There is bleeding from the uterus but there is no pain. Uterine bleeding: causes and treatment

Monthly uterine bleeding is normal for women of reproductive age. However, vaginal bleeding can also be pathological.

Heavy bleeding during menstruation indicates the development of pathological processes in the female body. In such situations, it is important to know how to stop bleeding at home.

Heavy bleeding during menstruation can be easily distinguished from normal menstrual flow. In the pathological process, bleeding is prolonged and is accompanied by the following symptoms:

heavy discharge does not stop for a week;
the need to frequently change hygiene products – up to 8-10 times a day;
presence of blood clots;
severe pain in the lower abdomen, which is nagging in nature;
headache and dizziness.

Blood loss during menstruation in a healthy woman averages 60 ml over the entire menstrual cycle. The first days of discharge are accompanied by mild aching pain in the lower abdomen caused by contraction of the uterus. Heavy menstrual bleeding is defined as bleeding from the uterus of more than 80 ml per cycle.

Causes of severe bleeding

Heavy menstrual bleeding may have the following causes:

abortions and medical termination of pregnancy;
inflammatory processes of the pelvic organs;
tumors and neoplasms in the uterus and ovaries;
infectious diseases;
endometriosis;
use of intrauterine contraceptives;
thyroid diseases.

Such processes that cause disturbances in the menstrual cycle and the amount of uterine discharge require mandatory treatment. However, it is important to know how to stop heavy periods at home in order to provide first aid before contacting a specialist.

As soon as a woman realizes that she has severe uterine bleeding, and there is a deterioration in her condition, she should call an ambulance. Before medical workers arrive, you can try to reduce the intensity of uterine bleeding on your own.

It is necessary to take a horizontal position so that your legs are higher in relation to your body. To do this, you can put a pillow under them.
Apply a cold object to the lower abdomen for 15 minutes. An ice pack will do. Cold constricts blood vessels and can reduce blood loss.
You need to drink plenty of fluids to replenish your fluid balance. You can drink water, juices, sweet tea.

This table presents the main hemostatic drugs used for severe uterine bleeding.

Drug name	Pharmacological properties	Directions for use
Calcium glucanate	Available in the form of an injection solution and tablets, it increases blood clotting	The woman is administered intravenously from 5 to 15 ml of calcium glucanate, after which tablets are prescribed - up to 6 pieces per day after meals.
Askorutin	Has a strengthening effect on the walls of blood vessels, reduces capillary fragility	Take up to 2 tablets several times a day
Oxytocin	Has a contractile effect on the uterus, increases the excitability of muscle fibers	It is administered into a woman’s body intravenously or intramuscularly. With the intravenous method of administering oxytocin, the effect of the drug occurs instantly
Aminocaproic acid	Relieves increased blood activity	Can only be used in a hospital setting; it is available in the form of powder and sterile 5% solution. Powders are prescribed 2-3 g up to 5 times a day, 100 ml of solution is administered intravenously every 4 hours
Vikasol	Normalizes blood clotting processes. This synthetic drug is designed as a replacement for vitamin K.	Available in the form of ampoules of 1 ml solution and tablets. Tablets are taken 4 pieces per day, solution - up to 2 ampoules. The effect occurs 12-14 hours after administration of the drug

All these medications can only be used under the supervision of specialists.

It is important to know how to stop bleeding during menstruation at home. In gynecology, two drugs are widely used for these purposes - Dicynon and Tranexam.

Action and use of Dicynon

Dicinone activates blood clotting and has a vasoconstrictor effect. The therapeutic effect occurs approximately 3 hours after administration of the drug into the body. When administered intravenously, the effect occurs after 20 minutes.

In case of severe blood loss, a single dose can consist of 3 tablets, or can be prescribed for a course of up to 10 days. In gynecology, Dicinon is also used for prophylaxis against a tendency to uterine bleeding.

The following side effects of Dicinon may occur:

nausea;
heartburn;
dizziness;
general weakness and malaise;
hypotension;
allergic reactions - itching and rashes on the skin.

Dicinon is not suitable for all women for menstrual bleeding. The drug has the following contraindications:

glucose-lactose deficiency;
blood diseases;
liver and kidney diseases;
increased blood clotting.

Tranexam for bleeding

Tranexam has hemostatic, anti-inflammatory, antitumor effects. The duration of taking the drug should not exceed 4 days. Daily dose – 6 tablets in 2-3 doses. Tranexam is administered intravenously every 8 hours.

Tranexam has the following contraindications:

thrombosis;
color vision impairment;
individual intolerance;
kidney diseases.

When using Tranexam, the following side effects are possible:

vomiting, dizziness, nausea;
weakness, drowsiness;
tachycardia;
chest pain;
allergy.

In addition to Dicinon and Tranexam, you can reduce menstrual flow using such means as:

Lagochilus tincture - dissolved in water 1:5, taken 3 times a day;
water pepper tincture - take 3 times a day, 30 drops.

