Bloody discharge from the genital tract. Spotting in the middle of the cycle: causes, norm or symptom of the disease

Every girl - girl - woman from 11-15 years old to 45-55 years old monthly (excluding pregnancy and breastfeeding) has menstruation. Its duration is normally 3-7 days, blood loss during the entire menstruation is about 80 ml, the interval between menstruation is 21-35 days. This is a normal menstrual cycle.

If "women's days" come irregularly, spotting appears outside the cycle, namely - before menstruation, after menstruation, in the middle of the cycle, critical days become excessively plentiful, painful - this is a reason to consult a gynecologist-endocrinologist in order to find out the cause of such phenomena and choice of treatment.

CAUSES OF BLEEDING

1. Hyperplasia and endometrial polyps. With these diseases, there are abundant painful menstruation, sometimes with clots, as well as bloody intermenstrual discharge from the genital tract.

2. Uterine fibroids with submucosal nodes. This disease is characterized by cramping pains in the lower abdomen and lower back during menstruation, which becomes protracted and profuse.

3. Endometriosis. Smearing spotting for several days before and after menstruation, painful menstruation with clots most often indicate the presence of endometriosis.

4. Ovulatory syndrome. Some women experience spotting vaginal discharge and/or lower abdominal pain in the middle of their menstrual cycle on ovulation days.

5. Injury to the genital organs and problematic defloration. It is characterized by a connection between rough, forced sex and subsequent bloody discharge from the genital tract. Most often, vaginal ruptures and rupture of the posterior commissure occur, for example, with violent or persistent defloration. In some situations, these injuries require surgical care.

6. Dysfunctional uterine bleeding. After a period of delayed menstruation, a very abundant painless menstruation comes, which does not end on its own, but turns into bleeding. At the same time, the general condition of the woman worsens due to blood loss, anemia occurs.

7. Insufficiency of the second (luteal) phase of the menstrual cycle. If, after ovulation, an inferior corpus luteum has formed that produces an insufficient amount of hormones, a few days before the next menstruation, dark bloody discharge from the vagina appears. This situation can occur in only one menstrual cycle, and may be repeated monthly.

8. Cancer of the cervix and endometrium. These diseases are characterized by bleeding from the vagina of varying intensity, not associated with the phase of the menstrual cycle.

9. Erosion of the cervix. For diseases of the cervix, contact discharge from the genital tract is characteristic, that is, resulting from contact of the cervix with the penis during sex, with a gynecological speculum during a medical examination, and also with constipation.

10. Endometritis. Inflammation of the uterine mucosa is often accompanied by prolonged menstruation and bloody intermenstrual discharge from the vagina.

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BLOODY DISCHARGE DURING PREGNANCY

The discharge of blood from the vagina in the first half of pregnancy most often indicates a lack of the hormone progesterone. It is often accompanied by pulling or cramping pains in the lower abdomen and lower back. If you do not pay attention to this, then everything can end in a spontaneous miscarriage. The period of bearing a child requires a particularly careful attitude of the expectant mother to her body. With an ectopic pregnancy, a woman may also have bloody discharge from the genital tract.

The phenomena described above during this period can signal one or another trouble, which only a doctor can figure out. Make an appointment with the gynecologist-endocrinologist of our clinic and undergo the necessary examination as soon as possible. This is especially required in the presence of bleeding.

Bloody discharge from the female genital organs in the period between menstrual bleeding, as a rule, is one of the symptoms of the development of pathology. Normally, in a healthy woman, such secretions should consist of a small amount of mucus produced by the glandular tissue of the cervix.

It is transparent or in some cases slightly cloudy, which is not a pathology. After all, the quantitative and qualitative composition of the mucous vaginal discharge largely depends on the period of the menstrual cycle during which the gynecological examination was performed. The main function of such secretions is to cleanse and protect the vagina from pathogenic microflora.

When will bleeding be the norm?

Sometimes a woman turns to a gynecologist with a complaint about the appearance of a meager discharge from the genital organs, which contains slight streaks of blood.

And it appears after the end of menstruation in about a week. As usual, the doctor reassures the patient.

After all, this phenomenon is not a pathology, but an element of the norm.

Slight spotting indicates the beginning of the ovulation period and is evidence that the female egg is ready for fertilization.

As a result, the most favorable moment comes for a woman to conceive a child.

As a rule, there is no pronounced presence of blood in the discharge during this period. By their nature, they remain mucous, but the mucus is no longer transparent, but slightly pinkish or brownish. The volume of allocations during this period may increase slightly.

These symptoms should not bother a woman. However, if the amount of blood in the discharge from the vagina has increased and this symptom manifests itself for more than three days, then it is necessary to visit a gynecologist for a consultation. Perhaps these are the first signs of the development of pathology.

Could this be a symptom of a pathology?

If we talk about the female menstrual cycle, then normally it can last more than thirty days. Directly during the period of menstrual bleeding is no more than a week. In the rest of the period, the discharge should be transparent, that is, free from blood. Accordingly, the presence of blood discharge in the intermenstrual period most often indicates the presence of a pathology of the female genital area. What diseases can be accompanied by this symptom?

1. Inflammation of the muscle tissue that forms the uterus, or in other words, endometritis. It develops as a result of penetration into the uterine cavity of pathogens of wound infection. As a rule, the cause of the disease is medical manipulations in the uterus, for example, abortion. In addition to the characteristic discharge, a woman may complain of pain of varying intensity and, in some cases, an increase in body temperature. If treatment is not carried out on time, then subsequently acute symptoms subside. The disease becomes chronic, which is characterized by periodic vaginal bleeding.
2. Endometriosis is often identified as the cause of this symptom. Pathology is caused by uncontrolled growth of the muscular tissue of the uterus. This disease is caused by various hormonal disorders of the patient. Most often, endometriosis occurs in women in the age group after forty years. Based on a simple examination, it is quite difficult to diagnose this pathology. To do this, you will need to conduct an ultrasound examination or perform a laparoscopy.
3. can also appear when using tableted contraceptive medicines. In this case, this is a sign that the doctor has chosen the wrong medicine for the patient. It is quite easy to eliminate the blood smearing that has arisen for this reason. You just need to replace one drug with another.
4. Such bleeding can also be observed in early pregnancy, that is, already when the egg is attached to the uterine wall. However, most often this is a rather unfavorable symptom. It may indicate an abortion.
5. Often, the presence of an intrauterine contraceptive device is indicated as the cause of bleeding. In this case, various pathologies provoked by this contraceptive device cause similar symptoms. These can be inflammatory processes as a result of infection with pathogenic bacteria or with cystic growths both in the uterus itself and in the region of its neck.
6. A small amount of blood may appear in the secretions of a woman after intercourse. As a rule, this is not caused by a disease, but is the result of minor trauma to the cervix or vagina during sexual contact. Concern should be caused by such symptoms with a sufficiently frequent occurrence. In this case, a visit to the gynecologist is mandatory.
7. The appearance of spotting in the middle of the cycle can be triggered by significant hormonal disorders. Moreover, the level of a certain biologically active substance in this case is not constantly elevated, but a single jump in its concentration is observed precisely at the moment the egg is released, that is, at ovulation.
8. Blood discharge from the vagina can be one of the symptomatic manifestations of the tumor process in the uterine cavity, for example, fibroids.

Other grounds for allocations

Bleeding occurs in the first trimester of pregnancy. Sometimes they can be timed to coincide with the period when the usual monthly bleeding should go.

If the discharge is scarce, then there is no need to worry. The doctor may advise you to do a control ultrasound study, and then recommend reducing the intensity of sexual relations.

If the bleeding is profuse, then this is a symptomatic manifestation of the threat of abortion.

Therefore, it is necessary to hospitalize a woman in the pregnancy pathology department to prevent the threat of losing a child.

Such violations can be provoked by significant physical exertion or a long-term depressive state of a woman.

Unusual vaginal discharge containing streaks or an admixture of blood may also appear after some gynecological manipulations, for example, after erosion treatment by cauterization or when taking a biopsy.

