Causes of uterine bleeding in women. vaginal bleeding

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Bleeding from the vagina

In healthy women between the ages of 13 and 50 (or so), bleeding is not something to worry about. You expect it - regularly, every month. If you are not menstruating, this is not normal.

But vaginal bleeding that are either too strong or too small or at the wrong time can be a problem. The different options depend on your age (especially if it's before or after menopause), whether you're on birth control pills, whether you're physically active, and your health status.

If you have abnormal bleeding from the vagina, it may be related to something else in the reproductive system and is the result of infection, hormonal changes, and sometimes cancer. The risk of malignant growth increases with age. The likelihood of infection largely depends on your sex life. Hormone levels fluctuate in response to signals from the brain, ovaries, thyroid, and adrenal glands. But make sure the blood you see is actually from the vagina and not in urine or stool.

Where can blood come from in the vagina?

Let's start by reviewing the different places in the female reproductive system where vaginal bleeding.

The pubic lips at the entrance to the vagina can be damaged, most often during violent intercourse. Sometimes, however, on close examination, you will see a small polyp there, or a small sore, or a wart, or even varicose veins - any of these can bleed.

When the hymen is torn, expect too; moderate bleeding.

The vagina itself can become inflamed, infected, or undergo malignant growth, all of which will cause bleeding.

Foreign objects inserted into the vagina, usually during masturbation, may bleed. (The amazing variety of such objects indicates imagination, not caution.)

After menopause, when the level of estrogen hormones drops sharply, the walls of the vagina become dry, less lubricated during intercourse, and this gives pain and bleeding.

Moving up the vagina, we reach the cervix, the entrance to the uterus. She may bleed from an infection (which is a fairly common thing here), if injured by deep intercourse or after inserting an intrauterine contraceptive device.

Polyps and malignant tumors the cervix will also cause bleeding. (Women should have regular Pap smears to detect these tumors at their earliest stages, when they can be treated.)

Bleeding from the uterus often occur with pathological pregnancy, cancer, polyps or fibroids, with abortion (spontaneous or caused). Foreign objects can also make their way here from the vagina. Fluctuating hormone levels, birth control pills, stopping or starting estrogen replacement can all cause uterine bleeding.

In pre-menopausal women, the ovaries release an egg every month, which then travels to the fallopian tubes, where it meets sperm. The fertilized egg then descends into the uterus, where it implants. If it remains in the tube without entering the uterus, the result is an ectopic pregnancy. There is no future for the egg at this point, and eventually it causes the fallopian tube to rupture, accompanied by severe pain and bleeding. This is serious enough. More commonly, bleeding occurs when the fallopian tubes become infected and inflamed due to a sexually transmitted disease.

malignant growth, infections, or ovarian cysts can cause vaginal bleeding. They are also caused by an underactive thyroid gland, or a poorly functioning pituitary gland, or other disturbances in the activity of the endocrine glands.

Trying to figure out why you're abnormal vaginal bleeding always remember that non-gynecological factors can play a role here - blood thinners, drugs, coagulation disorders: all will leave you vulnerable to abnormal bleeding, not only from the vagina, but from any organ of the body.

vaginal bleeding in menopausal women has many causes. Suppose you either just entered menopause, or have been in this state for a long time. You almost forgot what menstruation is when you suddenly see blood leaking from your vagina, or find it on your underwear. What could it be? Statistically, there is good reason to believe that the blood is the result of cancer of the cervix or uterine body. Indeed, uterine cancer in most cases occurs in menopausal women. The likelihood of such a tumor is greater when the bleeding is weak, and not strong, and when you have never given birth. The tumor could, of course, be a benign polyp, but without a biopsy, you can't tell for sure.

Here is another scenario.

You just turned 50 and your periods have become so irregular that you cannot accurately predict them. Moreover, you have hot flushes, cold sweats, and painless vaginal bleeding. It is very likely that you have simply entered the end phase of your period. The bleeding will stop within the next few months. But, with a high statistical probability of cancer, you should double check everything with your gynecologist.

If along with the bleeding you feel pain in your lower abdomen, cancer is possible, but fibromas are almost as likely. These large benign tumors in the wall of the uterus are a very common cause of bleeding in premenopausal women and one of the main reasons for amputation of the uterus.