Every woman's home medicine cabinet should have at least one of the drugs that have a hemostatic effect.

It is also possible that menstruation ends, but bleeding soon begins after menstruation. A specialist will tell you how to stop blood loss after a complete examination of the patient. Bleeding that begins after menstruation and is not associated with it is referred to in gynecology as “metrorrhagia.”

This pathology may have the following reasons:

ectopic pregnancy;
miscarriage;
hormonal disorders;
chronic infections of the pelvic organs;
rupture of a cyst or ovary;
presence of erosion, polyps;
taking oral contraceptives.

A specialist will be able to determine the exact cause of pathological bleeding from the vagina after an examination. Before contacting a specialist, a woman can take hemostatic drugs or traditional medicine.

Folk remedies for severe bleeding

Traditional medicine will also help stop bleeding.

Heavy bleeding during menstruation can be stopped using the following means:

Lemon. If you have heavy menstruation, you can eat lemon alone or with sugar. You need to eat two lemons a day.
Water pepper. This remedy increases blood clotting, relieves pain and has a wound healing effect. To prepare the medicine, 2 tbsp. l. dry herbs pour 400 ml of boiling water. Infuse water pepper for half an hour and take 1 tbsp. l. every two hours.
Cuff. The plant has an astringent, wound-healing, hemostatic and analgesic effect on the female body and is widely used in pharmacology. To prepare tea, pour 30 g of dry herb into 1/2 liter of boiling water. Infuse the drink for an hour and take it three times a day until the unpleasant symptoms disappear.
Shepherd's purse. This medicinal plant has a hemostatic effect on the body. You can use baths prepared from the plant or drink it as tea. To prepare medicinal tea, pour 20 g of herb into two glasses of boiling water, leave for an hour, divide into 3 doses and take before meals. To prepare a sitz bath for 1 liter of boiling water you will need 2 tbsp. plants. The duration of the procedure is 15 minutes, the course is 5 days.
Nettle. The plant is a good remedy for maintaining uterine tone. 1 tbsp. l. pour nettle leaves? l of water, strain after 20 minutes, and take 100 ml at a time.
Cinnamon. The spice will help reduce the intensity of bleeding during heavy menstruation. In a glass of warm water, stir 3 tbsp. l. ground cinnamon. This remedy should be taken every half hour until the heavy bleeding stops.

If heavy menstrual bleeding occurs, measures should be taken to reduce blood loss. To determine the cause of the pathology, you should seek help from a specialist.

In the practice of an obstetrician-gynecologist Uterine bleeding is one of the most common symptoms with which patients are admitted to the hospital or consult a doctor on their own. Uterine bleeding can occur both in a very young teenage girl and in an elderly woman who has been in menopause for more than 25 years.

However, The reasons that can cause this alarming symptom are completely different. As is known, for effective treatment of a pathological condition it is necessary, first of all, to understand its development mechanisms. It is for this reason In relation to uterine bleeding, the principle of “symptomatic treatment” is absolutely unacceptable, which eliminates the effect, not the cause. In addition, taking into account not only such different age groups, but also certain physiological conditions (for example, pregnancy), it becomes obvious that fundamental knowledge of medicine, as well as an individual approach to patients, is important in this matter.

In most cases, uterine bleeding occurs due to hormonal imbalance, which is why they are called dysfunctional. In this regard, for a thorough understanding of the true causes of bleeding, it is necessary to briefly understand the regulation of the menstrual cycle.

Briefly about the physiology of the menstrual cycle

For a simplified understanding of this complex system, the regulation of the cycle can be compared to a five-story building, where each lower floor is subordinate to the one above, but it is quite obvious that the upper floor cannot function independently without its “subordinates.” This comparison reflects the main principle: the existence of direct and feedback connections between all levels of regulation.

Classification of uterine bleeding

Depending on the age factor:

Juvenile – occurs in teenage girls from the age of menarche (first menstruation) to 18 years.
Reproductive age – typical for women over 18 years of age and before menopause.
Menopausal – occurs in women who are in the menopausal period.

In relation to pregnancy:

Uterine bleeding during pregnancy:
1. in the first trimester (up to 12 weeks);
2. in the second trimester (from 13 to 26 weeks);
3. in the third trimester (from 27 to 40 weeks).
Postpartum hemorrhage:
1. in the early postpartum period (within 2 hours after birth);
2. in the late postpartum period (within 42 days after birth).

Juvenile bleeding is a consequence of disruption of the hormonal regulation of the menstrual cycle in girls. The main problem is that girls rarely turn to a gynecologist with this problem for many reasons:

They are embarrassed to tell their parents about cycle disorders;
People mistakenly think that menstruation will become regular after some time. However, many studies have been conducted on the basis of which we can conclude: in the absence of treatment for cycle disorders during puberty, persistent abnormal changes in the menstrual and, most importantly, reproductive function of the female body subsequently develop.
Girls confuse menstruation with uterine bleeding.

