Stop uterine. How to stop uterine bleeding at home? Breakthrough uterine bleeding

Uterine hemorrhage is the loss of blood from the uterus, except for natural causes such as menstruation or labor bleeding. Dysfunctional uterine bleeding is a pathology associated with impaired production of sex hormones.

Such bleeding is accompanied by a large number of gynecological abnormalities, and can also act as independent disease. Abnormalities of uterine bleeding can occur at any period of a woman’s life, from infancy, when the discharge does not require treatment, to menopause, when it is the cause of serious pathology.

Most often, dysfunction occurs in young girls during puberty and is called juvenile. Uterine bleeding is expressed in prolonged duration and abnormal discharge large quantity blood during menstruation. At the same time, it is typical periodic occurrence amenorrhea. Pathological bleeding leads to the development of iron deficiency - anemia.

Uterine bleeding is the main manifestation of ovarian dysfunction or inflammatory processes in the pelvic organs. Uterine bleeding according to its symptoms can be distinguished as follows:

• Polymenorrhea – frequent menstruation, recurring every 21 days;
• Hypermenorrhea – heavy and prolonged menstruation for more than a week;
• Metrorrhagia – mild intermenstrual bleeding;
• Menometrorrhagia is irregular but prolonged bleeding.

Uterine bleeding can be divided into types according to age criteria:

1. Uterine bleeding in newborns, as a result of changes hormonal levels and do not require treatment.
2. Uterine bleeding in girls before puberty and under 10 years of age, associated with the formation of hormonally active tumors.
3. Juvenile uterine bleeding, in girls 12-18 years old, with the onset of monarchy.
4. Uterine bleeding of reproductive age up to 45 years. There are organic, dysfunctional, and may be associated with pregnancy or childbirth.
5. Uterine bleeding during menopause occurs due to organ disease or hormonal imbalance.

There are 3 causes of uterine bleeding, which are closely related to age and the nature of the ovaries:

• Organic bleeding is the result of abnormalities in the pelvic organs or systemic diseases.
• Dysfunctional bleeding – ovulatory or anovulatory.
• Iatrogenic bleeding - as a result of taking hormonal drugs or other medications that thin the blood. Installation of an intrauterine device.

If uterine bleeding is not associated with the stages of puberty, then such bleeding may occur for the following reasons:

• Ovarian dysfunction;

• Provokes changes in menstrual function due to disruption of the production of sex hormones.
• Pathology of pregnancy;
• Pathological birth;
• Injuries after childbirth, remaining placenta particles.
• Consequences of abortion;
• Due to mechanical injury uterus. Bleeding can be caused by uncleaned fetal membranes.
• Inflammatory diseases of the reproductive organs caused by infection;
• Blood diseases;
• Pathologies of the kidneys and liver;
• Diabetes;
• Benign formations, which include polyps, ovarian tumors;
• The use of hormonal drugs, as therapy or contraception.
• Bleeding during pregnancy is associated with unfavorable development of the fetus. In the early stages, up to 12 weeks, bleeding precedes a miscarriage; in the later stages, it means improper attachment of the placenta and threatens premature birth.

Juvenile uterine bleeding is extremely common. The reasons for this pathology in girls of puberty can be:

• Dysregulation of hormones;
• Physical injuries;
• Mental trauma;
• Overwork and stress;
• Adrenal cortex dysfunction;
• Violations thyroid gland;
• Previous infections: measles, whooping cough, rubella, chicken pox;
• The result of a complicated birth in the mother.

Consequences of uterine bleeding

Symptoms of uterine bleeding are expressed in significant discharge menstrual blood. With this pathology there are long absence menstruation, and then manifests itself as bleeding of varying intensity. Uterine bleeding is dangerous at any age, as it can cause anemia - anemia.

The main symptom of uterine bleeding is vaginal discharge . Bleeding is considered normal if it is associated with the following reasons:

• Menstruation;
• Mechanical damage associated with abortion or curettage;
• Due to therapeutic and diagnostic procedures: removal of the intrauterine device or cauterization of erosion;
• Bleeding occurs during or after childbirth.

Abnormal bleeding occurring at any age is accompanied by the following symptoms:

• Intense discharge;
• Prolonged bleeding for more than two weeks;
• Discharge during the intermenstrual period;
• Blood clots in the discharge
• Weakness and fatigue;
• Dizziness and headaches;
• Low blood pressure (hypotension);
• Pale skin;
• Discharge of blood after sexual intercourse;
• Blood clots;
• Continuous bleeding after childbirth or abortion;
• Nagging pain in the lower back and lower abdomen;
• Sudden bleeding after menopause;
• Irregularity of the cycle;
• Bleeding in postmenopause;
• Anemia.

A characteristic symptom of pathological uterine bleeding is expressed in heavy discharge, when a sanitary pad or tampon is completely wet within an hour. In this state, it is difficult for a woman to cope with everyday activities, and she is forced to spend large quantity resting time.

Diagnosis of uterine bleeding mainly depends on the period in which this pathology occurred.

To diagnose juvenile uterine bleeding, the doctor needs to establish the following:

• History data: date of onset of menstruation and last menstrual period, physical development;
• Presence of complaints;
• Complete blood count, coaguloramma, prothrombin index, coagulation and bleeding time;
• Blood test for sex hormones: prolactin, estrogen, testosterone, progesterone, cortisol;
• Blood test for thyroid hormones: TSH, T4, T3;
• Measurement basal temperature between menstruation;
• Pelvic ultrasound to determine the condition of the endometrium;
• Ultrasound of the thyroid gland;
• Ultrasound of the adrenal glands;
• Ultrasound control of ovulation;
• To determine the state of the hypothalamic-pituitary system: radiography of the skull, echoencephalography, EEG (electroencephalogram of brain activity), CT scan, MRI.

If pathological uterine bleeding occurs during reproductive age, it is important to conduct the following studies:

• Collection of medical history and complaints;
• Gynecological examination;
• Should be excluded organic pathology: ectopic pregnancy, spontaneous abortion;
• Diseases of organs that cause bleeding;
• Hysteroscopy;
• Ultrasound abdominal cavity;
• Ultrasound of the pelvis.

In 30%, uterine bleeding develops against the background of menopausal syndrome. If bleeding occurs during menopause, then first of all it is necessary to differentiate them from menstruation, since as menopause occurs, ovarian function gradually stops, making menstruation irregular. To exclude pathologies, it is carried out diagnostic curettage endometrium and hysteroscopy is performed. Endometrial curettage can identify endometriosis. Fibroids, uterine polyps that can cause uterine bleeding. A pelvic ultrasound or CT scan can exclude the cause of uterine bleeding, which can be caused by an ovarian tumor. Other diagnostics of pathologies of uterine bleeding are determined individually by a gynecologist.

Treatment of uterine bleeding is aimed at restoring blood loss and stopping pathological bleeding. The cause of bleeding is also eliminated.

Juvenile bleeding

Treatment of juvenile dysfunctional uterine bleeding involves hemostatic measures. As treatment proceeds, recurrent bleeding is prevented. Conservative and surgical methods are used to stop uterine bleeding; the choice depends on the patient’s health status. If the choice falls on conservative treatment, then they use hemostatic and uterine contracting drugs, as well as progesterone drugs. After a certain number of days, the bleeding will stop.

When blood loss does not stop and leads to deterioration of the condition, hysteroscopy and antianemic therapy are performed.

Reproductive age

Treatment of uterine bleeding of reproductive age is determined after receiving the results histological analysis. If a relapse occurs, non-hormonal and hormonal hemostasis is performed. Next, it is necessary to take measures to correct the identified dysfunction, using hormonal treatment. It is necessary to regulate menstrual function.