The appearance of bleeding during pregnancy

Insignificant bleeding from the vagina at the time of the introduction of a fertilized egg into the wall of the uterus is a fairly common phenomenon and is not pathological. In this case, the appearance of blood is explained by a small traumatization of the mucous tissue and small vessels of the uterus. This bleeding is called implantation bleeding. It may appear about a week before the expected monthly bleeding. It doesn't last long and stops on its own. Medical care is not required in this case.

However, this is the only case when the appearance of blood from the vagina in a pregnant woman is not a sign of the development of a pathological process. As a rule, the appearance of blood in the discharge is an unfavorable sign and requires immediate contact with a gynecologist for medical assistance.

What can cause this symptomatic manifestation? When a patient seeks medical help, a gynecologist suggests the following reasons for this phenomenon:

1. The first thing to be afraid of in the early stages of gestation is the threat of abortion.
2. At later dates, for example, in the last trimester, it may be premature birth.
3. Incorrect placenta previa.

As you can see, the alleged diagnoses are quite threatening. If a woman develops one of them, then it threatens not only her health, but also the life of the unborn child. Accordingly, at the first signs of bleeding, you should immediately contact your doctor, and if the symptoms increase, you do not need to wait, you should immediately call an ambulance.

In addition to bleeding, the following signs of pathology may appear:

• increasing in intensity pain in the lower abdomen;
• the woman begins to complain of weakness and dizziness;
• clouding of consciousness may be observed;
• on examination, the patient's skin will be pale, covered with droplets of sweat.

The presence of such symptoms is a sure sign of the onset of placental exfoliation and the development of internal bleeding.

The woman should be immediately hospitalized for medical attention.

Discharge after childbirth

Minor spotting in women, or they are also called lochia, in the postpartum period is not a pathology.

In their appearance, they have a slight pinkish color and are similar in texture to ichor. On average, they can be excreted from the genital tract about one and a half months after childbirth.

Initially, they contain most of the blood and look very similar to the usual monthly bleeding. Gradually, there is less blood, more mucous discharge prevails.

Therefore, the appearance of the secretions also changes, they become yellow, and blood is quite rare in the form of streaks or smears. About a month after birth, the intensity of the discharge decreases.

In fact, this is no longer a discharge, but a periodic, so-called daub. This is a natural process and gynecological care is not required in this case.

When is it necessary to consult a gynecologist?

1. If the bloody discharge continues to bother the patient for more than a month and a half after labor.
2. If the nature of the discharge has changed, for example, the amount of blood has increased; she went from dark brown to scarlet; bloody discharge from the vagina acquired an unpleasant odor and so on.
3. There were pain sensations in the lower abdominal region. They may be the first sign of infection of the uterus and the development of postpartum sepsis.

How is the diagnosis made?

Of course, stopping massive bleeding from the vagina should be carried out quickly enough. But if these are minor spotting, then before treating a woman, it is necessary to find out the cause of this phenomenon. Diagnosis begins with an initial visit to the gynecologist, where the woman is interviewed and examined.

During the conversation, the attending physician clarifies when the first signs of the development of the pathological process appeared. What contributed to this? Attention is drawn to the presence of concomitant pathology, especially to the violation of the hormonal background and metabolic processes.

Next is a gynecological examination. The woman is examined with the help of special gynecological mirrors. In addition, a palpation examination of the pelvic organs is performed through the vagina and through the anterior abdominal wall. At this stage, a preliminary diagnosis is made.

Blood discharge that appears in a girl during puberty is a physiological norm and indicates the end of the formation of the organs of the reproductive system and the body's readiness for procreation. This brown mucous secretion with blood clots is called menstruation. This phenomenon is absolutely physiological and has a cleansing function. In the process of menstruation, the unfertilized eggs formed during ovulation are removed from the uterus.

Menstruation is present in the life of every mature woman who does not have pathological abnormalities in the functioning of the genital organs, up to the onset of menopause. But what if the discharge with blood appears in the intermenstrual period? Does this phenomenon belong to the physiological norm or is blood secretion a sign of pathology? Why can there be uncharacteristic leucorrhoea with blood clots? Let's figure this out together.

When bloody discharge is considered a physiological norm

Bloody discharge from the vagina that appeared in the intermenstrual period does not always indicate the presence of pathological processes that have affected the reproductive organs of the female body.

Experts say that the appearance of secretion interspersed with blood can be caused by physiological processes that do not pose a threat to health. The phenomena listed below can cause an ichor in the middle of the menstrual cycle, which is not a problem.

Juvenile bleeding

The first menstruation appears in a girl at the age of 11–16 years and indicates the puberty of the fair sex. But the "coming" of the menarche is not a guarantee of the establishment of a clear calendar cycle of the menstrual cycle. Gynecologists say that the body may need up to 6 months to establish a clear periodization.

The presence of a scanty mucous daub of an unsaturated blood tint in a given time period is the age norm. But the duration of bloody discharge throughout the year is a serious reason for contacting a specialist. This phenomenon may indicate pathological processes taking place in the reproductive organs.

Ovulation

Spotting spotting that appears in the middle of the menstrual cycle may indicate the onset of ovulation. This phenomenon is associated with trauma to the blood vessels in the process of the release of the egg from the follicle. It is necessary to pay attention to the accompanying symptoms that accompany the appearance of blood secretion during the period of ovulation.

Doctors say that these discharges should be characterized by:

1. Scarcity and short duration. The spotting caused by the movement of the egg should not be more than 72 hours.
2. The absence of soreness. should not be accompanied by pain in the lower abdomen or pulling sensations in the lumbar region.
3. The absence of an unpleasant odor. Red or, caused by ovulation, have a faint, subtle smell of "iron". The presence of a strong, nauseating odor in the rejected fluid may indicate an infectious disease that has affected the genitals.
4. The absence of pronounced blood clots. Secretion during ovulation has a rich white color. Gynecologists also allow the presence of a scarlet, pink and pale brown tint in the daub at this stage of the cycle.

It is worth noting that the duration of rejection of uncharacteristic bloody mucus from the genital tract, exceeding 72 hours, may indicate the presence of uterine bleeding. When diagnosing a woman with a similar symptom, you should immediately contact a specialist!

oral contraception

The introduction of a new hormonal contraceptive can provoke the rejection of bleeding in the intermenstrual period.

A slight smearing secretion for 3 months should not cause concern for a woman. But against the background of the use of a new contraceptive, it is a sign of rejection of the remedy by the body. In this case, you must immediately stop taking the drug and consult a gynecologist to select a different method of contraception or replace pills.

Use of an intrauterine device

The use of this method of contraception is fraught with the appearance of a bloody daub, which lasts for several days after the start of using the spiral.

Experts attribute damage to the mucous surface during installation to the reasons for its appearance. It is important to remember that profuse prolonged discharge mixed with blood may indicate the need to change the method of contraception and require immediate medical attention!

Postcoital bleeding

Lack of lubricating fluid or too active sex can lead to the formation of microtraumas, leading to the appearance of secretions from the genitals mixed with blood clots. Light bleeding caused by intercourse should stop on its own within a few days, provided there is no re-exposure.

Operable intervention

"Purges", abortions and other surgical interventions on the organs of the reproductive system, a complete list of which can only be named by a highly specialized specialist, can lead to the appearance of vaginal discharge, accompanied by blood. The slight, smearing nature of the rejected secretion should not cause concern, but copious, dark clots released in large quantities may mean menstrual bleeding. In this case, you need to seek medical help as soon as possible!

postnatal period

implantation bleeding

Going instead of menstruation. This phenomenon is associated with the attachment of a fertilized egg to the wall of the uterus. In fact, you can count the start of pregnancy from implantation, but many women take bleeding for the onset of menstruation and do not associate the abrupt end of menstruation with a delay.

Gynecological examination

Statistics show that every woman at least once noticed a small bloody spot after a visit to the gynecologist. This phenomenon does not indicate the presence of any pathologies in the functioning of the reproductive organs.

Mucus with a bloody admixture in small quantities indicates microtraumas received during the examination. Most often, such a "complication" is fraught with the use of a gynecological mirror or the removal of a smear.

Smearing brown discharge resulting from injury will stop going by itself after the restoration of the mucous membrane.

emergency contraception

The use of postcoital contraception drugs, such as Postinor or Escapel, not only inhibits ovulation processes and prevents egg implantation, but also makes adjustments to the hormonal background and the subsequent functioning of the reproductive system. or Postinor usually do not come according to plan.