How to distinguish normal menstruation from bleeding during the menstrual period?

Criteria for normal menstruation:

The duration of the menstrual period does not exceed 7 days;
The volume of blood lost does not exceed 80 ml;
Should not be present in menstrual blood abundant blood clots.

At first glance, these are quite simple and clear criteria, but it is not always possible to calculate blood loss in milliliters. In addition, the system for assessing blood loss using the visual method is very subjective and is fraught with many errors. Even experienced doctors cannot always determine the amount of blood loss “by eye,” so for young girls it is very difficult.

For this reason, according to statistics, about 20% of uterine bleeding is mistaken for menstruation, which means that every fifth girl from this risk group is exposed to long-term chronic blood loss (anemia).

In this regard, a completely fair question arises: what other signs can be used to distinguish pathological blood loss from physiological?

Typically, such girls have characteristic symptoms:

Pale skin;
Brittle, dry hair;
Dull nails;
Expressed weakness, fatigue;
Reduced performance;
Possible fainting;
Increased heart rate.

Video: dysfunctional uterine bleeding, program “Live Healthy!”

Causes and treatment of uterine bleeding in girls

The main reason for such menstrual cycle disorders is changes in hormonal status, namely:

Violation of the production of the hormone progesterone by the ovaries;
A change in the ratio of pituitary hormones (an increase in follicle-stimulating hormone (FSH) and a decrease in luteinizing hormone (LH). Insufficient LH levels also lead to the fact that ovulation does not occur;
Excessive estrogen content in the body;
Pathology of the thyroid gland, adrenal glands.

Important! For the full functioning of the female reproductive system, it is important not only the quantitative content of hormones (their concentration in the blood), but also the ratio of one to the other. In other words, if, according to the results of the study, the concentration of sex hormones falls within the physiological norm, then this does not yet indicate complete well-being. It is for this reason that only a doctor can correctly evaluate the results of laboratory tests.

In addition, the causes of uterine bleeding are also:

Disorders of the blood coagulation system (thrombocytopathy);
Various anomalies of uterine development;
Adenomyosis is manifested by prolonged menstrual bleeding, which is accompanied by severe pain in the lower abdomen;
Oncological diseases of the blood ();
Ovarian cysts;
Pituitary tumors;
Inflammatory diseases of the female genital organs sometimes lead to uterine bleeding;
Increased endometrial thickness or polyp in the uterine cavity.

Treatment methods for juvenile uterine bleeding

Treatment should primarily be aimed at:

Stop bleeding as quickly as possible;
Treatment of anemia with large blood loss;
Eliminating the very cause of bleeding in order to prevent a recurrence of this situation.

Unfortunately, sometimes treatment stops at the first two points, and the matter never reaches the point of finding out the cause. But this is fundamentally wrong, since fighting exclusively with the investigation is a futile exercise. In addition, the lack of treatment for the cause itself leads not only to the risk of repeated bleeding, but also to reproductive dysfunction in the future.

Hemostatic drugs include:

Treatment of such complications of uterine bleeding as:

In case of severe anemia, when hemoglobin is less than 59 g/l, you cannot do without.
Intravenous iron preparations, such as Likferr, Venofer, Argeferr, and Ferizhekt, effectively increase hemoglobin levels. An infusion of 1 package of these drugs is enough to increase hemoglobin by 20-30 g/l in a short period of time. Their only drawback is their high price.
For mild anemia, it is enough to get by with tablet drugs (“Sorbifer”, “Ferrum-lek”, “Ferro-Folgamma”, “Fenuls”, “Maltofer”).
In parallel with the use of iron supplements, you can take B vitamins. The most effective scheme is to alternate intramuscular injections of vitamins B6 (“Pyridoxine chloride”) and B12 (“Cyancobalamin”) every other day.
Don’t forget about following a diet: eating meat, liver, apples, plums, carrots, beets.

Stage three - eliminating the cause of bleeding:

When all three stages of treatment are carried out, normal menstrual function is completely restored in almost 90% of girls within the first year, and episodes of repeated uterine bleeding also stop.

Uterine bleeding in women of reproductive age

According to statistics Every third woman experiences uterine bleeding at least once in her life. This means that the study of this problem must be given due attention.

Reasons

Principles of treatment

Considering the variety of causes that cause bleeding in women of reproductive age, for proper treatment it is necessary first of all to conduct a thorough diagnosis.

The main principle of treatment of uterine bleeding in women of reproductive age is the preservation of her reproductive and menstrual function.

Video: the problem of uterine bleeding in the program “Live Healthy!”

Bleeding during pregnancy

Obstetric hemorrhage is still one of the main causes of maternal mortality. Despite the development of new diagnostic and treatment methods, these bleedings cannot be completely avoided even in the best clinics and perinatal centers.