During menopause

Treatment of uterine bleeding during menopause is aimed at suppressing hormonal function and menstruation, in other words, menopause is provoked. Bleeding can only be stopped by surgery - curettage and hysteroscopy or surgical removal of the uterus.

• It is recommended to prevent juvenile uterine bleeding proper nutrition, With increased level iron in products. Held general hardening body, rehabilitation of chronic infectious foci, as well as the use of gestagenic drugs.
• To prevent uterine bleeding during reproductive age, concomitant diseases must be treated, the neuropsychic state is normalized with the help of vitamins and sedatives. But if the treatment is chosen incorrectly, uterine bleeding can occur again.

Prevention of dysfunctional uterine bleeding should be carried out even during the period intrauterine development. Further, as the body develops, measures should be taken to generally strengthen the body, for example, hardening. Diseases, including those of the genital area, must be treated in a timely manner. In the event of uterine bleeding, it is necessary to take measures to restore the menstrual cycle, for this purpose a prescription is indicated hormonal contraceptives. Oral contraceptives reduce the likelihood of unplanned pregnancy and as a consequence of abortion. In addition, the drugs help bring the body into hormonal balance. It is also recommended to regularly visit a gynecologist, at least 2 times a year or more often.

Blood is the basis of vital activity of the human body. Any blood loss potential danger for human life and health. In women, the most common cause of blood loss is uterine bleeding. The incidence of uterine bleeding ranges between 12 and 30%, and the likelihood of uterine bleeding increases with a woman's age and decreases with the number of births and the duration of breastfeeding periods. And although in most cases, uterine bleeding does not pose an immediate danger to a woman’s life, it often leads to the development of anemia, worsens a woman’s well-being, appearance and mood, and limits her sexual, physical and social activity.

Uterine bleeding is normal

Physiological (normal) uterine bleeding includes only menses (period). Normally, the duration of menstruation is 3-5 days, the interval between the first day of the previous menstruation and the first day of subsequent menstruation (menstrual cycle) is 21-35 days (on average 28 days). As a rule, the first 1-2 days of menstruation, bleeding is scanty, the next 1-2 days are more abundant and last days– again meager. The total blood loss during menstruation should not exceed 50-80 ml (the total volume of discharge, together with the sloughing layer of the endometrium, which looks like mucus - no more than 150 ml - approximately 8-10 pads). Blood loss exceeding 80 ml is fraught with the development iron deficiency anemia.

Your period should be painless. The first menstruation comes at the age of 11-15 years. Menstrual function lasts throughout a woman’s reproductive period, interrupted during pregnancy, childbirth and breastfeeding. The end of menstrual function (the onset of menopause) occurs on average at the age of 45-55 years.

Important! The appearance of “menstruation” in girls before puberty (up to 10-11 years) and in women after menopause (cessation of menstrual function) – pathological sign, requiring immediate consultation with a doctor (children's, adolescent or adult gynecologist). In most cases, such spotting is a symptom of a serious illness.

Uterine bleeding - between normal and pathological

Bloody discharge in the middle of the menstrual cycle can be considered as a variant of the norm. The cause of such discharge is a sharp fluctuation in hormone levels during ovulation (immediately after it), which leads to increased permeability of the walls. uterine vessels, sweating through vascular walls red blood cells and the appearance of blood in vaginal discharge. Usually such discharge is scanty and lasts no longer than 1-2 days. However, in some cases, the appearance of spotting in the middle of the cycle is a manifestation of a hormonal imbalance or an inflammatory process, so when such discharge first appears, you should consult a gynecologist to rule out these diseases.

Another almost normal type of vaginal bleeding that is not associated with menstruation is implantation bleeding, occurring on the 7th day after conception. The cause of implantation bleeding is the implantation of the embryo into the wall of the uterus, during which partial destruction of the structures of the uterine mucosa occurs, which can lead to minor bleeding. However, in some cases, uterine bleeding during this period may be a manifestation of progesterone hormone deficiency and a sign of a threatened miscarriage.

Important! Even if, in your opinion, you have one of the two types of bleeding indicated, it is better to consult a doctor (as planned) and make sure that everything is really in order with your health.

Uterine bleeding - pathology

All other types of uterine bleeding are pathological. Depending on the reason, causing development bleeding, uterine bleeding are divided into functional (more precisely dysfunctional), organic and bleeding associated with systemic diseases(for example, diseases of the blood, liver, kidneys, thyroid gland). The last category of uterine bleeding is relatively rare.

Dysfunctional uterine bleeding- this is abnormal (frequent, excessively profuse or prolonged) bleeding from the uterus, which is based on a disorder hormonal regulation menstrual cycle. Disturbances in the hormonal regulation of the menstrual cycle are often caused by psychological stress, induced abortions(as a reason hormonal stress), the use of some medicines(for example, sleeping pills or antidepressants), insufficient and irrational nutrition, mental and physical fatigue. Most sensitive to the effects unfavorable factors The female body becomes unstable during puberty and before menopause, when ovarian function is unstable and subject to fluctuations. The cause of bleeding is insufficient or excessive formation of female sex hormones - estrogens and progesterone, which have a decisive influence on the condition of the uterus and the processes occurring in it. Dysfunctional uterine bleeding is divided into ovulatory (in which ovulation persists) and anovulatory (in which ovulation is absent).

Ovulatory uterine bleeding often occur against the background of inflammatory processes in the genital organs or adhesions in the pelvis. This type of menstrual cycle disorder is characterized by a shortening or lengthening of the interval between menstruation, followed by heavy, prolonged menstruation. Very often, women suffering from ovulatory bleeding experience spotting before and after menstruation, as well as spotting in the middle of the menstrual cycle. Ovulatory uterine bleeding is often accompanied by infertility and miscarriage as manifestations of hormonal imbalance in a woman’s body. Ovulatory bleeding occurs mainly in women of childbearing age.

Anovulatory uterine bleeding occur approximately 10 times more often than ovulatory ones. As already mentioned, with this type of uterine bleeding, ovulation does not occur, the corpus luteum does not form, and during the entire menstrual cycle, only one sex hormone is produced in the woman’s body - estrogen, and progesterone is absent. This state of affairs, if persisted for a long time, leads to the development of hyperplasia (excessive growth) of the uterine mucosa, the development of fibroids, endometriosis, and over time, endometrial cancer. Anovulatory uterine bleeding very often occurs in women before menopause(premenopause), somewhat less often - in teenage girls, and even less often - in women of reproductive age. Anovulatory uterine bleeding is characterized by the occurrence of bleeding after a delay in menstruation and a longer than normal duration of bleeding. Bleeding can be profuse or moderate, but due to its long duration it almost always leads to the development of anemia, which is externally manifested by pale skin, weakness, increased fatigue, drowsiness, loss of appetite, decreased blood pressure and increased heart rate.

Important! Any increase in the duration or intensity of menstrual bleeding is absolute indication to visit a gynecologist (this recommendation does not depend on the woman’s age, it applies to both adolescent and adult women). The heavier and longer the bleeding, the sooner medical attention is needed. In case of intense bleeding, it is necessary to call " ambulance"and agree to be hospitalized in a gynecological hospital.

Organic uterine bleeding associated with the presence of diseases such as endometriosis, uterine fibroids, endometrial polyps, cancer of the body or cervix, inflammatory diseases of the uterus and appendages. In these diseases, uterine bleeding occurs on any day of the menstrual cycle and has different intensities, nature of discharge and duration. This type of uterine bleeding is chronic and, along with the underlying disease, quickly depletes compensatory reserves female body.

Examination and treatment for uterine bleeding

Uterine bleeding in adolescence

The examination includes a consultation with a teenage gynecologist, pediatrician, neurologist, hematologist, and endocrinologist. The gynecologist conducts a gynecological examination (for virgins - through the rectum), evaluates the structure of the internal genital organs. Functional diagnostic tests are performed, a blood test for the level of sex hormones, an ultrasound of the pelvic organs, general and biochemical analysis s blood, according to indications (if diseases of the liver, kidneys, blood, etc. are detected), the examination is expanded.

