be a large amount of lost blood. The reason for the development of such hemorrhage can be not only hormonal disorders in the female body, but also the consequences of the development of such pathologies as:
- growth and development of polyps,
- polycystic ovaries.
The main and important aspect is the question of how pathological bleeding differs from the menstrual cycle, which with the onset of the premenopausal period begins to lose its cyclical nature and regularity of manifestation.
The differences lie in the fact that menstrual flow can have a thick texture, including small streaks of endometrial tissue and a darkish tint. Pathological bleeding is characterized by a brighter color, have a more liquid consistency, which very quickly leaves the vaginal area, even in the supine position.
Hemorrhage and pregnancy
In the climacteric period, at the initial stages of its development, the functioning of the ovaries is still maintained, and hence the likelihood of egg maturation. But the processes of ovulation lose the same cyclicality, so to prevent the occurrence of unwanted pregnancies at 44-50 years old, it is recommended to use contraception.
Dysfunctional uterine bleeding can be caused by the use of any kind of contraceptive drugs, as they also affect the hormonal changes.
In cases where women are not protected, pregnancy may occur, which may be manifested by bloody spotting and associated symptoms.
The appearance of hemorrhage in the postmenopausal period should strongly alert the woman and cause the priority question: “What is it? Norm, or pathology? "
The ovaries at this stage of menopause are no longer functioning, therefore the only reason related to the norms is the use of hormone-containing medications aimed at eliminating the menopausal syndrome. All other cases of occurrence of such manifestations relate to the development of pathological processes in the field of reproductive and other organs in a woman’s body.
Dysfunctional uterine bleeding in the postmenopausal period may occur due to the following reasons:
- the formation of a failure in the hormonal system of the body,
- development of fibroids in the uterine cavity,
- the formation of polyps
- vaginitis development
- the occurrence of hyperplastic processes in the endometrial layer of the uterine cavity,
- the formation of a malfunction of the organs of the endocrine system of the body.
Postmenopausal metrorrhagia is also a dangerous phenomenon that may indicate:
- On the occurrence of a malignant tumor in the cervix.
- On the development of cancer in the endometrial layer of the uterine cavity.
- About the presence of a tumor state in the ovaries.
Bleeding after menopause can be caused by atrophic processes of mucous surfaces and muscle fibers in the vaginal area, due to which mucous surfaces become very thin and have a high degree of trauma. At the slightest damage to their integrity, bloody branches are observed. But in any situation, it is necessary to find out the true cause of these bloody manifestations together with a qualified specialist.
Treatment of uterine bleeding with menopause
The treatment of this pathology in the menopausal period depends on the diagnosis. With a pronounced degree of profusion hemorrhage tablets can be used to stop the bleeding, among which are the most effective:
If the reception of these drugs does not achieve the desired effect, then curettage of the uterine cavity is performed, allowing not only to stop uterine hemorrhage, but also to send the obtained biological materials for biopsy and to establish a more accurate cause of their occurrence.
As an additional treatment for bleeding in menopause, such herbs as:
But do not forget that before using the decoctions of the herbs presented, you should consult with a specialist.
Many women, noting that they have bloody, uncharacteristic secretions, do not rush to seek medical advice and help, which is a potential danger to the female body. Therefore, in order to prevent the development of serious pathologies and subsequent surgical treatment with the elimination of the reproductive organs, it is necessary to consult specialists in a timely manner, stop the pathological hemorrhages in time, and eliminate the causes contributing to their occurrence.
Interesting video on this topic:
Climax - a physiological phenomenon in the life of a woman, comes in all differently, on average it is the age of 45–52 years. Do not think that uterine bleeding in this age period, a natural phenomenon. This condition can be a sign of serious illness and requires the supervision of a doctor.
Completion of the reproductive function is not a one-time business, the reproductive system is being rebuilt slowly. This period can last up to 10 years. Gradually, the ovaries decrease in size, the amount of sex hormones produced decreases. The connective tissue grows and occupies the space of the gland, the number of released and mature eggs decreases.
The menstrual cycle fails, the intervals between periods grow. The balance of hormones is disturbed, their fluctuations lead to "tides". There is a feeling of a hot wave on the face in the chest and neck, then there is a strong sweating, fatigue, headache, chills.
Causes of bleeding
The egg supply is predetermined with the birth of a girl, with each ovulation they are spent. When their stock is reduced to a minimum, menstruation stops. The extinction of the reproductive function has three periods. In premenopause, the cyclical nature of menstruation is disturbed, they appear rarely and spontaneously. The onset of menopause is the last menstruation, the next stage is postmenopause.
Discharge can disturb a woman in any period of menopause. A visit to the doctor will provide an opportunity to find out the causes, establish the diagnosis and prescribe the necessary treatment in accordance with the stage of menopause. The causes of bleeding in a woman after menopause can be the following:
- the body's response to hormone jumps,
- diseases of the female genital and reproductive organs,
- use of certain medications
- diseases of other organs and systems.