Causes of bleeding during pregnancy:

Chorionic detachment (in the early stages) or placental abruption;
Antiphospholipid syndrome;
Hellp syndrome;
Disorders of the blood coagulation system of a pregnant woman;
Threatened spontaneous abortion;
Started or completed uterine rupture.

Treatment of obstetric hemorrhage is a difficult task for a doctor, since many factors influence the tactics: the condition of the fetus, the duration of pregnancy, whether there is a threat to the mother’s life, the amount of bleeding, etc.

Basic principles of treatment:

Important! Bleeding during pregnancy is an extremely unfavorable symptom. Only a doctor should provide qualified assistance in such a situation; there should be no methods of treatment with folk remedies at home!

Uterine bleeding after childbirth

According to statistics, 2% of all births are complicated by postpartum hemorrhage.

The most common reasons:

Decreased uterine tone after childbirth (may be a consequence of overstretching of the uterus with a large fetus, polyhydramnios);
Placenta accretion to the inner surface of the uterus;
Retention of parts of the placenta in the uterine cavity;
Cervical ruptures during childbirth;
Continuation of cervical rupture to the lower segment of the uterus;
Pathology of the blood coagulation system;
Suture dehiscence after caesarean section.

Treatment of postpartum hemorrhage should be carried out as soon as possible, since uterine bleeding after childbirth can be very massive and lead to serious blood loss.

Important! The first 24 hours after birth are the most dangerous for the development of bleeding. Therefore, during this period, the woman’s condition should be monitored around the clock.

After discharge from the maternity hospital, to prevent bleeding, a woman must independently take medications that contract the uterus: tincture of water pepper or nettle decoction. These remedies help the uterus return to normal size.

Bleeding in menopausal women

Bloody discharge during menopause is always an alarming sign. This should not be taken lightly or irresponsibly.

The main causes of bleeding during menopause:

Endometrial hyperplasia;
Precancerous processes in the endometrium;
Endometrial cancer;
Submucous uterine fibroids;
“Forgotten” intrauterine device.

Obviously, there are not many reasons, but they are all very serious.

The main difference in medical tactics for uterine bleeding in menopausal women is oncological alertness.

Treatment principles:

The predominance of surgical tactics in relation to uterine bleeding during menopause allows timely recognition of the benign or malignant nature of the pathological process.

Conclusions

Depending on the age of the woman, the causes of uterine bleeding differ. This means that therapeutic tactics to eliminate the cause cannot be the same and universal for all patients.

In addition, it is necessary to take into account the principle of “continuity” of pathologies. The essence of the principle is that the lack of treatment for dysfunctional uterine bleeding during puberty can lead to chronic anovulation and endocrine infertility during reproductive age. And this, in turn, is a “springboard” for the development of benign and malignant pathological processes of the endometrium in menopause. It is for this reason that uterine bleeding should be taken seriously at any age.

Video: lecture on uterine bleeding

Uterine bleeding is profuse abnormal blood discharge from the uterus. In medicine, they are usually called dysfunctional, since they are the most striking evidence of hormonal disorders in women.

With uterine bleeding, unlike menstruation, the volume of blood released and the duration of the discharge changes, or the regularity of menstruation is disrupted. This pathology occurs in many women, regardless of their age. In this regard, there is the following classification of uterine bleeding:

during puberty or juvenile age (12-18 years);
reproductive age (18-45 years);
period of decline of ovarian function (menopause - 45-55 years).

The development of this pathology is due to a number of reasons that determine several types of uterine bleeding: dysfunctional, organic and those caused by systemic diseases (diseases of the kidneys, liver, blood, thyroid gland).

Dysfunctional uterine bleeding is characterized by excessively heavy and prolonged discharge caused by disruption of the hormonal regulation of the menstrual cycle. In turn, they are divided into ovulatory and anovulatory.

Ovulatory uterine bleeding is characterized by the persistence of ovulation, as well as shortening or lengthening the interval between menstruation. This condition occurs most often against the background of inflammatory diseases of the genital organs or adhesions in the pelvis. Often before and after menstruation, as well as in the middle of the menstrual cycle, spotting is observed. Since ovulatory bleeding occurs most often in women of childbearing age, it is accompanied by miscarriage and infertility.

Anovulatory uterine bleeding is characterized by the absence of ovulation, which, over a long period of existence, can lead to the development of hyperplasia, fibroids, endometriosis and even endometrial cancer. This pathology most often occurs in premenopause (premenopause).

Organic uterine bleeding is accompanied by diseases such as endometrial polyp, uterine fibroids, endometriosis, inflammatory diseases of the uterus and appendages, cancer of the uterine body or cervix. This type of disease is chronic and is characterized by bleeding of varying intensity and duration on any day of the menstrual cycle.

Causes of uterine bleeding

Risk factors for the development of dysfunctional uterine bleeding at different periods of a woman’s life depend on her age.