When treating uterine bleeding in adolescents, drugs are prescribed that contract the uterus, hemostatic agents and strengthen the vascular wall, vitamins, herbal medicines, iron preparations, and in some cases, hormonal drugs(oral contraceptives) to regulate the menstrual cycle.

Uterine bleeding during reproductive age

Diagnostic measures for detecting uterine bleeding in a woman of reproductive age begin with curettage of the walls of the uterine cavity and cervical canal, followed by histological examination of the scraping obtained. Curettage not only allows you to identify the causes of bleeding, it also has a therapeutic effect - the removal of the defective layer of the endometrium, blood clots, as well as the mechanical effect on the walls of the uterus leads to a contraction of the uterine muscles and the cessation of bleeding. Additional methods of examination for uterine bleeding in adult women are ultrasound of the pelvic organs, hysteroscopy and hysterosalpingography, as well as general and biochemical blood tests, blood tests for hormone levels, consultations with related specialists.

Treatment of uterine bleeding in reproductive age (in addition to curettage of the walls of the uterine cavity, which is performed in 100% of cases to exclude precancerous and cancerous processes in the body and cervix) also consists of prescribing hormonal drugs, the action of which is aimed at restoring normal regulation of the menstrual cycle and preventing recurrences bleeding. From medicinal methods treatment, the same drugs are used as in the treatment of bleeding in adolescents. If the cause of uterine bleeding is an organic disease of the reproductive system (nodular form of uterine endometriosis, uterine fibroids, uterine cancer, recurrent endometrial hyperplasia), a surgical operation is performed to remove the uterus with or without appendages.

Examination and treatment for uterine bleeding in premenopause is carried out similarly to those for bleeding during the reproductive period.

Because the postmenopausal uterine bleeding in the overwhelming majority are a manifestation oncological pathology in the body, cervix or ovaries, treatment is carried out mainly surgically(removal of the uterus with appendages).

Uterine bleeding and pregnancy

Stand somewhat apart pregnancy-related uterine bleeding. These bleedings occur mainly during the reproductive period when a woman has sexual contact with men in her life. Most common reasons bleeding associated with pregnancy are miscarriage, ectopic pregnancy, bleeding from the vessels of the cervix in the presence of cervical diseases, placenta previa, premature abruption of a normally located placenta.

Miscarriage leads to the development of uterine bleeding, which is preceded and accompanied by cramping pain in the lower abdomen. The color of the blood during a miscarriage is bright red or dark red, and the bleeding intensity is often quite severe. As a rule, bleeding associated with a miscarriage occurs against the background of a delay in menstruation and the presence of other indirect signs pregnancy (morning sickness, changes in appetite, mood, etc.).

Bleeding during ectopic pregnancy also occurs after a missed period. The pain in the lower abdomen is cramping or constant in nature and is very intense. Often pain and bleeding are accompanied by nausea, vomiting, cold sweat, and fainting. Bloody discharge has dark color, with clots.

Bleeding from damaged vessels of the cervix is often contact - that is, it occurs after sexual intercourse, ultrasound with a vaginal sensor, gynecological examination. Such bleeding often occurs in the presence of pseudo-erosion of the cervix. As a rule, contact bleeding has the character of small spotting, sometimes - the appearance blood streaks as part of mucous vaginal secretions. However, in some cases the bleeding can be quite heavy. Only a doctor can distinguish contact bleeding from the cervix from uterine bleeding that occurs for another reason. Therefore, even slight spotting during pregnancy should be a reason to seek medical help.

Uterine bleeding caused by placenta previa, develops in the 2nd or 3rd trimesters of pregnancy. The cause of bleeding is the abnormally low location of the placenta, which in this case is located in the lower part of the uterus and blocks the exit from it. Bleeding develops against the background of complete health and is not accompanied by painful sensations, is often very abundant, which poses a threat to the life and health of the pregnant woman and her fetus.

In the second half of pregnancy, life-threatening uterine bleeding may develop due to premature detachment normally located placenta. This bleeding is often preceded by the threat of miscarriage, excessive physical activity, or a blow to the abdomen. Bleeding can have varying intensity (in some cases, most of the blood remains between the placenta and the wall of the uterus, increasing detachment, saturating the walls of the uterus and aggravating the condition of the woman and the fetus), accompanied by increased tone of the uterus, abdominal pain, and increased activity of the fetus.

Important! Bleeding from the genital tract during pregnancy is potentially very dangerous. Therefore, if even slight bleeding appears, you need to drop everything, call an ambulance and wait for the doctor, taking a horizontal position.

Finally

As you probably already understood, uterine bleeding can be a consequence huge amount reasons, which can be understood only by the amount, appearance of the blood released and accompanying bleeding general symptoms almost impossible. Therefore, any bleeding from the genital organs that differs from normal menstruation in the time of appearance, intensity, duration or nature of the discharge should become a danger signal for a woman of any age, a girl or a girl, and a reason to immediately contact a gynecologist. Take care of your health!

Uterine bleeding is the release of blood from uterus. Unlike menstruation, with uterine bleeding, either the duration of discharge and the volume of blood released changes, or their regularity is disrupted.

Causes of uterine bleeding

Causes of uterine bleeding may be different. They are often caused by diseases of the uterus and appendages, such as fibroids, endometriosis, adenomyosis), benign and malignant tumors. Bleeding can also occur as a complication of pregnancy and childbirth. In addition, there are dysfunctional uterine bleeding - when, without visible pathology of the genital organs, their function is disrupted. They are associated with a violation of the production of hormones that affect the genital organs (disorders in the hypothalamus-pituitary-ovarian system).

Much less often, the cause of this pathology can be so-called extragenital diseases (not related to the genital organs). Uterine bleeding can occur with liver damage, with diseases associated with blood clotting disorders (for example, von Willebrand's disease). In this case, in addition to the uterine, patients are also worried about nosebleeds, bleeding gums, bruising from minor bruises, prolonged bleeding from cuts, and others symptoms.

Symptoms of uterine bleeding

The main symptom of this pathology is bleeding from the vagina.

Unlike normal menstruation, uterine bleeding is characterized by the following features:
1. Increased blood volume. Normally, during menstruation, 40 to 80 ml of blood is released. With uterine bleeding, the volume of blood lost increases, amounting to more than 80 ml. This can be determined if there is a need to change hygiene products too often (every 0.5 - 2 hours).
2. Increased duration of bleeding. Normally, during menstruation, discharge lasts from 3 to 7 days. In case of uterine bleeding, the duration of bleeding exceeds 7 days.
3. Irregularity of discharge - on average, the menstrual cycle is 21-35 days. An increase or decrease in this interval indicates bleeding.
4. Bleeding after sexual intercourse.
5. Bleeding in postmenopause - at an age when menstruation has already stopped.

Thus, we can distinguish following symptoms uterine bleeding:

• Menorrhagia (hypermenorrhea)- excessive (more than 80 ml) and prolonged menstruation (more than 7 days), their regularity is maintained (occurs after 21-35 days).
• Metrorrhagia– irregular bleeding. They occur more often in the middle of the cycle, and are not very intense.
• Menometrorrhagia– prolonged and irregular bleeding.
• Polymenorrhea– menstruation occurring more frequently than every 21 days.

In addition, due to the loss of rather large volumes of blood, very common symptom This pathology is iron deficiency anemia (decreased amount of hemoglobin in the blood). It is often accompanied by weakness, shortness of breath, dizziness, and pale skin.