Experts say that after using emergency contraception, spotting can be observed instead of menstruation for several menstrual cycles. This phenomenon is one of the side effects of the use of oral postcoital contraceptives.

hormone therapy

The drugs that make up the course of hormonal therapy can cause bloody daub, rejected in the intermenstrual period. In this case, the appearance of uncharacteristic secretion is not pathological and does not require special treatment. The discharge will disappear some time after the cessation of the use of hormonal drugs.

When intermenstrual blood on underwear is a symptom of pathology

The causes of spotting in women during the intermenstrual period are not always rooted in the physiological processes and reactions that occur in the body. Much more often, specific secretion is a sign of pathological processes affecting the genitals.

Depending on the nature of the secretion and symptoms that aggravate the rejection of leucorrhoea with blood streaks, experts identify several reasons for the release of bloody mucus-like clots.

Hormonal disruptions

Dysfunction of the thyroid gland and adrenal glands, experts rightly call one of the most common causes of rejection of bloody daub between menstruation. Many factors can cause deviation:

• eating disorder;
• excessive physical activity;
• active pace of classes in the gym during menopause;
• change of climatic zones.

Pathological processes in these organs can affect the level of production of estrogen, the main female hormone, which, in turn, is fraught with disruptions in the cyclical characteristics of the menstrual cycle. Such deviations have mild symptoms and are diagnosed by testing for hormones.

Gynecologists say that hormonal imbalance can cause calendar periods to "linger" for a week or two. This phenomenon is extremely dangerous and requires immediate medical attention.

Sexually Transmitted Diseases (STDs)

Infectious diseases transmitted from partner to partner, regardless of the biological type of the pathogen, can provoke bloody discharge from the vagina, which is rejected during the entire intermenstrual period.

Gynecologists say that diseases of this etymology are accompanied not only by systematic brown secretion. The most common signs indicating damage to the genital organs by an infectious disease include:

1. Pain that accompanies the rejection of secretion.
2. A sharp pain spasm, "belt" covering the lower abdomen and lumbar.
3. The appearance accompanying the excretory process.
4. Itching in the perineum.
5. Burning during urination.
6. The presence of purulent inclusions in bloody discharge. The early stage of infection is characterized by rejection of yellow mucous clots. Clearly indicate a running inflammatory process.
7. Pain during intercourse.

The appearance of bloody secretion, aggravated by the above symptoms, is a serious reason for contacting a specialist.

The treatment of any sexually transmitted diseases requires the patient to strictly follow the therapeutic course prescribed by the doctors. In most cases, therapy is carried out in two stages. The first is aimed at the extermination of the pathogen with the help of antibiotics, while the second ensures the maintenance of the effect and the rapid recovery of the body.

Cervical erosion

Small spotting, systematically appearing after intercourse and in the intermenstrual period, may indicate the presence of erosion on the surface of the cervix. This pathology is the formation of scars and ulcers on the upper layer of the endometrium. The name of the disease is based on the "location" of the pathological deviation.

Diagnosis of the disease, in most cases, is possible only in the process of gynecological examination. Therapeutic therapy is carried out by cauterization of the affected areas. Recovery after treatment is quite fast, and does not last more than a month. Gynecologists say that the "old" erosion can lead to acquired female infertility.

endometritis

A disease that is an acute inflammation of the endometrium - the tissue that covers the reproductive organs. The symptoms of endometritis are extensive and depend on the neglect of the process. There are several factors, based on the presence of which in the anamnesis, a specialist can diagnose the inflammatory process in the endometrium. These include:

• the systematic appearance of red-brown discharge after the end of the calendar menstruation;
• pain in the lower abdomen;
• profuse secretion;
• increase in body temperature.

It is necessary to attach importance to even the slightest ailment, and the identification of the above signs should encourage a woman to immediately contact a specialist in order to prevent the transition of inflammation to the chronic stage.

Tumors and neoplasms in the organs of the reproductive system

The occurrence of such an ailment is most often affected by women during menopause and menopause.

Based on statistical data, the most common neoplasms in the reproductive organs are polyps. The tumor does not have severe symptoms at an early stage of development, but the subsequent phases are often characterized by the appearance in women of abundant, increased fatigue, low hemoglobin levels and constant pulling pain in the inguinal triangle.

It is possible to diagnose a neoplasm only in the process of gynecological examination and based on the results of ultrasound. If the tumor poses a threat to a woman's life, doctors may recommend surgery.

After such exposure, the patient should constantly monitor the health of the organs of the reproductive system, because even the focus of the removed tumor in the future can develop into a cancerous neoplasm.

Bloody discharge during pregnancy

Blood discharge in women during pregnancy is a serious cause for concern, whether it is secretion during a small period or in the last trimester. Depending on the accompanying signs, such a phenomenon may mean premature detachment of the placenta (typical for late periods), the presence of pathologies in the development of the fetus, or a miscarriage. Usually, such conditions are accompanied by pain in the lower abdomen and general weakness.

It must be understood that the cause that caused bloody secretion during pregnancy will not disappear by itself. Gynecologists remind that at the first signs of bleeding or in the presence of constant daubing, regardless of the period, it is necessary to immediately contact the gynecologist observing the woman.

Such processes can begin rapidly and every minute the patient may become worse.

Bloody discharge during pregnancy indicates a direct threat to the fetus and the woman in labor!

Summing up, we can say with confidence that the spotting that appears in women between menstruation can lie both in the plane of the physiological norm and indicate a developing pathology of the reproductive organs. In order to isolate the root cause of what is happening, it is necessary to consult a doctor and pass a series of tests that form the basis of the anamnesis.

Women's health is largely determined by hormonal balance. And a large number of gynecological pathologies are accompanied by a violation of regulatory mechanisms. Against this background, menstrual and reproductive functions are often disturbed, and other symptoms appear that disturb the woman. For example, mucous discharge with blood streaks may appear. But you need to understand in more detail the reasons for their appearance and the accompanying signs, because the situations are very different.

Causes and mechanisms

It is necessary to immediately reassure women - not all bloody discharge indicates pathology. A similar phenomenon occurs in the norm. It is based on various physiological processes:

• The formation of menstruation.
• Climax.
• Ovulation.
• Embryo implantation.
• postpartum period.
• The consequences of an abortion.

These are situations where mucus with blood can go regardless of the menstrual cycle. For example, teenage girls and menopausal women have irregular periods, and there will often be similar discharge between them. Just in one case, the ovaries have not yet tuned in to cyclic changes, and in the second, they are already moving into a state of functional rest.

Bleeding during ovulation (in the middle of the cycle) and implantation of the fetal egg should also not be frightening if it lasts no more than 3 days and has a very poor character (daub). And in the postpartum and post-abortion periods, there is a discharge of the remnants of the decidual membrane and the restoration of the functional layer of the endometrium, which can take several weeks. But this one also corresponds to the norm, therefore, there is no point in worrying.

But there are situations when vaginal discharge appears due to pathology - gynecological or obstetric. The range of possible conditions can be quite wide, but the main reasons will be:

• Infections.
• Cervical erosion.
• Fibroids and polyps.
• hyperplasia of the endometrium.
• Spontaneous abortion.
• Ectopic pregnancy.
• placental complications.
• Injuries of the genital tract.
• Varicose veins of the vagina.

It should also be noted that there are discharges even against the background of external influences. These factors include emotional stress, poor nutrition, irrational contraception, and taking certain medications. All this shifts the natural hormonal balance in a woman's body, contributing to various disorders.

Each condition requires a separate differential diagnosis, because the symptoms can be very similar. Therefore, noticing discharge with blood, you should immediately consult a doctor. The specialist will determine their origin and say whether there is reason to think about the pathology.

Bloody discharge is always a concern. But whether they are justified, only a competent person will determine.

Symptoms

To understand why blood can be released from the genital tract, you first need to conduct a clinical examination. It includes the analysis of anamnestic information, general and gynecological examination data. Any symptom requires detailing so as not to miss anything important. Be sure to establish the nature of the discharge:

• Color: transparent, whitish, with brown, yellow or green tints.
• Volume: scanty or plentiful.
• Smell: neutral or unpleasant.
• Duration: short-term or long-term.
• Frequency: rare or frequent.
• Dependence on the menstrual cycle, connection with pregnancy.