At the age of 12-18 years, uterine bleeding is caused by a violation of hormonal regulation at the stage of its formation for a number of reasons:

physical or mental injuries;
dysfunction of the thyroid gland and adrenal glands;
malnutrition, hypovitaminosis;
consequences of complicated pregnancy and pathological childbirth;
a history of childhood infectious diseases during puberty: whooping cough, mumps, measles, chickenpox, chronic tonsillitis, influenza, etc.;
sometimes tuberculosis of the female genital organs or bleeding disorders.

During reproductive age, uterine bleeding is not observed so often and is accompanied by ovarian dysfunction. This happens for the following reasons:

overwork, chronic mental stress, stressful situations;
ovarian tumors;
endometriosis of the uterus, chronic endometritis;
malignant tumors and polyps of the uterus and cervix;
change in climatic conditions;
uterine fibroids;
dysfunction of the hypothalamic-pituitary system caused by the use of certain medications;
ectopic pregnancy, miscarriages, medical or surgical termination of pregnancy;
poor environmental conditions in the place of permanent residence, harmful working conditions;
various infectious and inflammatory diseases of the female reproductive system.

Most often, uterine bleeding occurs in premenopausal women, which is due to a natural decrease in gonadotropins secreted by the pituitary gland. In this regard, the menopause is accompanied by an irregular release of hormones, which entails disruption of the ovulatory cycle, folliculogenesis, and development of the corpus luteum.

The occurrence of uterine bleeding at the age of 45-55 years indicates the absence of other pathologies that can cause it. In this case, the causes of uterine bleeding include:

uterine fibroids;
endometriosis;
uterine polyps;
hormone-active ovarian tumors.

Symptoms

Uterine bleeding is expressed by metrorrhagia, acyclic bleeding, an increase in the duration of menstruation and the amount of discharge released during this process.
Since uterine bleeding is essentially similar to menstruation, every woman should be able to recognize the symptoms of blood loss. Pathological bleeding can be determined by the following symptoms:

heavy discharge lasting more than a week with signs of anemia: low blood pressure, increased fatigue, weakness, pale skin, headaches, dizziness;
the presence of a large number of blood clots in the secretions;
the degree of profuse discharge is so high that the pad gets wet within an hour, and the woman often feels a loss of strength and is not even able to go to work;
bleeding is accompanied by severe pain in the lower abdomen and nagging pain in the lumbar region;
bleeding after intercourse is also a sign of uterine bleeding.

Diagnostics

In women of reproductive age, detection of uterine bleeding begins with curettage of the walls of the uterus and cervical canal. The resulting scraping is sent for histological examination. This procedure is not only diagnostic in nature, but also has a therapeutic effect, since it removes the defective layer of the endometrium and blood clots, and the contraction of the uterine muscles helps stop bleeding.

Additional diagnostic methods include:

hysterosalpinography;
hysteroscopy;
Ultrasound of the pelvic organs;
consultations of related specialists.

Treatment

Regardless of the woman’s age, treatment of uterine bleeding has the following goals:

stopping bleeding and replenishing blood loss;
eliminating the cause that caused this condition;
rehabilitation of patients.

In case of severe uterine bleeding, the patient must be given first aid, which is to stop the bleeding. It comes down to injections of contracting and hemostatic drugs, the introduction of tampons soaked in special medications, or emergency curettage. Minor bleeding stops as therapy progresses.

How to stop uterine bleeding

You can stop uterine bleeding before the doctor arrives as follows. The woman must be laid on a hard, flat, horizontal surface. She needs a pillow under her feet, and a heating pad with cold water or an ice pack on her stomach. It is strictly forbidden to warm the lower abdomen.

As first aid for uterine bleeding, Tranexam is used, which helps to quickly stop bleeding and dissolve blood clots. Depending on the activity of uterine bleeding, Tranexam is used either in the form of tablets or as intravenous injections.

For emergency symptomatic treatment of uterine bleeding, the following drugs and hemostatic agents are recommended: Dicion, Vikasol, Etamzilate, calcium preparations, aminocaproic acid. The use of Dicion and Vikasol for uterine bleeding helps to increase blood clotting, and also prevents bleeding and improves blood restoration and circulation.

Any bleeding from the genitals, which differs from normal menstruation, should alert the woman and serve as a reason to contact a gynecologist. Be extremely attentive to your health!

Uterine bleeding in medicine is usually called dysfunctional uterine bleeding - this is pathological heavy bleeding from the uterus. They are one of the most striking manifestations of hormonal dysfunction in women. Therefore, the main cause of uterine bleeding most often lies in the disruption of the production of female sex hormones. This pathology can occur in any woman, at any age, therefore uterine bleeding is classified according to age criteria as follows:

Uterine bleeding at the age of 12-18 years - during puberty or juvenile age
During the reproductive age period 18-45 years
During the menopausal period 45-55 years, when ovarian function fades away

Symptoms or signs of uterine bleeding are expressed either by significant bleeding during menstruation, or by an increase in the duration of menstruation, as well as acyclic bleeding or metrorrhagia, when there is no menstruation for 6 to 8 weeks or more, and then bleeding of varying intensity develops.