Types of uterine bleeding

Depending on the time of occurrence, uterine bleeding can be divided into the following types:
1. Uterine bleeding during the newborn period is scanty bloody discharge from the vagina, occurring most often in the first week of life. They are connected with what happens during this period abrupt change hormonal background. They go away on their own and do not require treatment.
2. Uterine bleeding in the first decade (before the onset of puberty) is rare and is associated with ovarian tumors that can secrete increased amount sex hormones (hormonally active tumors). Thus, so-called false puberty occurs.
3. Juvenile uterine bleeding - occurs at the age of 12-18 years (puberty).
4. Bleeding during the reproductive period (ages 18 to 45) can be dysfunctional, organic, or associated with pregnancy and childbirth.
5. Uterine bleeding during menopause is caused by impaired hormone production or diseases of the genital organs.

Depending on the cause of occurrence, uterine bleeding is divided into:

• Dysfunctional bleeding(can be ovulatory or anovulatory).
• Organic bleeding- associated with pathology of the genital organs or systemic diseases (for example, diseases of the blood, liver, etc.).
• Iatrogenic bleeding– arise as a result of taking non-hormonal and hormonal contraceptives, blood thinning drugs, due to the installation of intrauterine devices.

Juvenile uterine bleeding

Juvenile uterine bleeding develops during puberty (age 12 to 18 years). Most often, the cause of bleeding in this period is ovarian dysfunction - the proper production of hormones is adversely affected by chronic infections, frequent acute respiratory viral infections, psychological trauma, physical exercise, unhealthy diet. Their occurrence is characterized by seasonality - winter and spring months. Bleeding in most cases is anovulatory – i.e. due to disruption of hormone production, ovulation does not occur. Sometimes the cause of bleeding can be bleeding disorders, tumors of the ovaries, body and cervix, tuberculosis of the genital organs.
The duration and intensity of juvenile bleeding may vary. Heavy and prolonged bleeding leads to anemia, which is manifested by weakness, shortness of breath, pallor and other symptoms. In any case of bleeding in adolescence treatment and observation should take place in a hospital setting. If bleeding occurs at home, you can ensure rest and bed rest, give 1-2 tablets of Vikasol, put a cold heating pad on the lower abdomen and call an ambulance.

Treatment, depending on the condition, can be symptomatic - the following remedies are used:

• hemostatic drugs: dicinone, vikasol, aminocaproic acid;
• uterine contractants (oxytocin);
• iron supplements;
• physiotherapeutic procedures.

In case of insufficiency symptomatic treatment bleeding is stopped with the help of hormonal drugs. Curettage is performed only in cases of severe and life-threatening bleeding.

To prevent recurrent bleeding, courses of vitamins, physiotherapy, and acupuncture are prescribed. After bleeding has stopped, estrogen-progestin agents are prescribed to restore the normal menstrual cycle. Great importance V recovery period has hardening and physical exercise, proper nutrition, treatment of chronic infections.

Uterine bleeding during the reproductive period

During the reproductive period, there are quite a few reasons that cause uterine bleeding. These are mainly dysfunctional factors - when a violation of the proper production of hormones occurs after abortion, against the background of endocrine, infectious diseases, stress, intoxication, taking certain medications.

During pregnancy, in the early stages, uterine bleeding can be a manifestation of miscarriage or ectopic pregnancy. In later stages, bleeding is caused by placenta previa, hydatidiform mole. During childbirth, uterine bleeding is especially dangerous; the amount of blood loss can be large. A common cause of bleeding during childbirth is placental abruption, atony or hypotension of the uterus. IN postpartum period Bleeding occurs due to parts of the membranes remaining in the uterus, uterine hypotension or bleeding disorders.

Often, various diseases of the uterus can be the causes of uterine bleeding during the childbearing period:

• myoma;
• endometriosis of the uterine body;
• benign and malignant tumors of the body and cervix;
• chronic endometritis (inflammation of the uterus);
• hormonally active ovarian tumors.

Bleeding associated with pregnancy and childbirth

In the first half of pregnancy, uterine bleeding occurs when there is a threat of interruption of a normal or ectopic pregnancy. These conditions are characterized by pain in the lower abdomen, delayed menstruation, as well as subjective signs of pregnancy. In any case, if there is bleeding after pregnancy is established, you should urgently seek medical help. On initial stages Spontaneous miscarriage, with prompt and active treatment, pregnancy can be maintained. In the later stages, the need for curettage arises.

An ectopic pregnancy can develop in fallopian tubes, cervix. At the first signs of bleeding, accompanied by subjective symptoms of pregnancy against the background of even a slight delay in menstruation, it is necessary to urgently seek medical help.

In the second half of pregnancy, bleeding poses a great danger to the life of the mother and fetus, so it requires urgent medical attention. Bleeding occurs with placenta previa (when the placenta is not formed according to back wall uterus, and partially or completely blocks the entrance to the uterus), abruption of a normally located placenta or rupture of the uterus. In such cases, the bleeding may be internal or external, and requires an emergency caesarean section. Women at risk of such conditions should be under close medical supervision.

During childbirth, bleeding is also associated with placental previa or placental abruption. In the postpartum period, common causes of bleeding are:

• decreased uterine tone and ability to contract;
• parts of the placenta remaining in the uterus;
• bleeding disorders.

In cases where bleeding occurs after discharge from the maternity hospital, it is necessary to call an ambulance for urgent hospitalization.

Uterine bleeding during menopause

During menopause occurs hormonal changes body, and uterine bleeding occurs quite often. Despite this, they can become a manifestation of more serious diseases, such as benign (fibroids, polyps) or malignant neoplasms. You should be especially wary of the appearance of bleeding in postmenopause, when menstruation has already completely stopped. It is extremely important to see a doctor at the first sign of bleeding because... on early stages tumor processes respond better to treatment. For diagnostic purposes, separate diagnostic curettage of the cervical canal and the uterine body is performed. Then carry out histological examination scraping to determine the cause of bleeding. In case of dysfunctional uterine bleeding, it is necessary to select the optimal hormonal therapy.

Dysfunctional uterine bleeding

Dysfunctional bleeding is one of the most common types of uterine bleeding. They can occur at any age - from puberty to menopause. The cause of their occurrence is a violation of hormone production endocrine system– malfunction of the hypothalamus, pituitary gland, ovaries or adrenal glands. This complex system regulates the production of hormones that determine the regularity and duration of menstrual bleeding. Dysfunction of this system can be caused by the following pathologies:

• spicy and chronic inflammation genital organs (ovaries, appendages, uterus);
• endocrine diseases (thyroid dysfunction, diabetes, obesity);
• stress;
• physical and mental fatigue;
• climate change.

Very often, dysfunctional bleeding is a consequence of artificial or spontaneous abortion.

Dysfunctional uterine bleeding can be:
1. Ovulatory – associated with menstruation.
2. Anovulatory – occurs between menstruation.

With ovulatory bleeding, deviations occur in the duration and volume of blood released during menstruation. Anovulatory bleeding is not associated with the menstrual cycle and most often occurs after a missed period, or less than 21 days after the last menstrual period.

Ovarian dysfunction can cause infertility and miscarriage, so it is extremely important to consult a doctor promptly if any menstrual irregularities occur.

Breakthrough uterine bleeding

Uterine bleeding that occurs while taking hormonal contraceptives is called breakthrough bleeding. Such bleeding may be minor, which is a sign of a period of adaptation to the drug.

In such cases, you should consult a doctor to review the dose of the drug used. Most often, if breakthrough bleeding occurs, it is recommended to temporarily increase the dose of the drug taken. If the bleeding does not stop or becomes more profuse, additional examination should be carried out, as the cause may be various organ diseases reproductive system. Bleeding can also occur if the walls of the uterus are damaged by the intrauterine device. In this case, it is necessary to remove the spiral as soon as possible.

