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

Uterine bleeding is uterine bleeding, except for natural causes such as menstruation or birth bleeding. Dysfunctional uterine bleeding is a pathology associated with impaired production of sex hormones.

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

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

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

• Polymenorrhea - frequent menstruation, recurring after 21 days;
• Hypermenorrhea - heavy and prolonged menstruation for more than a week;
• Metrorrhagia - weak intermenstrual bleeding;
• Menometrorrhagia - irregular but prolonged bleeding.

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

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

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

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

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

• ovarian dysfunction;

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

Juvenile uterine bleeding is extremely common. The reason for such a pathology in girls of puberty can be:

• Dysregulation of hormones;
• physical injury;
• mental trauma;
• Overwork and stress;
• Dysfunction of the adrenal cortex;
• Violations thyroid gland;
• past infections: measles, whooping cough, rubella, chicken pox;
• The result of complicated childbirth in the mother.

Consequences of uterine bleeding

Symptoms of uterine bleeding are expressed in a significant release menstrual blood. With this pathology, long absence menstruation, and after it is manifested by bleeding of varying intensity. Uterine bleeding is dangerous at any age, as it can cause anemia - anemia.

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

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

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

• Intensive discharge;
• Prolonged bleeding for more than two weeks;
• Allocations in the intermenstrual period;
• Blood clots in the discharge
• Weakness and fatigue;
• Dizziness and pain in the head;
• Low blood pressure (hypotension);
• pale skin;
• Blood discharge after intercourse;
• blood clots;
• Incessant bleeding after childbirth or abortion;
• Drawing pains in the lower back and lower abdomen;
• sudden bleeding after menopause;
• cycle irregularity;
• Bleeding in postmenopause;
• Anemia.

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

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

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

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

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

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

In 30% of uterine bleeding develop on the background of menopausal syndrome. If bleeding occurs during menopause, then first of all it is necessary to differentiate them from menstruation, since as menopause occurs, ovarian function gradually stops, making menstruation irregular. To rule out pathologies, diagnostic curettage endometrium and hysteroscopy. Curettage of the endometrium reveals endometriosis. Fibroids, uterine polyps, which can cause uterine bleeding. A pelvic ultrasound or CT can rule out the cause of uterine bleeding, which can be triggered by an ovarian tumor. Other diagnostics of pathologies of uterine bleeding is determined by the gynecologist individually.

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

Juvenile bleeding

Treatment of juvenile dysfunctional uterine bleeding is hemostatic measures. As treatment progresses, rebleeding is prevented. Conservative and surgical methods are used to stop uterine bleeding, the choice depends on the patient's health status. If the choice falls on conservative treatment, then they use hemostatic and uterine-contracting drugs, as well as progesterone preparations. After a few days, the bleeding will stop.

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

reproductive age

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

During the menopause

Treatment of uterine bleeding during menopause is aimed at suppressing hormonal function and menstruation, in other words, menopause is provoked. Stopping bleeding stops only surgically - curettage and hysteroscopy or surgical removal of the uterus.

• As a prevention of juvenile uterine bleeding, it is recommended proper nutrition, With increased level iron in foods. Held general hardening organism, sanitation of chronic infectious foci, as well as the use of progestin preparations.
• As a prevention of uterine bleeding of reproductive age, the treatment of concomitant diseases is mandatory, the neuropsychic state is normalized with the help of vitamins and sedatives. But with the wrong choice of treatment, uterine bleeding can occur again.

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

Blood is the lifeblood of the human body. Any blood loss potential danger for human life and health. In women, uterine bleeding is the most common cause of blood loss. The incidence of uterine bleeding ranges between 12 and 30%, with the likelihood of uterine bleeding increasing with a woman's age and decreasing with an increase in the number of births and the duration of breastfeeding periods. And although in most cases uterine bleeding does not pose an immediate danger to a woman's life, they often lead to the development of anemia, worsen a woman's well-being, appearance and mood, and limit her sexual, physical and social activity.

Uterine bleeding is normal

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

Menstruation should be painless. The first menstruation comes at the age of 11-15 years. The menstrual function lasts the entire reproductive period of a woman, interrupted by periods of pregnancy, childbirth and breastfeeding. Completion of menstrual function (onset of menopause) occurs on average at the age of 45-55 years.