In addition, you need to determine if there are any additional symptoms. Sometimes they can play an even more significant role in the diagnosis than the discharge itself. And having received a holistic view at the clinical level, you can count on confirming the diagnosis through additional studies.

infections

If a woman has vaginal discharge, then first of all, many will think about an infectious lesion of the genital tract. Microbial invasion may be accompanied by blood streaks or diffuse seepage. Under certain conditions, the discharge takes on a specific form:

• Thick and cloudy with a yellow-green tint - with gonorrhea.
• Abundant, liquid and foamy - with trichomoniasis.
• With white curd-like inclusions and a sour smell - with candidiasis.

The infectious process is necessarily accompanied by subjective symptoms. A woman feels burning and itching in the vagina, pain during urination, discomfort during intercourse. Sometimes pulling pains in the lower abdomen are possible, but they are more characteristic of the spread of inflammation upwards.

Cervical erosion

Cervical erosion is considered a common gynecological pathology. This is a benign process, which nevertheless increases the likelihood of metaplastic transformations on the mucous membrane. For a long time, erosion does not appear in any way. With the development of pathology, a woman notes the appearance of such signs:

• Drawing pains in the lower abdomen.
• Scanty mucous discharge with streaks of blood (contact).
• Painful intercourse.

A defect in the mucous membrane of the cervix contributes to the attachment of infection. Then the discharge takes on a different character, becoming more abundant, and subjective symptoms expand.

Cervical erosion is detected in almost every second woman of reproductive age, which should be the reason for regular examinations by a gynecologist.

Fibroids and polyps

Among benign diseases of the uterus, endometrial hyperplasia, fibromyomas and polyps are widespread. Their clinical features are largely similar. Most often we are talking about hypermenstrual syndrome, which combines the following conditions:

• Polymenorrhea - long periods.
• Poiomenorrhea - frequent menstruation.
• Hypermenorrhea - profuse discharge.

If the bleeding is cyclical, then they are called menorrhagia, and in the absence of such a connection, we are talking about metrorrhagia. There are also combined cases when, against the background of heavy menstruation, erratic discharge appears, sometimes with clots. If there is no ovulation in the cycle, then there are problems with conceiving a child, and with intense blood loss, signs of anemia are observed: pallor, dizziness, weakness, brittle nails, hair loss, etc.

Spontaneous abortion

With the onset of pregnancy, a woman is probably most afraid of a miscarriage. It can occur in the early stages, starting with the threat of abortion and ending with the complete discharge of the fetal egg. But in order to prevent the latter, one should pay attention to all deviations in well-being, especially to such symptoms:

• Bloody issues.
• Drawing pains in the lower abdomen.
• Pressure on the rectum.
• Frequent urination.

In the future, all signs will only intensify, predetermining the transition of the pathological process to new stages. The fetal membranes exfoliate from the endometrium, and the embryo dies. If for some reason it lingers in the uterus, then a missed pregnancy is diagnosed. If it is stored for more than a few weeks, the risk of massive bleeding and infectious complications increases.

Ectopic pregnancy

Allocations with an admixture of blood also occur during ectopic pregnancy. Most often, implantation of the fetal egg in the fallopian tube occurs. Until a certain time, the fetal egg develops according to physiology, but the walls cannot stretch indefinitely. At an early stage, the pregnancy is terminated in the form of an abortion or rupture of the tube. In both cases, the clinic is similar - scanty vaginal discharge against the background of pulling pains on one side - but the latter is characterized by a sudden development and more intense symptoms. When the tube ruptures, signs of an "acute abdomen" and internal bleeding appear:

• Sharp pains radiating to the sacrum, rectum, legs.
• Tension of the muscles of the anterior wall of the abdomen.
• Signs of irritated peritoneum.
• Pain on palpation.
• Overhanging of the posterior fornix of the vagina.
• Dullness of percussion sound in the iliac regions.
• Deterioration of the general condition (severe weakness, pallor, increased heart rate, pressure drop).

It must be understood that such a condition requires urgent measures, because continued bleeding will lead to the development of hemorrhagic shock. And this is already associated with a real risk to life.

Placental complications

Another situation where spotting may appear in obstetrics is placental abruption or placenta previa. The latter manifests itself immediately before childbirth, when the cervix begins to open. There is bleeding from the genital tract because the placenta partially or completely blocks the cervical canal. And the first or second trimesters may be accompanied by premature detachment. This condition is characterized by the following features:

• Scanty discharge mixed with blood.
• Local pain in the abdomen.
• Deterioration of the fetus.

And if placenta previa is dangerous primarily for a woman, then abruption poses a threat of premature termination of pregnancy. But in any case, qualified medical assistance is required.

Placental complications in obstetrics are a serious pathology that creates risks for the fetus and the woman herself.

Additional diagnostics

Any pathology must be accurately verified. But clinical signs do not give full confidence in the correctness of a particular diagnosis. Therefore, additional methods are extremely important, confirming the doctor's assumption and clarifying the nature of the changes. If a woman has a discharge with streaks of blood, she will most likely have to undergo such studies:

• General blood and urine tests.
• Blood biochemistry (hormones, antibodies to infections, coagulogram, etc.).
• Bakposev and microscopy of secretions.
• Ultrasound of the pelvis.
• Hysteroscopy.
• Metrography.
• Fetal cardiotocography.

What tests should be carried out, the specialist will determine, because the examination program depends on the results of preliminary diagnostics. And having received all the information about the condition of the woman, the doctor will accurately indicate the origin of the discharge and determine the measures that need to be taken to eliminate the pathology. If probable deviations are excluded, then the woman just needs to calm down and continue to lead a normal life, taking care of her own health and noticing alarming changes in it.

Thank you

Many women consider any discharge from the genitals a sign of some kind of disease, and seek to get rid of them. This is a fundamental misconception. Vaginal discharge just as physiological as the secretion of the salivary and lacrimal glands, gastric juice, etc. Trying to get rid of all these secretions is not only pointless, but also unsafe. In some cases, this also applies to spotting. But their appearance occupies a special place in gynecology- the admixture of blood in the vaginal secretion often serves as a sign of various pathologies. Let's try to understand in more detail what spotting means, and in what cases, when they appear, you need to see a doctor.

Bloody discharge in girls

Secretion from the genital organs is characteristic of the female body at almost any age, with the exception of the period from birth to 9-11 years. Before puberty, girls should not have vaginal discharge. This is due to the structure of the genital organs and the peculiarities of the hormonal profile in this age period. The menstrual function is still absent, the eggs do not mature, the production of female sex hormones is very low, and their effect on the girl's body is minimal. This is the so-called period of physiological rest.

Therefore, the appearance of a vaginal secretion in a girl up to 10-12 years old, and even more so bloody discharge in a newborn, clearly indicates the presence of problems. This may be pathologically early puberty, an infectious lesion, or even a disease of the digestive or urinary tract, which are located nearby.

In any case, the appearance of spotting before puberty is a reason for seeking advice from a pediatric gynecologist.

Bloody discharge in girls

Spotting during this period is called juvenile, or puberty.
Most often, these are uterine bleeding, which are a violation of the menstrual cycle in girls aged 12-18 years. They are also often called dysfunctional - associated with violations of the hormonal function of the ovaries.

Clinical signs
Most often, spotting in girls appears after a delay in the next menstruation for several weeks. They usually last more than a week. In some cases, such juvenile bleeding can be observed for several months, periodically weakening, then intensifying. With such prolonged bleeding, the patient's condition can be quite severe. Intense and prolonged spotting can lead to the development of anemia. This condition requires urgent medical attention.

Treatment of bleeding in girls
Adequate therapy of juvenile bleeding is necessary in order to avoid such severe complications as hemorrhagic shock or anemia.

With a timely visit to the gynecologist and the beginning of treatment, in most cases, spotting disappears, and the menstrual cycle returns to normal. But if bleeding during adolescence remains untreated, then it can turn into bleeding of reproductive age, which can cause infertility and the development of diseases already in an adult woman.