How to independently determine uterine bleeding - symptoms of blood loss

Causes of uterine bleeding

Let us consider the causes of dysfunctional uterine bleeding depending on the woman’s age, since at different periods of a woman’s life, the risk factors for the development of bleeding are different.

Uterine bleeding at the age of 12-18 years

During this period, uterine bleeding appears in almost 20% of all gynecological pathologies in girls, this is due to a violation of the formation of hormonal regulation for a number of reasons:

Provoking factors are mental or physical trauma
Hypovitaminosis, malnutrition
and thyroid gland
Various serious childhood infectious diseases also affect the appearance of signs of uterine bleeding in girls of puberty - influenza, chronic tonsillitis, chickenpox, measles (see), mumps, whooping cough (), etc.
If a girl was born to a mother during a complicated pregnancy and pathological birth.
Rarely, there are cases when the cause of bleeding is a bleeding disorder or tuberculosis of the female genital organs.

Causes of uterine bleeding in women of reproductive age

During childbearing age, this pathology among all gynecological diseases accounts for only 5% of cases. As a rule, uterine bleeding is accompanied by ovarian dysfunction, the causes of which are a number of provoking factors:

Stressful situations, chronic mental stress, overwork
Occupational hazards, living in cities with developed chemical and metallurgical industries
Climate change
Various inflammatory and infectious diseases of the female reproductive system, which lead to thickening of the ovarian capsule, and also reduce the sensitivity of their tissues to gonadotropins, as well as:
- Chronic endometritis, endometriosis of the uterus
- Myoma
- Polyps and malignant neoplasms of the cervix and uterus itself
- Ovarian tumors
Surgical or medical termination of pregnancy, miscarriages,
The use of drugs that cause dysfunction of the hypothalamic-pituitary system.

Uterine bleeding during menopause

This is the most common pathology occurring in premenopausal women - 15% among all gynecological diseases in this age category. This is explained by a natural decrease in gonadotropins secreted by the pituitary gland, therefore, during menopause, the release of hormones occurs irregularly, ovulation, development of the corpus luteum, and folliculogenesis. Uterine bleeding especially often accompanies menopausal syndrome - in 30% of cases, when it is significantly pronounced and intense. Characteristic of the menopausal period, hyperestrogenism and endometrial proliferation develop.

If a woman aged 45-55 years has uterine bleeding, other pathologies that can cause it should be excluded, so the woman should have it twice - both before and after diagnostic curettage. The most common causes of uterine bleeding in this case are:

Endometriosis
Uterine fibroids
Uterine polyps
Rarely - ovarian tumors are hormonally active

Common causes of uterine bleeding

Thyroid dysfunction - with diseases such as hyperthyroidism and the risk of symptoms of uterine bleeding increases.
Hormonal imbalance. This is the most common cause of uterine bleeding in young girls and women over 45 years of age. With normal hormonal levels, when the balance between progesterone and optimal, blood loss during menstruation is usually minimal. When this imbalance is disturbed, uterine bleeding occurs.
Diseases of the circulatory system. With a decrease in platelet levels, as well as with other blood diseases, bleeding is also possible in women.
Uterine fibroids. Particularly severe bleeding occurs in women with internal uterine fibroids, when the only option is surgery.
Adenomyosis. This disease is characterized by fusion of the inner and muscular layers of the uterus; menstruation with adenomyosis becomes painful, prolonged and abundant, since the menstrual area expands significantly.
Polyps. These are benign formations that often occur in women of childbearing age. If their number or size is significant, their removal is indicated, since they are the cause of uterine bleeding and painful menstruation.
Ectopic pregnancy, miscarriage, premature placental abruption. These complications during pregnancy have recently become quite common among women. If there is any bleeding during pregnancy, a woman should immediately call an ambulance, since bleeding can threaten the life of not only the baby, but also the expectant mother.
Malignant neoplasms of the genital organs. This is the most serious cause of possible bleeding, and regardless of the location of the tumor - uterus, cervix, ovaries, with any bleeding, a woman should first of all exclude cancer, since in our time the oncological intensity increases every year, and no longer has clear age boundaries , oncology occurs both in very young women and in women during menopause.
Breakthrough uterine bleeding. This reason is directly related to the use of intrauterine contraceptives - spirals or the use of hormonal contraceptives. The risk of bleeding especially increases after simultaneous use of both contraceptives and anticoagulants (aspirin). Breakthrough bleeding may be minor when starting to use hormonal contraceptives as an adaptation to the drug. In these cases, the dosage should be reconsidered or the drug discontinued; if this does not help, then another cause of uterine bleeding should be sought. Blood loss also occurs due to damage to the uterus by the intrauterine device, and it should be removed as quickly as possible.