Important! The appearance of "menstruation" in girls before puberty (up to 10-11 years) and in women after menopause (cessation of menstrual function) - pathological sign requiring immediate medical advice (pediatric, adolescent or adult gynecologist). In most cases, such spotting is a symptom of a serious illness.

Uterine bleeding - between norm and pathology

Bloody discharge in the middle of the menstrual cycle can be considered as a variant of the norm. The reason for such secretions is a sharp fluctuation in the level of hormones during ovulation (immediately after it), which leads to an increase in the permeability of the walls uterine vessels sweating through vascular walls erythrocytes and the appearance of blood in the vaginal discharge. Usually such discharge is scarce, lasting no longer than 1-2 days. However, in some cases, the appearance of bloody discharge in the middle of the cycle is a manifestation of a hormonal failure or an inflammatory process, therefore, at the first appearance of such discharge, it is necessary to seek advice from a gynecologist to exclude these diseases.

Another almost normal type of bleeding from the vagina that is not associated with menstruation is implantation bleeding occurring on the 7th day after conception. The cause of implantation bleeding is the introduction of the embryo into the wall of the uterus, during which there is a partial destruction of the structures of the mucous membrane of the uterus, which can lead to the appearance of minor spotting. However, in some cases, uterine bleeding during this period may be a manifestation of progesterone deficiency and a sign of threatened abortion.

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

Uterine bleeding - pathology

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

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

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

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

Important! Any increase in the duration or intensity of menstrual bleeding is absolute reading to visit a gynecologist (this recommendation does not depend on the age of the woman, it applies to adolescents and adult women). The more abundant and prolonged bleeding, the sooner medical attention is needed. In case of heavy bleeding, it is necessary to call " ambulance”and agree to hospitalization in a gynecological hospital.

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

Examination and treatment for uterine bleeding

Uterine bleeding in adolescence

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

In the treatment of uterine bleeding in adolescents, drugs are prescribed that reduce the uterus, hemostatic and strengthen the wall of blood vessels, vitamins, herbal remedies, iron preparations, and in some cases are prescribed hormonal preparations(oral contraceptives) to regulate the menstrual cycle.

Uterine bleeding in reproductive age

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

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

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

Because the postmenopausal uterine bleeding in the vast majority are manifestations oncological pathology in the body, cervix or ovaries, treatment is mainly surgically(removal of the uterus with appendages).

Uterine bleeding and pregnancy

A few stand out uterine bleeding associated with pregnancy. These bleedings occur mainly in the reproductive period in the presence of sexual contacts with men in the life of a woman. Most common causes bleeding associated with pregnancy are miscarriage, ectopic pregnancy, bleeding from the vessels of the cervix in the presence of its diseases, placenta previa, premature detachment of a normally located placenta.

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

Bleeding in an ectopic pregnancy also occurs after a delay in menstruation. Pain in the lower abdomen at the same time are cramping or constant in nature and are very intense. Often pain and bleeding are accompanied by nausea, vomiting, cold sweat, fainting. Bloody discharge has dark color, with clots.

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

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

In the second half of pregnancy, life-threatening uterine bleeding associated with premature detachment normally located placenta. This bleeding is often preceded by the threat of termination of pregnancy, excessive physical exertion, a blow to the stomach. Bleeding can have different intensity (in some cases, most of the blood remains between the placenta and the uterine wall, increasing detachment, impregnating the walls of the uterus and aggravating the condition of the woman and the fetus), accompanied by an increase in uterine tone, abdominal pain, increased fetal activity.

Important! Bleeding from the genital tract during pregnancy is potentially very dangerous. Therefore, when even slight spotting appears, it is necessary to quit everything, call an ambulance and wait for the doctor, taking a horizontal position.

Finally

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

Uterine bleeding is the secretion of blood from uterus. Unlike menstruation, with uterine bleeding, either the duration of the discharge and the volume of the secreted blood change, or their regularity is disturbed.

Causes of uterine bleeding

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

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

Symptoms of uterine bleeding

The main symptom of this pathology is the discharge of blood from the vagina.