Bloody discharge in women of reproductive age

When can they normally meet?

As a rule, such discharges appear in women about a few days before the onset of menstruation, and gradually develop into more heavy menstrual bleeding. In addition, they can continue for several days after the end of menstruation. Most often, this phenomenon is observed in women who are protected with an intrauterine device. In such cases, if the discharge is not very abundant, then they are considered a physiological norm, and no special treatment is required.

Bloody discharge from the vagina as a sign of pathology

An important factor in determining the danger when such secretions appear is their amount and relationship with the woman's menstrual cycle.

Profuse bleeding
If a woman has abundant spotting that is not related to the physiological menstrual cycle, this is a sign of a serious pathology. Such a patient should be examined by a gynecologist as soon as possible. This symptom is potentially life-threatening for a woman, and the loss of time can result in serious consequences for women's health.

Brown spotting, and in some cases even black, is a consequence of the destruction of blood cells in the uterine cavity. It is necessary to determine the cause of bleeding as soon as possible.

Scanty and spotting
If spotting, not associated with the menstrual cycle, is scarce, then they may indicate the following pathologies:

• menstrual irregularities;
• the presence of endometriosis;
• erosion of the cervix in severe form;
• cervical cancer;
• infectious lesions (with systematic spotting spotting, associated or not associated with the days of the menstrual cycle, and having a fetid odor).

The relationship of bleeding with the menstrual cycle

Bleeding before and after menses
Bloody discharge after menstruation and before them is a fairly common occurrence. In her life, almost every woman at least once noticed unexpected vaginal bleeding.

It should be remembered that scarlet spotting, which gradually becomes more and more abundant, is considered the norm on the first day of menstruation.

Brown dark spotting before menstruation indicates the presence of a pathological process in the uterus: endometriosis, polyp, hyperplasia (growth) of the endometrium, etc. Pink discharge like diluted blood with an unpleasant odor before and after menstruation is a symptom of chronic endometritis or chronic endocervicitis.

Abundant and prolonged spotting after menstruation and before them are most often dysfunctional. They need to be stopped, and then to find out and start treating the causes of their appearance. They arise due to violations of the hormonal function of the ovaries. It is in these organs that the eggs mature cyclically and female sex hormones are produced, which are involved in maintaining the normal menstrual cycle.

The causes of spotting after menstruation and before them can be:

• hormonal disorders in the body with various diseases and stress;
• endocrine pathologies, most often - a small amount of thyroid hormones;
• stopping or starting hormonal contraceptives;
• the use of emergency contraception drugs: Postinor, Ginepriston, etc.;
• certain medications, and starting or stopping estrogen supplements.

Bloody discharge in the middle of the menstrual cycle
Experts say that intermenstrual light bleeding from the vagina is a phenomenon that does not pose a danger. It is caused by hormonal fluctuations associated with the onset of ovulation. Bloody discharge between periods occurs in almost 30% of women.

Normal discharge during ovulation is characterized by the following features:

• small total volume (spotting spotting);
• duration - no more than 72 hours;
• slimy consistency of scarlet, pinkish or brown;
• no need to use feminine hygiene products;
• the examination does not determine other causes of bleeding from the genital organs.

Often, unexpected spotting from the genital tract, even a small amount, can also be a sign of gynecological diseases.

Bleeding between periods usually begins on the 10-16th day, counting from the first day of the last menstruation, that is, from the beginning of the cycle. Normally, they look like poorly visible mucous secretions with streaks of blood, which last from half a day to three days. If, over time, spotting becomes stronger, or does not stop for more than three days, then you should definitely contact a gynecologist.

The doctor must stop the bleeding and prescribe the necessary examinations. But even if such bleeding has stopped on its own, then it is still worth it to undergo an examination by a gynecologist and perform an ultrasound of the pelvic organs. Such a phenomenon can serve as the only symptom of the presence of a latent gynecological disease.

Causes and treatment of spotting in the middle of the cycle
The most common cause of uterine bleeding between periods in a healthy woman is a sudden sharp fluctuation in the level of estrogen in the body. During ovulation, the level of this hormone rises rapidly. And since it affects the lining of the uterus, a similar symptom appears. Bloody discharge during or after ovulation is considered a physiological norm if no signs of other diseases are found during a medical examination. However, they are subject to medical correction. For the treatment and prevention of such hormonal surges, a woman is usually advised to avoid stressful situations and prescribe herbal preparations.

Smearing brown, pink or dark spotting in the middle of the menstrual cycle occurs when:

• the release of the egg from the follicle at the time of ovulation;
• the presence of an intrauterine device;
• taking hormonal contraceptives;
• the use of certain other drugs that affect the menstrual cycle;
• performing gynecological procedures, for example, cauterization or conization of the cervix;
• low functional activity of the thyroid gland;
• polyposis, endometriosis, cervical erosion, chronic inflammation of the uterus (endometritis);
• genital infections (for example, gonorrhea);
• genital injuries;
• fibromas and other tumors of the genital organs.

Bloody discharge during menstruation
Of course, bleeding is an integral part of menstruation. However, in some cases, a change in the consistency of the discharge may be a sign of pathology.

So, if spotting instead of menstruation takes on the character of large clots, this may indicate:

• pathological bend of the cervix;
• violation of blood clotting and a tendency to thrombosis;
• insufficiency of vitamins of group B;
• pathological processes in the uterus (myoma, polyp, endometriosis).

Bloody discharge before menstruation, after them and in the middle of the cycle, require special attention and a thorough examination, which should include:

• consultation with a gynecologist;
• bacteriological and microscopic analysis of secretions;
• Ultrasound of the pelvic organs.

Bloody discharge during pregnancy

Bloody discharge as a sign of pregnancy
Minor bleeding from the genital tract can occur when a fertilized egg (implantation) is introduced into the wall of the uterus. It is associated with microscopic damage to the uterus and possible traumatization of small vessels in it. Such secretions, called implantation ones, are scarce, hardly noticeable and do not pose any threat to health.

Implantation bleeding most often occurs about 7-9 days before the expected start of the next period. Many women, noticing it, believe that this is a harbinger of normal menstruation, and do not consider this symptom as a sign of pregnancy.

Bloody discharge in pregnant women
A woman should be alerted to any spotting (of any duration, in any amount, of any color) that occurs during pregnancy, even if they are not accompanied by pain. The reason for such allocations may be:

• premature detachment of the placenta;
• detachment of the fetal egg;
• improper location of the placenta (previa);
• threatened miscarriage.

Such spotting is often brown in color, and can appear at almost any stage of pregnancy.

Another, but not so dangerous, cause of bleeding during pregnancy is microtrauma and rupture of the vessels of the cervix during its erosion. Only a specialist can accurately determine the true cause of bleeding, therefore, if any such discharge appears, it is necessary to undergo an examination by a gynecologist.

Bleeding during pregnancy is characterized by the fact that it can sharply and unexpectedly intensify, leading to very serious complications and consequences. A danger to the health, and sometimes the life of a pregnant woman, may be the appearance of copious brown, scarlet, pink or dark spotting.

It is urgent to call an ambulance for the following symptoms:

• a sharp decrease in blood pressure;
• weak pulse;
• general weakness;
• pale skin;

With the appearance of such spotting during pregnancy, it is necessary to observe bed rest and complete rest. In addition, gynecologists almost always recommend urgent hospitalization. The health and life of a pregnant woman and her child may depend on this.

Bloody discharge in early pregnancy
In the early stages of pregnancy, the appearance of spotting can mean the threat of spontaneous miscarriage. As a rule, such discharge in the first trimester occurs if the process of rejection of the fetal egg begins. Therefore, in order to prevent abortion and the threat of losing a child, a woman must be hospitalized as soon as possible in the gynecological department. Only specialists in a hospital will be able to carry out all the necessary measures aimed at maintaining pregnancy.

Discharge in late pregnancy
At a later date, spotting may indicate a threat of premature placental abruption, or mean premature onset of labor. In such cases, emergency assistance from gynecologists is necessary.

However, the appearance at 38-40 weeks of spotting brown, not red, in small quantities is not a cause for particular concern. In many women, such discharge occurs as a result of weak bleeding from the vessels that are located on the cervix. However, at the next scheduled visit to a gynecologist, a pregnant woman must tell him about the noticed vaginal discharge.