Which doctor should I contact if I have uterine bleeding?

If uterine bleeding occurs, regardless of the age of the woman or girl, you should contact gynecologist (make an appointment). If uterine bleeding begins in a girl or young girl, it is advisable to contact pediatric gynecologist. But if for some reason it is impossible to get to one, then you should contact a regular gynecologist at a antenatal clinic or a private clinic.

Unfortunately, uterine bleeding can be a sign not only of a long-term chronic disease of a woman’s internal genital organs, which requires routine examination and treatment, but also symptoms of an emergency condition. Emergency conditions mean acute diseases, in which a woman needs urgent qualified medical care to save her life. And if such help emergency bleeding will not be provided, the woman will die.

Accordingly, you need to contact a gynecologist at the clinic for uterine bleeding when there are no signs of an emergency. If uterine bleeding is combined with signs of an emergency condition, then you should immediately call an ambulance or use your own transport to as soon as possible get to the nearest hospital with a gynecological department. Let's consider in what cases uterine bleeding should be considered as an emergency.

First of all, all women should know that uterine bleeding at any stage of pregnancy (even if the pregnancy is not confirmed, but there is a delay of at least a week) should be considered an emergency condition, since the release of blood, as a rule, is provoked by threats to the life of the fetus and future mothers with conditions such as placental abruption, miscarriage, etc. And in such conditions, a woman should be provided with qualified assistance to save her life and, if possible, preserve the life of the gestating fetus.

Secondly, uterine bleeding that begins during or some time after sexual intercourse should be considered a sign of an emergency. Such bleeding may be due to pregnancy pathology or severe trauma to the genital organs during previous intercourse. In such a situation, help for a woman is vital, since in her absence the bleeding will not stop, and the woman will die from blood loss incompatible with life. To stop bleeding in such a situation, it is necessary to sutured all ruptures and injuries to the internal genital organs or terminate the pregnancy.

Thirdly, uterine bleeding, which turns out to be profuse, does not decrease over time, and is combined with severe pain in the lower abdomen or lower back, causes a sharp deterioration in health, paleness, decreased blood pressure, palpitations, increased sweating, and possibly fainting. General characteristics an emergency condition during uterine bleeding is the fact of a sharp deterioration in a woman’s well-being, when she cannot perform simple household and everyday actions (she cannot get up, turn her head, it is difficult for her to speak, if she tries to sit up in bed, she immediately falls, etc.), and literally lying flat or even unconscious.

What tests and examinations can a doctor prescribe for uterine bleeding?

Despite the fact that uterine bleeding can be provoked by various diseases, when they occur, the same examination methods (tests and instrumental diagnostics) are used. This is because pathological process with uterine bleeding, it is localized in the same organs - the uterus or ovaries.

Moreover, at the first stage, various examinations, allowing you to assess the condition of the uterus, since most often uterine bleeding is caused by the pathology of this particular organ. And only if, after the examination, the pathology of the uterus was not detected, methods of examining the functioning of the ovaries are used, since in such a situation the bleeding is caused by a disorder of the regulatory function of the ovaries. That is, the ovaries do not produce required amount hormones in different periods menstrual cycle, causing bleeding as a response to hormonal imbalance.

So, in case of uterine bleeding, first of all, the doctor prescribes the following tests and examinations:

• General blood analysis ;
• Coagulogram (indicators of the blood coagulation system) (sign up);
• Gynecological examination (make an appointment) and inspection in mirrors;
• Ultrasound of the pelvic organs (sign up).

A complete blood count is needed to assess the extent of blood loss and whether the woman has developed anemia. Also general analysis blood allows you to identify whether there are inflammatory processes in the body that can cause dysfunctional uterine bleeding.

A coagulogram allows you to evaluate the functioning of the blood coagulation system. And if the coagulogram parameters are not normal, then the woman should consult and undergo necessary treatment at hematologist (make an appointment).

A gynecological examination allows the doctor to feel with his hands various neoplasms in the uterus and ovaries, and determine the presence of an inflammatory process by changes in the consistency of the organs. And examination in the mirrors allows you to see the cervix and vagina, identify neoplasms in the cervical canal or suspect cervical cancer.

Ultrasound is a highly informative method that allows you to identify inflammatory processes, tumors, cysts, polyps in the uterus and ovaries, endometrial hyperplasia, as well as endometriosis. That is, in fact, ultrasound allows you to identify almost all diseases that can cause uterine bleeding. But, unfortunately, the information content of ultrasound is not sufficient for final diagnosis, since this method only provides guidance in the diagnosis - for example, ultrasound can identify uterine fibroids or endometriosis, but it is impossible to establish the exact location of the tumor or ectopic foci, determine their type and assess the condition of the organ and surrounding tissues. Thus, ultrasound makes it possible to determine the type of existing pathology, but to clarify its various parameters and determine the causes of this disease, it is necessary to use other examination methods.

When a gynecological examination, speculum examination, ultrasound, and a general blood test and coagulogram will be performed, it depends on what pathological process was identified in the genital organs. Based on these examinations, the doctor may prescribe the following diagnostic procedures:

• Separate diagnostic curettage (sign up);
• Hysteroscopy (sign up);
• Magnetic resonance imaging (sign up).

So, if endometrial hyperplasia, polyps of the cervical canal or endometrium, or endometritis are detected, the doctor usually prescribes separate diagnostic curettage followed by histological examination of the material. Histology allows us to understand whether there is malignant tumor or malignancy of normal tissue in the uterus. In addition to curettage, the doctor may prescribe a hysteroscopy, during which the uterus and cervical canal They are examined from the inside with a special device - a hysteroscope. In this case, hysteroscopy is usually performed first, and then curettage.

If fibroids or other uterine tumors are detected, the doctor prescribes hysteroscopy in order to examine the organ cavity and see the tumor with the eye.

If endometriosis has been identified, the doctor may prescribe magnetic resonance imaging in order to clarify the location of ectopic foci. In addition, if endometriosis is detected, the doctor may prescribe a blood test for the content of follicle-stimulating, luteinizing hormones, and testosterone in order to clarify the causes of the disease.

If cysts, tumors or inflammation were detected in the ovaries, additional examinations are not carried out because they are not needed. The only thing the doctor can prescribe in this case is laparoscopic surgery (make an appointment) for removal of tumors and conservative treatment for the inflammatory process.

In the case when, according to the results Ultrasound (sign up), gynecological examination and speculum examination did not reveal any pathology of the uterus or ovaries; dysfunctional bleeding is assumed due to a hormonal imbalance in the body. In such a situation, the doctor prescribes the following tests to determine the concentration of hormones that can affect the menstrual cycle and the appearance of uterine bleeding:

• Blood test for cortisol (hydrocortisone) levels;
• Blood level test thyroid-stimulating hormone(TSH, thyrotropin);
• Blood test for triiodothyronine (T3) level;
• Blood test for thyroxine (T4) level;
• Blood test for the presence of antibodies to thyroid peroxidase (AT-TPO);
• Blood test for the presence of antibodies to thyroglobulin (AT-TG);
• Blood test for follicle-stimulating hormone (FSH) levels;
• Blood test for luteinizing hormone (LH) levels;
• Blood test for prolactin level (sign up);
• Blood test for estradiol levels;
• Blood test for dehydroepiandrosterone sulfate (DEA-S04);
• Blood test for testosterone levels;
• Blood test for sex hormone binding globulin (SHBG) levels;
• Blood test for the level of 17-OH progesterone (17-OP) (sign up).

Treatment of uterine bleeding

Treatment of uterine bleeding is aimed primarily at stopping bleeding, replenishing blood loss, as well as eliminating the cause and preventing it. All bleeding is treated in a hospital setting, because first of all it is necessary to carry out diagnostic measures to find out their cause.