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

Thus, it is possible to distinguish the following symptoms uterine bleeding:

• Menorrhagia (hypermenorrhea)- excessive (more than 80 ml) and prolonged menstruation (more than 7 days), while maintaining their regularity (occur after 21-35 days).
• metrorrhagia- Irregular bleeding. Occur more often in the middle of the cycle, and are not very intense.
• Menometrorrhagia- Prolonged and irregular bleeding.
• Polymenorrhea- menstruation occurring more often than 21 days later.

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

Types of uterine bleeding

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

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

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

Juvenile uterine bleeding

Juvenile uterine bleeding develops during puberty (ages 12 to 18 years). The most common cause of bleeding in this period is ovarian dysfunction - the correct production of hormones is adversely affected by chronic infections, frequent SARS, psychological trauma, physical exercise, malnutrition . Their occurrence is characterized by seasonality - winter and spring months. Bleeding in most cases are anovulatory - i.e. due to a violation of the production of hormones, ovulation does not occur. Sometimes the cause of bleeding can be bleeding disorders, tumors of the ovaries, body and cervix, tuberculous lesions of the genital organs.
The duration and intensity of juvenile bleeding may be different. Abundant and prolonged bleeding leads to anemia, which is manifested by weakness, shortness of breath, pallor and other symptoms. In any case, the occurrence of bleeding in adolescence treatment and observation should take place in a hospital setting. If bleeding occurs at home, you can ensure peace and bed rest, give 1-2 vikasol tablets, put a cold heating pad on the lower abdomen and call an ambulance.

Treatment, depending on the condition, may be symptomatic - the following agents are used:

• hemostatic drugs: dicynone, vikasol, aminocaproic acid;
• uterine contractions (oxytocin);
• iron preparations;
• physiotherapy procedures.

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

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

Uterine bleeding in the reproductive period

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

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

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

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

Bleeding associated with pregnancy and childbirth

In the first half of pregnancy, uterine bleeding occurs when there is a threat of interruption of a normal, or when an ectopic pregnancy is terminated. These conditions are characterized by pain in the lower abdomen, delayed menstruation, as well as subjective signs of pregnancy. In any case, in the presence of bleeding after the establishment of pregnancy, it is necessary to urgently seek medical help. On early stages Spontaneous miscarriage with timely initiated and active treatment, you can save the pregnancy. In the later stages, there is a need for curettage.

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

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

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

• reduced uterine tone and its ability to contract;
• parts of the placenta remaining in the uterus;
• blood clotting disorders.

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

Uterine bleeding with menopause

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

Dysfunctional uterine bleeding

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

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

Very often, dysfunctional bleeding is the result of artificial or spontaneous abortions.

Dysfunctional uterine bleeding can be:
1. Ovulatory - associated with menstruation.
2. Anovulatory - occur between periods.

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

Ovarian dysfunction can cause infertility, miscarriage, so it is extremely important to consult a doctor in a timely manner if there is any menstrual irregularity.

Breakthrough uterine bleeding

Breakthrough is called uterine bleeding that occurred while taking hormonal contraceptives. Such bleeding may be minor, which is a sign of a period of adaptation to the drug.

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

Which doctor should I contact for uterine bleeding?

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

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

Accordingly, it is necessary to contact a gynecologist at a polyclinic for uterine bleeding when there are no signs of an emergency. If uterine bleeding is combined with signs of an emergency, then you should immediately call an ambulance or on your own transport to as soon as possible get to the nearest hospital with a gynecological department. Consider in which cases uterine bleeding should be considered as an emergency.

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

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

Thirdly, an emergency should be considered uterine bleeding, which is profuse, does not decrease with time, is combined with severe pain in the lower abdomen or lower back, causes a sharp deterioration in well-being, blanching, decreased pressure, palpitations, increased sweating, possibly fainting. General characteristic an emergency condition for uterine bleeding is the fact of a sharp deterioration in the woman's well-being, when she cannot perform simple household and daily activities (she cannot stand up, turn her head, it is difficult for her to speak, if she tries to sit up in bed, she immediately falls, etc.), and literally lies in a layer or even is unconscious.