If something unusual happens during menstruation, in the middle of the cycle, during pregnancy or premenopause, at the slightest suspicion of starting bleeding, a woman should immediately contact her gynecologist for consultation, examination and establishment of the true cause of uterine bleeding, since only knowing the exact diagnosis, adequate and timely treatment can begin.

For emergency symptomatic treatment of uterine bleeding, experts recommend the following hemostatic drugs: etamzilate, vikasol, dicinone, aminocaproic acid, calcium preparations.

Opening internal bleeding is a health and life-threatening condition that occurs for various reasons. Most often, blood penetrates into the cavities of the body, as well as the spaces formed by it.

Internal bleeding - what is it?

This is a rapid loss of blood, in which it does not flow out of the body, but ends up in certain places inside. This could be the uterus in women, the space between joints, stomach, bladder, lungs, intestines.

The symptoms of this condition depend on the location of its location. Hemorrhage can occur in the abdominal cavity, intermuscular, etc.

The causes of pathology are, as a rule, of two types: mechanical damage (trauma, shock) and chronic illness.

The danger of this phenomenon is increased by untimely provision of first aid, ignoring signs by patients, and late diagnosis.

If you seek medical help in time, you can minimize serious complications, determine the location of the bleeding and stop it.

Symptoms of pathology

Intra-abdominal bleeding is one of the most common in mechanical injuries. The symptoms of this form are quite serious.

The patient becomes very sick and vomits blood if the pathology is in the gastrointestinal tract. Diarrhea occurs when there is internal bleeding in the upper esophagus or small intestine. If there is a lesion in the large intestine, red discharge will come from the anus.

Gastrointestinal bleeding is one of the most dangerous. Symptoms include fever, and the patient may feel abdominal pain. If, then the person is tormented by a strong bloody cough, and the place of accumulation of secretions is the pleural cavity. Shortness of breath appears, there is not enough air.

With uterine bleeding, blood flows in the middle of the cycle and pours out of the vagina. However, many symptoms in a number of types are not clearly expressed, which complicates diagnostic measures and leads to a deterioration in the patient’s condition.

So, the symptoms of bleeding that occurred inside the body:

Deterioration in health.
Sudden weakness, lethargy, apathy.
Chills, heat, fever, sweating, pallor.
Acute feeling of fear.
Nausea, vomiting.
Thirst.
Loss of self-control.
Dizziness, fainting.
Severe cough with blood.
Dyspnea.
Sudden pain inside or its complete absence.

If no one is nearby, you need to call the ambulance service, then take a horizontal position. If possible, you should also call your loved ones if they are nearby. In this case, being alone is not only scary, but also dangerous..

You cannot take any pills or drink water. You need to apply ice to your head, chest, and stomach. It is important to try not to panic or make sudden movements.

Common signs of bleeding

The main signs for all forms of bleeding that occur inside the body: weakness in the body, lethargy, blood pressure (BP) decreases significantly, the skin turns pale, and cold sweat appears.

Suspicion of such a condition should arise if there were provoking factors (impacts with blunt, piercing objects; injuries), diseases of the internal organs were diagnosed.

The patient may lose appetite, feel very thirsty, and even lose consciousness. How serious a person’s condition is can be recognized by certain signs.

If the bleeding is minor, then the pulse is intense - up to 80 beats per minute, and blood pressure decreases, other symptoms may be absent.

If the bleeding is moderate, the upper pressure drops to 90 mm. rt. Art. and below, the heart rate increases. In this case, the skin turns pale, hands and feet become cold, breathing quickens, nausea, weakness, dizziness appear, and all psychomotor reactions slow down.

In severe cases, the patient’s blood pressure drops significantly, the pulse is rapid, breathing is intermittent, cold sweat appears, drowsiness appears, trembling of the arms and legs, the eyes darken, vomiting begins, the skin turns pale, cyanosis develops, and the person’s condition is critical.

If the blood loss is massive, then the pressure drops sharply, the pulse is very fast - up to 160 beats per minute, the patient’s consciousness is confused, pale skin, delirium, cold sweat are observed, facial features become sharpened.

Fatal blood loss: slow pulse, low blood pressure, respiratory arrest, convulsions, dilated pupils, dry and pale skin, agony and death.

Species

There are several types of bleeding: arterial, capillary, venous. The cause of arterial disease is damage to the artery by a sharp, cutting object, a gunshot wound; trauma resulting from blunt impact.

It is very difficult to stop bleeding on your own. Blood flows like a fountain inside and outside the organs; the victim can lose a critical volume of blood in a few minutes, which will lead to death.

Capillary - common. In this case, the surface of internal organs may bleed, these include the liver, kidneys, and spleen.

Symptoms are mild at the very beginning, which complicates the diagnostic process. A stomach ulcer can cause it, and hemorrhage also occurs in the brain tissue. In this case, it is necessary to urgently provide assistance to the patient.

Venous is formed if the walls of the veins are damaged. The patient instantly develops symptoms of anemia, anemia, and a state of shock occurs. With venous bleeding, dangerous conditions can occur in which the escaping fluid accumulates in the pleural and retroperitoneal cavities.