Bloody discharge during miscarriage

Bloody discharge from the genitals during pregnancy is the most common symptom of a threatened miscarriage. At the same time, pain in the lower back and pulling pain in the lower abdomen can accompany the discharge, or precede their appearance.

It must be remembered that if a woman suddenly had bloody discharge from the vagina, and she was diagnosed with a threatened miscarriage, this does not mean at all that the pregnancy will be terminated in any case. Most women, despite the presence of bloody discharge in the early or late stages, with timely and adequate treatment, successfully endure pregnancy and give birth to healthy children.

Bloody discharge after childbirth

Normal discharge after childbirth (called lochia) is pink and resembles dilute blood or ichor. This is postpartum physiological discharge from the uterus, which includes blood, mucus and torn off non-viable tissues of the decidua of the uterus.

Most often, the duration of the allocation of such lochia is from 3 to 6, occasionally up to 8 weeks after childbirth. A necessary sign of the normal course of this process is the tendency to reduce the amount and clarify the discharge. Lochia in the first week resemble regular periods, only more abundant and sometimes containing blood clots. Every day their number should decrease.

Gradually, the lochia becomes yellowish white due to the increase in mucus, begins to resemble egg white, but may still contain small blood impurities. Around the 4th week after childbirth, only meager, "smearing" discharge should be observed. By the end of 6-8 weeks after childbirth, vaginal discharge should acquire the same character and quantity as before the onset of pregnancy.

Bloody discharge after examination by a gynecologist

The appearance of scanty spotting after a gynecological examination is not uncommon, and should not cause much concern. During the examination, microtrauma of blood vessels and minor damage to the mucous membranes are not excluded. Often such discharge occurs in cases where the doctor uses a mirror when examining, or takes a smear. The smear is taken from the mucous membrane of the vagina, urethra and canal of the uterine neck. Simply put, the cells of the mucous membrane are simply scraped off the wall of the vagina or other organ. It is quite natural that damaged tissue may bleed for some time.

The main thing to remember is that spotting should stop as soon as possible. In any case, it will be useful for a woman to monitor her condition. If the discharge of blood does not stop, or itching, burning or pain joins it, then you should immediately contact a gynecologist, describing all the details.

Bleeding after an abortion

Any abortion is associated with more or less extensive trauma to the vessels of the uterine wall. Therefore, the appearance after an abortion of spotting, different in color and quantity, is almost inevitable.

In about 80% of women after drug exposure, a complete abortion occurs after a week, and spotting completely stops. In 95% of women, a complete abortion occurs by the 14th day after the manipulation. Scanty secretions of a bloody nature after a medical abortion can be observed until the next menstruation.

Menstruation after a medical abortion should begin approximately after such a period, the duration of which for a particular woman is a normal menstrual cycle. In addition, they can normally be delayed up to 10 days. Although in some cases (in about 13% of patients), the first menstruation after a medical abortion may begin only 2 months after the abortion procedure.

Abundant spotting after an abortion is quite rare. This usually serves as an indicator of violations of the blood coagulation system. It must be remembered that after an abortion, uterine bleeding is considered severe if:
1. Two sanitary pads of the largest size are completely soaked with blood within an hour.
2. This goes on for over two hours straight.

In such cases, a woman needs to urgently undergo a second consultation with a gynecologist and do an ultrasound scan. To stop uterine bleeding, your doctor may prescribe additional drugs that shrink the uterus and reduce bleeding.

Regardless of the presence or absence of spotting, a week after the abortion, you must definitely contact the gynecologist again and undergo a control ultrasound.

Bloody discharge after intercourse

Bloody discharge of a brown tint, pink or dark spotting that occurs after intercourse, most often has fairly safe causes that are easily eliminated with a timely visit to a gynecologist. However, it must be remembered that if spotting during or after sex is profuse and accompanied by severe pain, then you need to seek medical help as soon as possible.

Bloody discharge that occurs in women after intercourse is called postcoital bleeding. Consider the main reasons for their appearance.

Mechanical damage
The release of blood after sex from the genitals can be caused by physical impact. Most often, these are injuries that a woman can get in the process of too rough or active sex:

• injuries and ruptures of the walls or fornix of the vagina;
• damage to the mucous membrane of the cervix;
• damage to the eroded cervix.

The likelihood of injury or rupture of the vaginal wall is especially high if the pain and blood appear unexpectedly, right during intercourse, and the bleeding is quite heavy. In such cases, you must immediately call an ambulance, as with any serious injury, accompanied by bleeding.

infectious diseases
Often the cause of spotting after intercourse can be an infectious lesion - chlamydia and other sexually transmitted diseases. Another symptom of an infectious pathology of the reproductive system is the addition of a fetid odor to the secretions.

Inflammatory lesions
Bloody discharge after and during sex can occur due to inflammatory diseases of the female genital organs. Most often, bleeding after sex occurs with cervicitis (inflammation of the cervix) or vaginitis (inflammation of the vagina). In both cases, bleeding from the genitals of a woman occurs not only after sex. Sexual intercourse in this situation is only a stimulating factor.

Polyps and cervical erosion
A common cause of spotting after sex is polyps and erosion of the cervix. Such secretions, as a rule, are very transient, disappear in just a few hours, but resume again at the next sexual contact. To get rid of this symptom, you need to contact a gynecologist and undergo a course of treatment for cervical erosion. But polyps, which can cause the development of malignant tumors in the future, must be removed.

The use of drugs
Bleeding after intercourse may be due to taking certain medications that reduce blood clotting (such as aspirin) and birth control. Taking such drugs is associated with the risk of developing hypoplasia (reducing the thickness) of the uterine mucosa, which can lead to trauma.

The cause of spotting can also be errors in taking contraceptives. Skipping the next dose of these drugs, or using them late, can provoke bleeding after sex. In such cases, the gynecologist may advise changing the drug that caused the adverse reaction, or temporarily stop it if the bleeding was caused by errors in its use.

Other pathologies
In rare cases, the cause of spotting after sex can be pathological changes in the cells of the cervix (dysplasia), certain blood diseases and uterine cancer. The presence of such pathologies is determined by laboratory analysis of the vaginal discharge, and other examinations.

Bleeding while using contraceptives

Brown spotting in the first two months after the start of taking hormonal contraceptives is considered a variant of the norm. During the use of medications such as Regulon, Yarina, Jess, spotting can appear in any phase of the menstrual cycle, which is associated with the suppression of ovulation. After the use of postcoital hormonal contraceptives, such as Postinor, spotting can also occur due to sudden changes in the hormonal balance of the body.

It should be remembered that if spotting does not stop in the third and fourth months of continuous use of the drug, the woman should consult a gynecologist. Most likely, this oral contraceptive simply does not suit her, and it needs to be replaced.

Bloody discharge during menopause

Bleeding during menopause (even the smallest spotting) is a symptom of diseases, and sometimes quite serious, up to uterine cancer. Therefore, in no case should such a situation be ignored.

Many women are quite hard to endure menopause. Signs of its pathological course are:

• strong and frequent hot flashes;
• violations of metabolic processes in the body;
• increased blood pressure;
• the appearance of psychological disorders;
• periodic bleeding from the genitals.

The widespread belief that any symptoms are possible during menopause leads many women to ignore bleeding that should not be normal. They occur quite often - according to statistics, more than half of patients over 45 years old turn to a gynecologist because of bleeding during menopause.

Causes and treatment of bleeding in menopause
Symptoms of pathological menopause are primarily due to hormonal changes in the female body, that is, they are dysfunctional. But we must not forget that in some cases, bleeding indicates the presence of tumor neoplasms of a benign (polyps and fibroids) or malignant nature.

Bloody discharge can occur if a woman after menopause uses hormone replacement therapy. In this case, taking progesterone can stimulate the recovery of light menstrual bleeding. They can be observed within 1-2 years, usually pass painlessly and easily, lasting no more than 3-4 days. This is the only type of spotting in menopause that does not require immediate interruption of the course and treatment. But if a woman takes progesterone, and menstrual bleeding starts at the wrong time, lasts longer than expected, is very plentiful or contains blood clots, then you should definitely consult a gynecologist.