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

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

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

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

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

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

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

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

Ultrasound is a highly informative method that allows you to identify inflammatory processes, tumors, cysts, polyps in the uterus and ovaries, endometrial hyperplasia, and endometriosis. That is, in fact, ultrasound can detect almost all diseases that can cause uterine bleeding. But, unfortunately, the information content of ultrasound is insufficient for final diagnosis, since this method provides only an orientation in the diagnosis - for example, ultrasound can detect uterine myoma or endometriosis, but it is impossible to establish the exact localization of the tumor or ectopic foci, determine their type and assess the condition of the organ and surrounding tissues. Thus, ultrasound, as it were, allows you to determine the type of existing pathology, but to clarify its various parameters and find out the causes of this disease, it is necessary to use other examination methods.

When a gynecological examination is performed, examination in the mirrors, ultrasound and a general blood test and a coagulogram are made, it depends on which pathological process was detected in the genitals. Based on these examinations, the doctor may prescribe the following diagnostic manipulations:

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

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

If fibroids or other tumors of the uterus have been detected, the doctor prescribes hysteroscopy in order to examine the cavity of the organ and see the neoplasm with the eye.

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

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

In the event that the results Ultrasound (make an appointment), gynecological examination and examination in the mirrors, no pathology of the uterus or ovaries was revealed, dysfunctional bleeding is assumed due to a violation of the hormonal balance in the body. In such a situation, the doctor prescribes the following tests to determine the concentration of hormones that can affect the menstrual cycle and the appearance of uterine bleeding:

• Blood test for cortisol (hydrocortisone) levels;
• Blood test per level thyroid-stimulating hormone(TSH, thyrotropin);
• Blood test for the level of triiodothyronine (T3);
• Blood test for thyroxine level (T4);
• Blood test for the presence of antibodies to thyroperoxidase (AT-TPO);
• Blood test for the presence of antibodies to thyroglobulin (AT-TG);
• 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 dehydroepiandrosterone sulfate (DEA-S04);
• Blood test for testosterone levels;
• A blood test for the level of sex hormone-binding globulin (SHBG);
• Blood test for the level of 17-OH progesterone (17-OP) (enroll).

Treatment of uterine bleeding

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

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

Hemostatic agents used in uterine
bleeding

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

• dicynone;
• etamsylate;
• vikasol;
• calcium preparations;
• aminocaproic acid.

In addition, uterine contraction agents - oxytocin, pituitrin, hyfotocin - have a hemostatic effect in uterine bleeding. All these funds are most often prescribed in addition to surgical or hormonal methods stop bleeding.

Dicynon for uterine bleeding

Dicynon (etamsylate) is one of the most common remedies used for uterine bleeding. It belongs to the group of hemostatic (hemostatic) drugs. Dicinon acts directly on the walls of capillaries (the smallest vessels), reduces their permeability and fragility, improves microcirculation (blood flow in the capillaries), and also improves blood clotting in places where small vessels are damaged. At the same time, it does not cause hypercoagulability (increased formation of blood clots), and does not constrict blood vessels.

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

Dicynon is contraindicated in the following cases:

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

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

What to do with prolonged uterine bleeding?

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

The main signs of anemia:

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

Folk remedies

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

The causes of bleeding in women depend on age. It can be hormonal disorders, pregnancy pathology or neoplasm. Consultation of the gynecologist is necessary.

Causes of bleeding in women of different age groups

Vaginal bleeding in women is alarm symptom, which can speak of a variety of diseases and emergency situations. causing bleeding in women, the causes can be varied and depend on age.

In order to simplify the diagnosis of bleeding, they are conditionally divided into two groups depending on the affected system:

• pathology of the reproductive system;
• extragenital pathology.

An important point in the diagnosis of vaginal bleeding is associated with pregnancy. After all, it can be an early miscarriage, a threatened abortion, an ectopic pregnancy.

All systems and organs interact with each other. The disease of one system can affect another, showing different symptoms. Extragenital causes:

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

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

Bleeding in women involving the reproductive system

If pregnancy has not yet been established, early miscarriage or ectopic pregnancy should be considered. Other causes may be endometriosis, uterine fibroids,. In view of the fact that oncopathology recent years rejuvenated, we must not forget about cervical cancer. A feature of blood discharge in cervical cancer is that the discharge has a specific smell and appears more often after intercourse.