Methods to stop bleeding depend on age, its cause, and the severity of the condition. One of the main methods of surgically stopping bleeding is separate diagnostic curettage - it also helps to identify the cause of this symptom. To do this, a scraping of the endometrium (mucous membrane) is sent for histological examination. Curettage is not performed for juvenile bleeding (only if heavy bleeding does not stop under the influence of hormones, and threatens life). Another way to stop bleeding is hormonal hemostasis (use large doses hormones) - estrogen or combined oral contraceptives Mirena). If intrauterine pathology is detected, chronic endometritis, endometrial polyps, uterine fibroids, adenomyosis, and endometrial hyperplasia are treated.

Hemostatic agents used for uterine
bleeding

Hemostatic agents are used for uterine bleeding as part of symptomatic treatment. Most often prescribed:

• dicinone;
• ethamsylate;
• vikasol;
• calcium preparations;
• aminocaproic acid.

In addition, drugs that contract the uterus - oxytocin, pituitrin, hyfotocin - have a hemostatic effect during uterine bleeding. All of these drugs are most often prescribed in addition to surgical or hormonal methods stop bleeding.

Dicinone for uterine bleeding

Dicynone (etamsylate) is one of the most common drugs used for uterine bleeding. Belongs to the group of hemostatic (hemostatic) drugs. Dicynone acts directly on the walls of capillaries (the smallest vessels), reduces their permeability and fragility, improves microcirculation (blood flow in the capillaries), and also improves blood clotting in places where small vessels are damaged. However, it does not cause hypercoagulation (increased blood clot formation) and does not constrict blood vessels.

The drug begins to act within 5-15 minutes after intravenous administration. Its effect lasts 4-6 hours.

Dicinone is contraindicated in the following cases:

• thrombosis and thromboembolism;
• malignant blood diseases;
• hypersensitivity to the drug.

The method of administration and dose is determined by the doctor in each specific case of bleeding. For menorrhagia, it is recommended to take dicinone tablets, starting on the 5th day of the expected menstruation and ending on the fifth day of the next cycle.

What to do with prolonged uterine bleeding?

With prolonged uterine bleeding, it is important to seek medical help as soon as possible. If signs of severe anemia appear, it is necessary to call an ambulance to stop the bleeding and further observation in the hospital.

Main signs of anemia:

• severe weakness;
• dizziness;
• decreased blood pressure;
• increased heart rate;
• pale skin;

Folk remedies

As folk remedies for the treatment of uterine bleeding, decoctions and extracts of yarrow, water pepper, shepherd's purse, nettle, raspberry leaves, burnet and other medicinal plants are used. Here are some simple recipes:
1. Infusion of yarrow herb: 2 teaspoons of dry herb are poured with a glass of boiling water, left for 1 hour and filtered. Take 4 times a day, 1/4 cup of infusion before meals.
2. Infusion of shepherd's purse herb: 1 tablespoon of dry herb is poured with a glass of boiling water, left for 1 hour, pre-wrapped, then filtered. Take 1 tablespoon, 3-4 times a day before meals.
3.

The causes of bleeding in women depend on age. These could be hormonal imbalances, pregnancy pathologies, or neoplasms. Consultation with a gynecologist is necessary.

Causes of bleeding in women of different age groups

Vaginal bleeding in women is alarming symptom, which can speak of many diseases and emergency situations. Causing bleeding In women, the reasons can be varied and depend on age.

In order to simplify the diagnosis, bleeding is conventionally divided into two groups depending on the affected system:

• pathology of the reproductive system;
• extragenital pathology.

An important point in diagnosis when vaginal bleeding is a connection with pregnancy. After all, it could be an early miscarriage, a threatened miscarriage, or an ectopic pregnancy.

All systems and organs interact with each other. An illness of one system can affect another, exhibiting different symptoms. Extragenital reasons:

• changes in thyroid function (hypothyroidism, hyperthyroidism);
• diseases of the heart and blood vessels (hypertension);
• hepatitis, cirrhosis;
• blood diseases;
• hypovitaminosis (lack of vitamins affecting the condition of blood vessels and blood clotting);
• various infectious diseases;
• prolonged stress and emotional overload, physical exhaustion.

These causes are a specific manifestation of the underlying disease and require primary care treatment.

Bleeding in women involving the reproductive system

If pregnancy has not yet been established, then early miscarriage or ectopic pregnancy should be assumed. Other causes may include endometriosis, uterine fibroids,. Due to the fact that oncopathology is recent years I’m younger, we shouldn’t forget about cervical cancer. A peculiarity of bleeding in cervical cancer is that the discharge has a specific smell and appears more often after sexual intercourse.

In the later trimesters of pregnancy, causes may include:

• placenta previa;
• premature placental abruption;
• eclampsia;
• gestosis;
• scar on the body of the uterus.

During pregnancy, if there is bleeding of any nature or intensity, the woman is advised to immediately seek medical help. antenatal clinic or call an ambulance.

Causes of blood loss not related to pregnancy:

• neoplasms of the uterus and ovaries;
• ovarian apoplexy;
• various inflammatory diseases;
• injuries;
• cervical erosion;
• endometriosis.

Women with the above pathology should be systematically examined by doctors.

Uterine bleeding at different ages

All uterine bleeding is divided into pathological and physiological. Therefore, first of all, the chronological stage of individual development of the reproductive system is determined.

Bleeding is conventionally divided into age periods:

• juvenile (from 10 to 18 years);
• reproductive (fertile period from 18 to 50 years);
• menopausal period (time of decline of ovarian function);
• postmenopausal (final completion of menstruation).

Most often, signs of uterine bleeding in women occur from 28 to 40 years old, but can appear at any age. The main cause of uterine bleeding most often at this age is a violation of the ovulation process.

The ongoing shift in hormonal system provokes the growth of the mucous membrane in the uterus, resulting in stagnation and accumulation of blood, thereby disrupting blood circulation. Once vascular permeability changes, conditions arise for the development of bleeding. The uterus becomes a place where blood accumulates.

If the platelet count decreases, causing the blood to become thinner, this increases blood loss and worsens posthemorrhagic anemia. After all, a lot of blood can be lost. Although the female body is adapted to certain monthly expenses and subsequent replenishment.

For each age period the reasons may be different, since each age has certain characteristics. But we can highlight the main points that have an equally bad effect, despite age.

Factors that negatively affect the hormonal system:

• infectious diseases of acute and chronic nature;
• lack of vitamins and microelements;
• psychological trauma and emotional stress;
• physical exhaustion;
• diseases of the thyroid gland (hypothyroidism, hyperthyroidism);
• inflammatory diseases of the genitourinary system;
• complicated childbirth and abortion.

In a certain age category there are risks for one or another disease. For example, hypovitaminosis is more typical for young and those who are postmenopausal. Accordingly, abortions for women with complete menstrual function are casuistry.

Differences between bleeding and normal menstruation

With normal periods, 70-100 ml for the entire period, but again, they can be more intense. With menorrhagia, about 120 ml more may be lost per day. How can you understand that this is not just menstruation, but true blood loss?

Signs of uterine bleeding:

• impotence accompanied by dizziness;
• marbling of the skin;
• There may be vomiting and nausea, but not necessarily;
• fainting or pre-fainting;
• weak pulse, rapid heartbeat, tachycardia;
• hypotension, blood pressure decreases;
• presence of vaginal blood;
• During menstruation, clots and pads are released, and tampons fill up very quickly;
• at night you have to change hygiene products more often than twice;
• the duration of such bleeding is more than eight days, and;
• not accompanied by pain;
• may appear after sex;
• most often do not coincide with menstruation.