It is necessary to distinguish between two types of bleeding in menopause:
1. Bleeding during menopause.
2. Bleeding during the postmenopausal period.

Bloody discharge in premenopause
Bleeding during premenopause is usually caused by a violation of the production of sex hormones in women aged 45-50 years, up to the complete cessation of menstruation. Their cause is violations of the timing of ovulation, which lead to the failure of cyclic changes in the thickness of the uterine mucosa.

Usually, menopausal bleeding in premenopause appears after a delay in menstruation, and sometimes they begin on the day of the expected menstruation, or even a little earlier. Such spotting can have a different intensity, and be observed for several weeks, or even months. They are characterized by relapses that sometimes occur within 4-5 years.

Especially often, spotting during menopause is observed in women suffering from metabolic disorders and various endocrine diseases. Therefore, the appearance of the first signs of menopausal bleeding is a reason for a mandatory examination in order to identify violations of the functions of the thyroid and pancreas, liver, fat and carbohydrate metabolism.

Bloody discharge in postmenopausal women
Any spotting in the postmenopausal period, that is, after the complete cessation of menstruation, should always be considered as a threatening symptom. Such bleeding is a sign of tumors, including malignant ones. In such cases, diagnostic curettage is almost always performed, affecting the mucous membrane of the body of the uterus and the canal of its neck, as well as the subsequent histological examination of the scraping.

Diagnosis and treatment of bleeding

Which doctor should I contact with bloody discharge from the genital tract?

With the appearance of spotting of various nature and quantity in women and girls of any age, you should contact gynecologist (make an appointment). If we are talking about teenagers or girls under 10 years old, then you should contact a pediatric gynecologist.

Despite the fact that bloody discharge from the vagina can be evidence not only of diseases of the female genital area, but also a symptom of a disorder of the blood coagulation system, you still need to contact a gynecologist when they appear, since coagulopathy (blood clotting disorders) are much less common than gynecological pathology . This means that the doctor will examine the woman and, if necessary, refer her to hematologist (make an appointment).

In addition, every woman and girl should know that the discharge of blood from the genital tract in some cases is a sign of an emergency, the essence of which is that some kind of catastrophe occurs in the body and immediate medical attention is required to save a life. If signs of such a dangerous condition appear, you should immediately call an ambulance and be hospitalized in a hospital so that doctors can provide the assistance necessary to save a life.

So, urgently call an ambulance and be hospitalized in a hospital if during or after intercourse in the abdomen or vagina there is severe pain and heavy bleeding begins. In this situation, urgent help is needed due to the fact that during sexual intercourse an injury occurred to the organs and tears and traumatic injuries must be sutured so that the woman does not die from blood loss.

In addition, it is imperative to call an ambulance and be hospitalized for pregnant women at any gestational age if they have bloody discharge from the vagina. Any discharge of blood from the vagina during pregnancy should be considered dangerous. Although theoretically bleeding from the vagina during pregnancy can be harmless, due, for example, to cervical erosion, it is difficult to distinguish them from dangerous ones. Moreover, at the beginning, spotting may have signs of benign, but this is deceptive, since at any moment they can intensify, take on their true nature and become very dangerous (for example, with an ectopic pregnancy, miscarriage, placental abruption, etc.) .

In addition, bloody discharge from the vagina in women and girls of any age should be considered dangerous if it increases or does not decrease with time, possibly combined with severe pain in the lower abdomen (right, left, in the middle or everywhere) or lower back, high body temperature, a strong and rapid deterioration in well-being after the onset of spotting, blanching, decreased pressure, increased heart rate, profuse sweating, possibly fainting. Remember that with a dangerous discharge of blood from the vagina, the woman's condition quickly and sharply worsens so much that she literally cannot stand and sit, and almost faints.

Treatment of bleeding from the genital organs in women of any age has several goals:
1. Stop heavy bleeding as soon as possible and replenish blood loss.
2. Eliminate the cause that caused the bleeding.
3. Compensation for the consequences of blood loss (for example, anemia).

Examination for bleeding
Before prescribing treatment, the gynecologist conducts an examination to establish the true cause of bleeding.

The program of examinations, as a rule, includes:

• a detailed survey of the patient, on the basis of which the doctor draws conclusions about her psychological state, hereditary diseases in the family, etc.;
• visual examination of the vagina with the help of mirrors;
• laboratory examination of vaginal smears;
• examination of the tissues of the cervix using colposcopy or biopsy;
• ultrasound examination of the pelvic organs;
• in certain cases - diagnostic curettage of the uterine cavity, followed by microscopic examination of endometrial tissues;
• determining the level of hormones;
• general blood analysis .

What tests and examinations can a doctor prescribe for bloody discharge from the vagina?

Bloody discharge from the vagina can be provoked by various diseases and conditions, for the diagnosis of which different methods are used. The choice of a diagnostic method in each case of bleeding from the vagina is carried out by the doctor individually, depending on the accompanying symptoms, due to which it is possible to presuppose the disease that caused bleeding or spotting. Below we will consider what tests and examinations a doctor can prescribe for bleeding from the vagina with various concomitant symptoms, and we will only touch on those situations where there is no need to urgently call an ambulance.

Dark spotting from the vagina (brown, brownish, maroon, dark red, etc.) in large or small amounts, appearing outside of menstruation or before menstruation, makes the doctor suspect a pathological process in the uterus (for example, endometrial or cervical polyps channel, endometrial hyperplasia, endometriosis, etc.). In such a situation, the doctor prescribes the following tests and examinations:

• Bimanual gynecological examination;
• Inspection of the genital tract in the mirrors;
• Vaginal smear for flora (make an appointment);
• Hysteroscopy (make an appointment);
• Ultrasound of the pelvic organs (make an appointment);
• Separate diagnostic curettage (sign up);
• Magnetic resonance imaging (make an appointment);
• General blood analysis;
• General urine analysis ;
• Blood chemistry;
• Coagulogram (sign up);
• Blood test for luteinizing hormone;
• A blood test for follicle-stimulating hormone;
• Blood test for testosterone.

First of all, a bimanual two-handed examination and examination of the genital tract in the mirrors is always carried out. A swab is also taken for the flora, an ultrasound scan of the pelvic organs is prescribed, since it is these examination methods that make it possible to diagnose the disease or narrow the diagnostic search. To assess the general condition of the body, general blood and urine tests, a biochemical blood test and a coagulogram (assessment of the blood coagulation system) are also prescribed. Further, if, according to the results of ultrasound and examination, a disease is detected (for example, a cervical polyp, uterine fibroids, endometriosis, etc.), the doctor prescribes hysteroscopy or magnetic resonance imaging to clarify the data on the localization of the pathological focus and assess the condition of the tissues. If, according to the results of ultrasound, endometrial hyperplasia is detected, the doctor prescribes a separate diagnostic curettage. If the examination revealed endometriosis, then in addition, the doctor may prescribe blood tests to determine the concentration of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone in a woman.

If the examinations did not reveal any diseases, and there are spotting, the doctor prescribes tests for genital infections ( chlamydia (sign up), mycoplasmosis (sign up), ureaplasmosis (sign up), trichomoniasis, candidiasis, gardnerellosis, gonorrhea (sign up), syphilis (sign up)).

If a woman systematically has spotting spotting that emits an unpleasant or fetid odor, and they can be observed on any days of the menstrual cycle, the doctor suspects an infectious and inflammatory process in the genital organs and prescribes tests for genital infections (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis , gardnerellosis, gonorrhea, syphilis), as well as ultrasound of the pelvic organs. For analysis for sexual infections (sign up) you can donate blood, vaginal discharge and urethra. As a rule, the doctor recommends to the woman which tests she needs, and which biological material should be taken for this.

If periodically pinkish discharge appears before menstruation, resembling diluted blood and emitting an unpleasant odor, endometritis or endocervicitis is suspected. In this case, the doctor prescribes the following tests and examinations:

• Gynecological examination (make an appointment);
• General blood analysis;
• smear on flora;
• Bacteriological culture of the vaginal discharge;
• Ultrasound of the pelvic organs;
• Hysteroscopy;
• Separate diagnostic curettage with histological examination of the material;
• Extended colposcopy (make an appointment);
• Cervical smear for cytology (make an appointment);
• Bacteriological culture of a smear from the cervical canal;
• Blood tests or vaginal discharge for sexual infections (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis, gardnerellosis, gonorrhea, syphilis) by ELISA methods, PCR (sign up) and etc.;
• Biopsy of the cervix.