In the late trimesters of pregnancy, the reasons may be:

• placenta previa;
• premature detachment of the placenta;
• eclampsia;
• preeclampsia;
• scar on the body of the uterus.

During pregnancy, in the presence of bleeding of any nature and intensity, a woman is advised to immediately seek medical help in women's consultation or call an ambulance.

Causes of blood loss not related to childbearing:

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

Women with the above pathology should systematically undergo medical examinations.

Uterine bleeding in different age periods

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

Bleeding is conditionally divided into age periods:

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

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

The ongoing shift in hormonal system provokes the growth of the mucosa in the uterus, it turns out stagnation and accumulation of blood, thereby disrupting blood circulation. After the permeability of the vessels changes, the conditions for the development of bleeding develop. The uterus becomes a place of accumulation of blood.

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

For each age period the reasons may be different, since each age has certain features. But you can highlight the main points that affect equally bad, despite age.

Factors that negatively affect the hormonal system:

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

In a certain age category there are risks for one disease or another. For example, hypovitaminosis is characteristic, to a greater extent, for young age and those who are in the postmenopausal period. Accordingly, abortions for women with the complete completion of the menstrual function is casuistry.

Differences between bleeding and normal menstruation

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

Signs of uterine bleeding:

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

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

Summarizing

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

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

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

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

It is important to know that normal uterine bleeding includes only menstruation, the duration of which is up to 5 days, with stable interruptions, 28 days long.

All other bleeding is a pathology and requires medical supervision.

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

Most often, the first couple of days of menstruation are not abundant, the next two are intensified and, at the end, again become scarce; blood loss these days should be no more than 80 ml.

Otherwise, iron deficiency anemia develops.

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

The onset of menstruation usually occurs at 11-15 years of age and lasts until the end of the reproductive period (menopause). During pregnancy and breastfeeding, menstruation is absent, but this phenomenon is temporary.

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

Sometimes spotting in the middle of the cycle (on the 10-15th day after the end of menstruation) can become a variant of the norm. Their cause is hormonal fluctuations after ovulation: the walls of the uterine vessels become excessively permeable, so the vaginal discharge may have blood impurities.

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

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

Nobody is protected. Age classification

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

Causes

There are many reasons that can cause uterine bleeding. In order to systematize them, it should be understood that the resulting blood loss can be a malfunction in organ systems, as well as disorders in the genital area.

TO extragenital causes uterine bleeding, that is, those caused by disorders in the work of non-genital organs include:

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

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

Cirrhosis of the liver.

Prolapse of the urethra.

Violations in activity of cardio-vascular system such as hypertension, atherosclerosis, etc.

decline functionality thyroid gland.

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

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

Signs and symptoms

In order to start actions to stop uterine bleeding at home, one should recognize the threat to the woman's health, which means that one must be exactly aware of the symptoms. Here are distinguished:

• bleeding from the vagina that does not fall on the onset of menstruation;
• general weakness, dizziness and fainting;
• pallor of the skin;
• dangerous bleeding is accompanied by bouts of nausea and vomiting;
• due to loss of blood in large quantities, a decrease in blood pressure can be detected;
• highlighting blood clots;
• at profuse bleeding women have to change tampons or pads more often (as opposed to normal menstruation);
• dangerous bleeding can be indicated by the duration of menstruation, which already exceeds 7-8 days at a rate of 6 days;
• bleeding starts every time after intercourse.

All the symptoms presented indicate an approaching danger and irreversible consequences. If the bleeding lasts for several days, the woman may experience characteristics severe blood loss.

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

Symptoms

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

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

According to the duration, regularity and volume of uterine bleeding, there are 4 types.

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

In the vaginal discharge, blood clots are noted, abdominal pain is disturbing. Blood loss leads to general weakness, fatigue, blanching of the skin.

Juvenile bleeding

Uterine bleeding of any kind - dangerous symptom, their appearance is a reason for treatment. emergency treatment require acute blood loss (sudden copious excretion blood), they are accompanied severe symptoms(weakness, pressure drop, increased heart rate, loss of consciousness, disability), sometimes sharp pains in the abdomen.

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

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

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

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

Typical signs of uterine bleeding:

• bleeding;
• lowering blood pressure;
• increased heart rate;
• weakness;
• increased fatigue;
• drowsiness;
• dizziness;
• headache;
• pallor of the skin.