Reasons

Why does such a pathology occur? The factors of its formation can be different, at first glance, even impossible. Among them:

poor blood clotting (heredity);
rib fractures, mechanical injuries, wounds;
infections, pathologies, liver cirrhosis, ulcers, tuberculosis, incorrect location of internal organs, their displacement, enlargement due to illness;
during pregnancy - ovarian rupture, cysts, ectopic location of the ovum;
disintegration of a malignant tumor;
arterial hypertension, atherosclerosis.

There can be many more reasons, so it is important to respond in a timely manner to sudden changes in well-being, especially if there have been provoking factors, and chronic diseases of the intestines, stomach and other vital organs have been diagnosed.

Methods for determining the location of internal damage

If a person feels bad, how to find an objective sign of internal bleeding and recognize its source?

If hemorrhage occurs in the abdominal cavity, followed by a rupture of the spleen or liver, then general symptoms include dizziness, weakness, low blood pressure and tachycardia. The patient experiences heaviness in the abdomen, pain in the left and right shoulder, and upon palpation of the peritoneum there is pain in the upper part.

It is difficult, but possible, to independently determine bleeding and its nature..

If there is a rupture of the tubes or ovaries, then there is pain in the lower abdomen, in the anus, deterioration in health, and there is red discharge from the genitals.

When bleeding occurs in the retroperitoneal space (ruptures of the kidneys, aorta), the patient experiences general symptoms, which are not very pronounced.

There is pain in the lumbar region; if you lightly tap on the spine, it will intensify.

If the lesion is in the stomach or intestines, then bloody vomiting or diarrhea and no abdominal pain are observed.

How to stop bleeding

If there is a suspicion of internal hemorrhage, then first aid at home will play an important role in the outcome of the situation. Before the doctors arrive, the patient should be laid down so that the muscles relax. If the victim has a cough, then his body is given a semi-sitting position.

Be sure to open a window in the room and apply cold to the suspected area of damage.

It is important to control a person’s breathing and pulse. If he gets worse, artificial respiration needs to be done and carried out.

You cannot give painkillers, water, medicine, stretch the body, tightly bandage the injury site, or move the victim.

Drug therapy

The best treatment for internal hemorrhages is timely help and surgery. Therapy for this pathology is carried out in a hospital setting, in the departments of gynecology, surgery, neurosurgery - depending on the source of blood loss.

Doctors first stop the blood, replace its loss, and improve circulation. Physical solutions and glucose are used; other medications are prescribed in accordance with the patient’s condition.

In what cases is surgery required?

Surgery is necessary if the patient's condition is critical. After the person has been given first aid, he is hospitalized. Specialists take into account the source of bleeding, and then take measures.

If the place of concentration of fluid is the pleural cavity, then the treatment is carried out by traumatologists, if the lungs are treated - by surgeons, in case of intracranial damage - by neurosurgeons, in case of uterine damage - by gynecologists.

Surgery will be required if the source is in the gastrointestinal tract.

The main task of the doctor is to stop the bleeding, compensate for the amount of loss and improve blood supply. Patients often experience shock, in which the internal organs do not receive enough oxygen.

In such cases, patients are given a transfusion, glucose and saline are administered. If the case is severe, the bleeding is stopped by cauterization, but most often surgery is required.

In case of pulmonary hemorrhage, bronchial tamponade is performed. If the abdominal part is filled with blood, then an urgent laparotomy is performed. If the damage is intracranial, then trepanation is performed. In case of an ulcer, damaged vessels are removed; in case of cracks in the intestines, surgery is performed and they are sutured.

If a woman has an ectopic pregnancy (a tube ruptures), the pathology can only be eliminated surgically.

Internal bleeding during pregnancy

This condition is also called premature placental abruption, and it requires urgent intervention from a specialist.

Clinical manifestations of this condition:

discharge can be abundant, average, or absent altogether;
pain in the lower abdomen, the uterus “turns to stone,” which is easy to feel upon palpation;
the cardiac activity of the fetus is disrupted, hypoxia occurs (determined by ultrasound);
The woman's body temperature rises.
health worsens.

Abruption is provoked by maternal alcohol consumption, drug addiction, smoking, anemia, low red blood cell count, abdominal trauma, allergies to medications, and fluctuations in blood pressure.

Consequences

Any bleeding poses a threat to a person, and internal bleeding even more so. In this condition, blood pressure suddenly drops and hemoglobin decreases.

If blood gets into the cavities of internal organs, their activity is disrupted. If the vessels are compressed, tissue necrosis occurs. Blood that remains in the cavities of organs for some time (not circulating) becomes a suitable place for bacteria to multiply and develop infections.

If the patient is not provided timely assistance, there is a high probability of death. The body is bleeding, the activity of the heart and brain is disrupted. If a person manages to get help, then a long recovery period awaits him, and everything depends on the severity of the condition.