Bleeding that occurs after a delay in menstruation is usually functional in nature. If the discharge is abundant in volume and cyclical, then this may indicate uterine fibroids and systemic blood pathologies. , that is, a year after the last menstruation in women, is interpreted as an obvious pathology. In this case, it is necessary to urgently exclude a malignant neoplasm. But, as a rule, discharge at this age is quite scanty and occurs due to atrophy of the vulva and vagina.

Summarizing

The presence of bleeding is alarming and can indicate many diseases. The problem of bleeding remains relevant today. If timely medical care is not provided, everything can end tragically.

For the purpose of prevention, it is necessary to visit a gynecologist once a year, and, if necessary, a hematologist and endocrinologist. In addition, strengthen your body, adhere to a balanced diet and perform measured physical activity.

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Uterine bleeding is the discharge of blood from the uterus. Most often it is a serious symptom of diseases of the female body.

Any uterine bleeding should be diagnosed in time, and the woman should receive medical assistance. Ignoring such a symptom leads to serious consequences, even death.

It is important to know that normal uterine bleeding includes only menstruation, which lasts up to 5 days, with stable breaks of 28 days.

All other bleeding is pathological and requires medical supervision.

Menstruation (menstruation) is the only physiological normal looking uterine bleeding. Typically, its duration is from three to five days, and the interval between menstruation (menstrual cycle) normally lasts from 21 to 35 days.

Most often, the first couple of days of menstruation the discharge is not abundant, the next two days intensify and finally become scanty again; blood loss these days should be no more than 80 ml.

Otherwise, iron deficiency anemia develops.

U healthy women menstruation is painless. In case of pain, weakness and dizziness, a woman should consult a doctor.

The onset of menstruation usually occurs at 11–15 years of age and lasts until the end of the reproductive period (menopause). During pregnancy and breastfeeding, there is no menstruation, but this phenomenon is temporary.

It's important to remember that early appearance spotting in girls (up to 10 years old), as well as in women after menopause (45–55 years old) is an alarming sign of serious illness.

Sometimes spotting in the middle of the cycle (10–15 days after the end of menstruation) can become a variant of the norm. They are caused by hormonal fluctuations after ovulation: the walls of the uterine vessels become excessively permeable, so vaginal discharge may contain blood.

Such discharge should not last more than two days. Sometimes the cause of bleeding is inflammatory process, so a woman should definitely consult a gynecologist.

A variant of the norm is also implantation bleeding, which occurs as a result of the implantation of the embryo into the uterine wall. This process occurs a week after conception.

No one is protected. Age classification

It seems to you that only women of reproductive age should be afraid of bleeding, then you are deeply mistaken. Blood - all ages are submissive.

Causes

There are many reasons that can cause uterine bleeding. In order to systematize them, it is necessary to understand that the caused blood loss can be a disruption in organ systems, as well as disorders in the sexual sphere.

TO extragenital reasons uterine bleeding, that is, those caused by disturbances in the functioning of non-genital organs include:

Some diseases infectious nature, this is: sepsis, typhoid fever, flu, measles.

Diseases of the hematopoietic system are: hemophilia, hemorrhagic vasculi, low level vitamin C and K, etc.

Cirrhosis of the liver.

Prolapse of the urethra.

Violations in activity of cardio-vascular system, for example, hypertension, atherosclerosis, etc.

Decline functionality thyroid gland.

The causes of uterine bleeding are genital, in turn, may be associated with a woman carrying a child.

The causes of uterine bleeding are hormonal disorders and changes in organ structure.

Signs and symptoms

To begin actions to stop uterine bleeding at home, you should recognize the threat to a woman’s health, which means you need to be fully aware of the symptoms. Here they highlight:

• bloody discharge from the vagina that does not fall within the onset of menstruation;
• general weakness, dizziness and fainting;
• pale skin;
• dangerous bleeding is accompanied by attacks of nausea and vomiting;
• due to loss of blood in large quantities, a decrease in blood pressure can be detected;
• there is a discharge blood clots;
• at heavy bleeding a woman has to change tampons or pads more often (as opposed to normal menstruation);
• Dangerous bleeding may be indicated by the duration of menstruation, which already exceeds 7-8 days when the norm is 6 days;
• bleeding begins every time after sexual intercourse.

All the symptoms presented indicate impending danger and irreversible consequences. If the bleeding continues for several days, the woman may experience characteristic features serious blood loss.

You may need a transfusion from a donor. There is no need to talk about treatment at home.

Symptoms

Main symptom- discharge of blood from the vagina. Significant differences from menstruation:

• more periods, which forces you to change sanitary pads more often;
• bleeding lasts more than a week;
• appears earlier than 21 or later than 35 days;
• bleeding after sexual intercourse;
• develops in the menopausal period after the cessation of menstruation.

There are 4 types of uterine bleeding based on duration, regularity and volume.

1. Menorrhagia occurs cyclically, but abundantly and for a long time.
2. Metrorrhagia - irregular appearance of small bleeding in the middle period monthly cycle.
3. Menometrorrhagia is prolonged and inconsistent discharge.
4. Polymenorrhea is the appearance of blood at intervals of more than 21 days.

There are blood clots in the vaginal discharge, and there is abdominal pain. Blood loss leads to general weakness, fatigue, and pale skin.

Juvenile bleeding

Uterine bleeding of any kind - dangerous symptom, their appearance is a reason for treatment. Emergency appeal require acute blood loss (sudden copious discharge blood), they are accompanied by severe symptoms (weakness, drop in blood pressure, increased heart rate, loss of consciousness, loss of ability to work), sometimes sharp pain in the abdomen.

In this case, a person’s life depends on the timely provision of assistance.

With sparse, but frequent bleeding the symptoms are not as pronounced, although weakness and progressive anemia gradually worsen the quality of life and reduce the ability to work. The patient develops fatigue, dizziness, and decreased blood pressure.

Bleeding is characterized by the release of any amount of blood (not necessarily copious):

• between cycles or during menstruation;
• during menopause, after a stable absence of menstruation for more than 12 months;
• after medical procedures and childbirth in combination with high fever and abdominal pain.

Characteristic signs of uterine bleeding:

• bleeding;
• decreased blood pressure;
• increased heart rate;
• weakness;
• increased fatigue;
• drowsiness;
• dizziness;
• headache;
• pale skin.

At large blood loss the main symptoms replace each other quite quickly, the condition is complicated by loss of consciousness, hemorrhagic shock. With prolonged, continuous bleeding (after abortion) in combination with high fever (up to 40°C) and sharp pain in the abdomen, the development of purulent postoperative complications and sepsis (general purulent infection).

Minor uterine bleeding slowly leads to the development of iron deficiency anemia. After hemoglobin levels decrease to less than 50 G/l, the condition is complicated by metabolic and gas exchange disorders, the development of heart failure and other pathologies.

Symptoms of anemia

Diagnostics

To diagnose the pathology that provoked the appearance of uterine bleeding, sometimes a whole range of methods is necessary:

The gynecologist collects information about the pathology and performs an external examination; the medical history includes the following information:

• about the cyclicity of menstruation;
• start and end date of last menstruation;
• O physical development and age;
• results of consultation with an endocrinologist, neurologist.

Treatment

Treatment options depend on the severity and duration of blood loss. In each case, the gynecologist individually decides what to do in case of uterine bleeding. It is not always necessary for a woman to be hospitalized, for example, if the blood is not released profusely, but general state women are not violated.

Urgent uterine bleeding must be stopped in case of severe weakness, loss of consciousness, sharp fall blood pressure. Only a qualified specialist knows how to do this quickly. In this case, it is dangerous to carry out treatment on your own; you need to urgently call an ambulance.

Before the doctor arrives, emergency care consists of laying the woman down; you need to elevate her legs using a bolster from a blanket or pillow. A method is used to stop parenchymal bleeding: cold is applied to the lower abdomen.