First of all, the doctor conducts a gynecological examination, prescribes a general blood test, a smear on the flora, sowing of the vaginal discharge and ultrasound of the pelvic organs, since it is these examinations that make it possible to understand whether a woman suffers from endocervicitis or endometritis. Further, other examinations are prescribed already in order to clarify the parameters of the pathological process and find out the causes of the disease. So, with identified endometritis, a separate diagnostic curettage is performed with or without hysteroscopy. Hysteroscopy allows you to see the endometrium inside the uterus and assess its condition, and curettage makes it possible only to get the result of its histology and understand whether there is only inflammation, or whether we are talking about precancerous conditions or even cancer. From the point of view of cancer alertness, doctors prefer to carry out curettage followed by a histological examination of the material, and hysteroscopy is performed only in some cases.

If endocervicitis has been detected, then, first of all, an extended colposcopy is prescribed and performed and a smear is taken for cytology to determine whether there is a cancerous degeneration of cells. Next, a blood or vaginal discharge test is prescribed for sexual infections and bacteriological sowing of a smear from the cervical canal in order to determine the microbe that has become the causative agent of the infectious process. If, according to the results of cytology, the presence of tumor cells is revealed, then biopsy (make an appointment) cervix for early detection of cancer.

Scanty and spotting spotting of any nature (pink, red, brownish, etc.) in various parts of the menstrual cycle (in the middle, before menstruation, after menstruation) makes us suspect menstrual irregularities, endometriosis, polyps, endometritis, fibroids, genital infections , genital trauma, cervical erosion, cervical cancer. In such a situation, the doctor first of all prescribes a gynecological examination, examination in the mirrors, a smear on the flora and ultrasound of the pelvic organs, since these simple examinations reveal a number of additional signs that can be used to accurately diagnose an existing disease and then conduct other additional studies to confirmation of the diagnostic guess.

So, if as a result of the examination, damage to the genital organs is revealed, the doctor eliminates it - sutures the tears, removes foreign objects, treats the mucous membrane with an antiseptic, etc. In such a situation, other examinations are not prescribed, since they are not needed. If, during the examination and ultrasound, an erosion or an incomprehensible formation on the cervix was detected, the doctor prescribes a colposcopy, a smear for cytology, or immediately takes a biopsy of the affected area to understand if there is erosion or if it is a precancer or cancer.

If, according to the results of ultrasound, endometriosis is detected, tomography is prescribed to clarify the localization of ectopic foci and blood tests for hormones - testosterone, luteinizing and follicle-stimulating. If the examination and ultrasound reveal polyps or a tumor (myoma, etc.), hysteroscopy is additionally prescribed. If the examination and ultrasound revealed endometritis, a separate diagnostic curettage is additionally assigned. If ultrasound and examination revealed signs of genital infections, then a blood test or vaginal discharge for inflammatory pathogens (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis, gardnerellosis, gonorrhea, syphilis) is prescribed. And when the results of ultrasound and examination did not reveal any pathology, the doctor prescribes blood test for thyroid hormones (make an appointment), since in such a situation, most likely, scanty spotting is due to a violation of the work of this particular organ.

When large blood clots appear in a woman during menstruation, this suggests a bending of the cervix, a pathology of blood clotting, a deficiency of B vitamins, endometriosis, or neoplasms in the uterus (polyps, fibroids). In such a situation, the doctor, first of all, performs a gynecological examination and examination in the mirrors, prescribes an ultrasound of the pelvic organs, a general blood test, a coagulogram (APTT, PTI, TV, fibrinogen, clot retraction, etc.). If the results of the coagulogram reveal a pathology, the woman is referred to a hematologist. If the results Ultrasound (make an appointment) and inspection revealed a bend of the cervix - prescribe therapy. If ultrasound and examination revealed endometriosis, tomography is prescribed, blood tests for hormones - testosterone, luteinizing and follicle-stimulating. If ultrasound and examination revealed polyps or fibroids, hysteroscopy is prescribed.

If a girl or woman develops heavy and prolonged dysfunctional bleeding before or after menstruation, hormonal imbalance is suspected, in which case the doctor prescribes the following tests to understand why the ovaries do not function normally and do not produce the necessary amount of hormones to maintain the correct menstrual cycle:

• Blood test for the level of thyroid-stimulating hormone (TSH, thyrotropin);
• Blood test for the level of triiodothyronine (T3);
• Blood test for thyroxine level (T4);
• Blood test for the level of follicle-stimulating hormone (FSH);
• Blood test for luteinizing hormone (LH) levels;
• Blood test for prolactin level (sign up);
• Blood test for estradiol levels;
• Blood test for testosterone levels.

If a woman has spotting after intercourse, then STIs, cervicitis, vaginitis, polyps and cervical erosion are suspected, and in this case, the doctor prescribes, first of all, an examination in the mirrors, a bimanual examination, taking a smear for flora, taking a smear from cervix for cytology and ultrasound of the pelvic organs. Further appointments are based on the data of these primary surveys. So, if as a result of the examination cervical erosion is revealed, then a colposcopy is prescribed and performed. When polyps are detected, treatment is carried out (they are removed). If cervicitis is detected, then colposcopy is also performed and tests for genital infections are prescribed to understand which pathogen provoked the inflammatory process. If, according to the results of the examination and a smear on the flora, an inflammatory process is detected, then tests for STIs are also prescribed. After the result of a smear for cytology from the cervix comes, the doctor decides whether to take a biopsy. So, if cytology did not reveal atypical (tumor) cells, then the biopsy is not taken, but if any are found, then a cervical biopsy is prescribed, which is necessary to understand whether there is a malignant tumor, or whether atypical cells are an accidental finding.

If, after an abortion, a woman has heavy uterine bleeding, then the doctor, first of all, performs an ultrasound scan to make sure there are no residues in the uterus. If any are found, scraping is carried out. If none are found, then a coagulogram is prescribed, and the woman is referred to a hematologist, since bleeding is considered to be caused by a pathology of blood coagulation.

If profuse bleeding develops in a woman in menopause, then a separate diagnostic curettage with a histological examination of the material is necessarily prescribed, since such a situation is often a sign of tumors or precancerous background diseases.

If spotting appears in a girl under 12 years old, the doctor prescribes a full range of diagnostic manipulations - ultrasound of the pelvic organs, tests for genital infections, tests for hormones (cortisol, triiodothyronine, thyroxine, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, testosterone). In addition, to exclude kidney disease, a general urine test is prescribed, and to exclude the pathology of the digestive tract, a biochemical blood test and Ultrasound of the abdominal organs (make an appointment).

Treatment of spotting

Conservative Methods:
1. Most often, the basis of the therapeutic program is hormonal therapy. Such treatment courses are usually prescribed for up to 3 months. After its completion, a break is made in the treatment, during which the gynecologist evaluates its results.
2. In addition to hormonal agents, symptomatic treatment is also used - hemostatic drugs and drugs that enhance the contractile activity of the uterus.
3. General strengthening therapy, which helps to restore the female body as a whole.
4. Also, experts recommend avoiding physical and psychological stressful situations.

The selection of the optimal treatment regimen for spotting occurs individually. It should also be remembered that the treatment will last from 3-4 weeks to six months or more, depending on the cause of the violations. In order to restore the normal functioning of the female reproductive system, it may take several months.

Operational Methods
Surgical methods are also used to treat severe bleeding. For example, in patients who are in menopausal age, curettage of the uterus is the main diagnostic method. And with juvenile bleeding in adolescent girls, such a procedure is carried out exclusively for health reasons. After the application of surgical methods, treatment is prescribed aimed at preventing the recurrence of discharge.

Conclusion

Treatment of bloody discharge from the genital tract should only be carried out by a gynecologist. Self-medication is absolutely unacceptable even if a woman is sure that she knows the true cause of bleeding. Misdiagnosis