During the premenopausal period, the reproductive functions are just beginning to fade. Uterine bleeding at this time may be associated with the use of oral contraceptives or the presence of a spiral in the uterus. Also at this time, an ectopic pregnancy with subsequent bleeding may occur.
Types of bleeding
Bleeding with menopause have different duration and number of discharge, characterized by other signs. More than half of all women experience breakthrough ovulation. It occurs during the premenopause. This is due to the fact that at a certain point the release of hormones increases dramatically, which contributes to the growth of the follicle, ovulation and subsequent bleeding. But in postmenopausal women, such a phenomenon is rare, so the diagnosis of bleeding is easier, since menstruation is no longer observed.
Polymenorrhea - bleeding that occurs regularly, with an interval of less than 21 days. Occur in women entering the period of menopause. Abnormal bleeding - menorrhagia - lasts more than a week, with a blood volume of about 80 ml. Menometrorrhagia is characterized by the duration of abundant hemorrhage, at irregular intervals. More often observed in the premenopausal phase.
With metrorrhagic discharge scanty, observed frequently and irregularly, more characteristic in the postmenopausal period. General characteristics do not provide a clear picture of the pathology, the possible causes and diagnosis are individual for each patient, taking into account the current period of menopause.
Hops hormone levels in menopause affect not only the menstrual cycle. The nervous system, the gastrointestinal tract is affected. The musculoskeletal apparatus, organs of the cardiovascular system are altered.
When menopause occurs, the involution of the hypothalamus occurs, its sensitivity to hormones and regulatory function are reduced. With insufficient exposure to the pituitary gland, the release of substances responsible for the maturation and release of the egg decreases. Endometrial function is impaired, it exfoliates prematurely, uterine bleeding appears in postmenopausal women.
Imbalance of sex hormones - the predominance of estrogen, leads to increased proliferation of the endometrium, which provokes abnormal menstrual bleeding. During postmenopausal ovaries have already developed their resource, so the imbalance of hormones and blood can be explained by taking hormonal drugs to eliminate the unpleasant symptoms of menopause.
Both hypo-and hyperthyroidism provoke a violation of the cycle. With insufficient production of thyroid hormone, bleeding often occurs, or there is a complete absence of menstruation.Hormonal failure in a woman's body often leads to diseases of the pelvic organs.
Uterine fibroids can occur at any age, often in women closer to menopause. This is a benign muscle tumor. In the uterus appears compacted myoma node size from millimeters to ten centimeters. With the rapid growth and the formation of several nodes, pain and bleeding appear. Sometimes after menopause, the tumor disappears completely.
The inner layer of the uterus is very sensitive to hormonal changes. The growth of the endometrium is often found in the period of the onset of menopause. According to the mechanism of occurrence, several types of hyperplasia are distinguished - glandular, cystic, glandular-cystic. The main reason for the formation of hyperplasia is a lack of the hormone progesterone and an excess of estrogen.
Polypous hyperplasia is characterized by excessive proliferation of the connective tissue of the uterus. The polyp consists of the body and legs, is attached inside the body, often at the bottom of the uterus. Polyps can be single or multiple. Pathology is characterized by severe pain and bleeding after menopause. Polypoid hyperplasia is close to a precancerous condition.
An ovarian cyst is a sac filled with fluid. The causes of appearance are associated with the production of large amounts of male hormones. When polycystic in the ovaries accumulates a lot of follicles. They grow, but do not mature, turning into functional cysts. The ovum does not come out, and ovulation happens very rarely, almost absent. After menopause, the risk of developing oncology increases.
After the cessation of menstruation, cervical cancer and ovarian tumors can be a common cause of bleeding. Since bleeding is one of the first symptoms of pathology, it is impossible to ignore this symptom and promptly consult a gynecologist for help.
In menopausal women, a woman has weak vaginal muscles, mucosal atrophy, which becomes thinner and fragile. If the integrity of the mucous membranes is violated and vascular damage occurs, the uterus may bleed.
Sometimes bleeding after menopause can occur due to low platelet levels in the blood. Laboratory research will help confirm this fact. In this case, carry out the adjustment of the functions of the circulatory system.
Uterine Bleeding Therapy
With severe bleeding, you must call an ambulance. It is better for a woman to lie down, to put cold on her stomach. You can take a tablet Vikasol, you can not use a heating pad, take a hot bath, douche. Even with a slight discharge of blood, the problem should be solved at the level of professional assistance.
The examination examines the patient's blood for hormone levels, clotting and biochemical composition. A biopsy and smears for tumor markers. Perform transvaginal ultrasound or MRI of the reproductive organs.
Treatment of uterine bleeding depends on the diagnosis. In the first stage, injectables are prescribed to stop bleeding, as well as drugs that relieve uterine tone. In the absence of the effect, curettage is shown, since this will accelerate the release of the discharge, will allow to make an analysis of tissues.
If there are no pathological causes, and bleeding during menopause is associated with an imbalance of hormones, treatment is performed using hormonal means. At risk of developing cancer, treatment is radical. Sometimes, to save the life of a woman, the doctor has to remove both the uterus and ovaries.