For this, ice from the freezer, food, a bottle of cold water which need to be wrapped in a towel.

You can begin to stop blood loss by taking one Tranexam tablet. After the doctor arrives, you must tell him how many and what medications the woman took. To compensate for blood loss before the ambulance arrives, you need to drink as much liquid as possible.

In the hospital, uterine bleeding is treated with the following medications:

• hemostatic agents: Vikasol, Tranexam, Dicynon;
• oxytocin for uterine contractions;
• replacement therapy.

Medicines are produced in different forms: suppositories, tablets and solutions. If blood loss cannot be controlled with therapy, emergency surgery is necessary.

Tranexam

Tranexam acts faster and more effectively than other drugs for uterine bleeding, therefore it is a first aid remedy. This medicine directly improves the blood clotting process by acting on a special protein, plasminogen.

The drug is available in tablets and solutions for intravenous administration.

Indications for the use of Tranexam:

• bleeding from internal organs;
• stopping bleeding after surgery;
• allergic conditions;
• inflammatory diseases of the mouth and throat.

The drug is contraindicated in hypersensitivity to him and intracranial hemorrhage. Side effects include nausea, heartburn, drowsiness, rarely thrombosis, itching. This is one of the few drugs used in pregnant women.

Dicynone

Dicinone is a hemostatic drug that reduces the fragility of capillaries, normalizes blood clotting in the area where they are damaged small vessels.

There are two ways to take Dicinone: it can be used in tablets and in injections. When administered into a vein, it acts after 5-10 minutes, and is effective from 4 to 16 hours.

Dicynone can be used for:

• surgical blood loss;
• uterine and intracranial hemorrhage;
• retinal hemorrhage in diabetes.

The medicine is not used for asthma, leukemia, individual intolerance and thrombosis.

Taking Dicinone causes side effects such as nausea, skin rash, headaches, low blood pressure, allergies and weakness. Dicinon is prescribed to pregnant women with caution. When choosing the drug to use, the doctor takes into account the risk to the mother and fetus.

Vikasol

It is a synthetic analogue of vitamin K, which plays an important role in the blood clotting process. Vikasol for uterine bleeding is not used in the acute period, since it begins to work no earlier than 12 hours after administration.

Vikasol is prescribed for combination therapy for bleeding and its prevention after childbirth. To do this, the drug is administered to women at the beginning of their first contractions.

The drug is contraindicated in cases of increased blood clotting. Side effects are infrequent, such as allergies, low blood pressure, and jaundice in newborns.

For uterine bleeding, all treatment depends on the underlying cause and the age of the patient. Firstly, before prescribing appropriate therapy for the patient, the doctor must conduct an examination to establish the causes and select treatment in accordance with them.

For juvenile bleeding in adolescents, drugs are prescribed that promote contraction of the uterus, strengthen the walls of blood vessels and stop blood loss; treatment at home is also continued with a course of vitamins; hormonal drugs are prescribed less frequently.

Stopping uterine bleeding in women of reproductive age occurs with the help of hormone therapy, and in case of serious diseases (myoma, febroma), surgical intervention is performed.

If a woman discovers the above deviations from the norm, she should take appropriate actions to narrow the blood vessels. However, under no circumstances should you use medicines, promoting contraction of the uterus, as well as applying heat or taking warm baths (showers).

First aid for uterine bleeding

Heavy bleeding must be stopped immediately after its detection. At the initial stage, it is recommended to call an ambulance, and before it arrives, do the following:

Treatment of uterine bleeding largely depends on its causes and the age of the patient.

Bleeding can be stopped; this is vital, especially when the blood loss is acute and life-threatening; in 85% of cases this can be done (in 15% the pathology ends fatal).

Treatment of any bleeding is carried out in a hospital setting, acute blood loss requires emergency measures for first aid and emergency calls.

1. Stop the bleeding.
2. Replenish blood loss.
3. Eliminate the cause of the symptom.
4. Prevent recurrence of bleeding.

Use drug therapy, infusion methods for restoring blood volumes and surgical methods, the latter are used if the bleeding is not stopped with medications.

How to give first aid

First aid for bleeding at home

Everyone should know what first aid is for this type of blood loss, because this coordinated action sometimes depends on the life and health of a woman. What to do if there is uterine bleeding? The following recommendations must be strictly followed:

First aid for uterine bleeding is to call an ambulance as quickly as possible. This is especially true when a woman is carrying a child, her blood loss is profuse, and her condition worsens sharply. In this case, every minute counts. If it is not possible to call a medical team, then it is necessary to take the woman to the hospital on our own.

Any uterine bleeding is serious threat life and health, so the reaction must be appropriate.

In case of dysfunctional bleeding, it is strictly forbidden to apply hot or warm heating pad, douching with any compositions, taking a bath, using drugs that promote uterine contractions.

A woman can be helped independently, at home until the ambulance arrives in the following way:

The woman must be placed in bed, preferably on her back, and her legs placed on some kind of elevation. To do this, you can place a pillow or a cushion from a blanket. In this way, it will be possible to maintain the patient’s consciousness, especially if the blood loss is significant.

You need to apply something cold to your stomach. If you don’t have a heating pad on hand, you can wrap the ice in regular cloth. You can replace ice with an ordinary bottle filled with cold water. Cold exposure time is up to 15 minutes, then a break of 5 minutes. This will achieve vasoconstriction, which means slightly reducing bleeding.

A woman needs to be given water. Since it is not possible to place an IV at home, it is necessary to offer the patient drinking plenty of fluids. Plain water and sweet tea will do. This will contribute to the loss of fluid along with the blood, glucose will provide nutrition to the nerve cells of the brain.

For appointment medications must be treated with extreme caution, especially if a woman is carrying a child. Before taking them, you should definitely consult your doctor, but sometimes it happens that this option is not available.

Therefore, it is necessary to know the names of hemostatic agents and their minimum dosage. These include Vikasol (taken 3 times a day, at a dosage of 0.015 g), ascorbic acid (maximum daily dose 1 g), Dition (take 4 times a day, at a dosage of 0.25), calcium gluconate (1 tablet up to 4 times per day).

Before use, it is important to remember that all medications have side effects.

How to stop uterine bleeding?

When the ambulance team arrives at the scene, its actions will be as follows:

A bubble containing ice is placed on the woman's stomach.

If the bleeding is profuse, then the woman should be taken to the car on a stretcher.

Hospitalization of the patient with transfer directly to a specialist.

Introduction of solution magnesium sulfate, when there is a threat or beginning of a miscarriage. Or, if spontaneous abortion occurs, the woman is given calcium chloride intravenously, and ascorbic acid, diluted in glucose. An injection of Etamzilat may be given.

Doctors in the hospital use hormonal drugs to stop bleeding, if the woman has not given birth yet, she does not suspect the presence of a tumor.

Hormonal drugs include Jeannine Regulon, etc. On the first day, an increased dose is given (up to 6 tablets), in subsequent days one less tablet, bringing it to 1 piece.

Sometimes gestogens are used, but it can be used only in the absence of severe anemia.

Hemostatic agents can also be used, for example, Dicynon, Vikasol, Ascorutin, Aminocaproic acid.

Sometimes surgical intervention is used, such as uterine curettage (an effective method of stopping blood loss), cryosurgery (a method without contraindications), laser removal endometrium (used in those women who do not plan to have more children).

Prevention

Prevention of rebleeding consists of following several rules:

• mandatory elimination of the underlying cause of the symptom;
• regular examination (at least 2 times a year);
• contacting a gynecologist if any changes in the menstrual cycle or other warning signs occur;
• appointments and reception oral contraceptives only on the recommendation and under the supervision of the attending physician;
• pregnancy planning;
• healthy eating and lifestyle;
• eliminating stressful situations.