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

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

Symptoms of anemia

Diagnostics

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

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

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

Treatment

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

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

Before the arrival of the doctor, emergency care consists in laying the woman down, you need to lift her legs with a roller from a blanket or pillow. A method of stopping parenchymal bleeding is used: cold is applied to the lower abdomen.

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

You can start to stop blood loss by taking one tablet of Tranexam. After the arrival of the doctor, it is necessary to tell him how much and what drugs the woman took. To make up for blood loss before the arrival of an ambulance, you need to drink as much liquid as possible.

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

• hemostatic agents: Vikasol, Tranexam, Dicinon;
• oxytocin for uterine contraction;
• replacement therapy.

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

Tranexam

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

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

Indications for the appointment of Tranexam:

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

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

Dicynon

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

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

Dicynon can be used for:

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

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

Taking Dicynon causes side effects in the form of nausea, skin rash, headache, lowering blood pressure, allergies and weakness. Dicinon is prescribed to pregnant women with caution. Choosing the drug used, the doctor takes into account the risk to the mother and fetus.

Vikasol

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

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

The drug is contraindicated in patients with increased blood clotting. Side effects are infrequent in the form of allergies, lowering blood pressure, jaundice in newborns.

With uterine bleeding, all treatment depends on the underlying cause and the age of the patient. First, before prescribing the appropriate therapy for the patient, the doctor needs to do an examination to establish the causes and choose the treatment in accordance with them.

With juvenile bleeding in adolescents, drugs are prescribed that help contract the uterus, strengthen the walls of blood vessels and stop blood loss, and treatment at home continues with a course of vitamins, hormonal drugs are prescribed less often.

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

If a woman has found the abnormalities presented above, she should take appropriate actions to narrow the vessels. Under no circumstances should you use medicines, contributing to uterine contraction, as well as applying heat or taking warm baths (showers).

First aid for uterine bleeding

Abundant bleeding must be stopped immediately after they are detected. At the initial stage, it is recommended to call an ambulance, and before it arrives, do the following:

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

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

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

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

use drug therapy, infusion methods for restoring blood volumes and surgical methods, the latter are used if the bleeding does not stop with medications.

How to give first aid

First aid for bleeding at home

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

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

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

Categorically, with dysfunctional bleeding, it is forbidden to apply hot or warm heating pad, douching with any composition, take a bath, use drugs that promote uterine contraction.

Independently, at home until the ambulance arrives, a woman can be helped in the following way:

The woman must be put to bed, preferably on her back, and her legs placed on some kind of elevation. To do this, you can put a pillow or a roller from a blanket. Thus, it will be possible to preserve the consciousness of the patient, especially if the blood loss is impressive.

Something cold should be applied to the stomach. If there was no heating pad at hand, then the ice can be wrapped in a regular cloth. You can replace the ice with an ordinary bottle filled with cold water. Cold exposure time - up to 15 minutes, then a break of 5 minutes. This will achieve vasoconstriction, and therefore somewhat reduce bleeding.

The woman needs to drink. Since it is not possible to put a dropper at home, it is necessary to offer the patient plentiful drink. Plain water and sweet tea will do. This will contribute to the loss of fluid along with the blood, glucose will provide nutrition to the nerve cells of the brain.

To the reception medications should be treated with extreme caution, especially if a woman is carrying a child. Before taking them, you should always consult with your doctor, but sometimes it happens that there is no such possibility.

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

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

How to stop uterine bleeding?

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

A bubble containing ice is applied to the woman's stomach.

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

Hospitalization of the patient with transfer directly to a specialist.

Introduction of the solution magnesium sulfate, with a threat or the onset of a miscarriage. Or if a spontaneous abortion occurs, the woman is given intravenous calcium chloride, and ascorbic acid diluted with glucose. An injection of Etamzilat can be made.

Doctors in the hospital use hormonal drugs to stop bleeding, in the event that a woman has not yet given birth, she does not have a suspicion of a tumor.

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

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

Hemostatic agents can also be used, for example, Dicinon, Vikasol, Askorutin, Aminocaproic acid.

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

Prevention

Prevention of rebleeding consists of observing several rules:

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