In premenopausal women, vaginal bleeding may simply reflect a variation of the normal 28-day menstrual cycle. This cycle can be shortened to 24 or 25 days and lengthened to 30 or even 32 days. The bleeding period itself usually lasts 3 to 7 days, and most women use four or five sanitary napkins a day. If a tampon is sufficient for your bleeding, it is probably normal in amount.

What then does abnormal vaginal bleeding mean?

Excessive bleeding during periods, even if they occur regularly every 28 days. Common causes are fibromas (more common in menopausal women, but by no means limited to that age) or underactive thyroid (women with overactive thyroid will have less menstrual bleeding).

vaginal bleeding between periods is abnormal, but sometimes it's hard to figure out if your cycles are very wrong.

Here are some additional signs to help you figure out what happened.

If you are taking birth control pills, expect unpredictable bleeding.

The presence of clots in the menstrual blood indicates heavy bleeding in the uterus.

If your periods have always been normal and you suddenly bleed profusely, you may have been pregnant without knowing it - and you have had a spontaneous miscarriage.

"Blood spots" on underwear between periods can be cervical or uterine cancer or with a polyp.

If you are bleeding and have pain in your lower abdomen, you probably have a pelvic infection (especially if the pain comes on gradually and is accompanied by fever and vaginal discharge).

If you are an alcoholic and/or you have severe liver disease, too much estrogen is present in your body and this will cause vaginal bleeding.

Regardless of your own diagnosis, see your gynecologist when you're bleeding. While you are waiting for your appointment, consider a few additional items that you can bring to the doctor's attention.

Is your skin dry and rough? Are you feeling tired and sleepy? If so, the abnormal bleeding may be due to an underactive thyroid.

Have you had a temperature that comes and goes? It often happens that when you visit a doctor you do not have a temperature. So tell your doctor about it. Temperature usually means infection.

If you bleed slightly under the skin or bleed easily in other parts of the body, the condition may be a general clotting disorder, and bleeding from the vagina is only one of the manifestations.

After talking with you and a thorough external examination, the doctor can make any appointment - from a pregnancy test to a smear from the cervix, an ultrasound examination or a tomogram.

But by making all the above observations, you greatly simplify the process of establishing a diagnosis and shorten it.

Every third representative of the fair sex faces at least once in her life with uterine bleeding. Bleeding is called different in nature and etiology of the discharge of blood from the uterus. The causes can be various gynecological diseases, problems associated with bearing a child, labor activity, and the postpartum period. Less commonly, but also possible bleeding in women, which may be associated with trauma to the genital organs or problems with the blood system.

Etiology of bleeding

Dysfunctional bleeding in gynecology is commonly called uterine bleeding. Abundant discharge is the first signal that violations occur in the hormonal background. More often the reason lies in the lack of normal levels of sex hormones.

Pathology can occur in every woman at any age. From the age category, uterine bleeding is classified depending on predisposing factors:

Puberty (12-18 years) - infectious diseases, lack of essential vitamins, excessive physical activity, psycho-emotional trauma.
Reproductive (18-45 years) - stresses of a different nature, childbirth and abortion with complications, diseases of the endocrine system, inflammatory processes in the reproductive organs.
Menopause (45-55 years), the work of the ovaries fades away - infectious diseases of a chronic and acute type, injuries provoked by diseases of the psyche or nervous system.

Clinical signs and symptoms of bleeding are expressed either by profuse spotting during menstruation, or by an increase in the duration of critical days, as well as by acyclic discharge between periods. Sometimes there may be no discharge for 6-8 weeks, and then their appearance with varying intensity.

The main reasons for the manifestation of abundant discharge

There are a lot of reasons that can become a catalyst. Therefore, in order to identify the exact cause, they are divided into several categories.

discharges are caused by deviations associated with different organs and systems;
bleeding associated with an imbalance in the genital area.

Causes of an extragenital nature:

infections (measles, syphilis, etc.);
blood diseases (hemophilia, vasculitis, lack of vitamins of group C, K);
liver problems;
diseases of the cardiovascular system;
disorders in the thyroid gland.

Genital causes are divided into those related to pregnancy and those not related to pregnancy.

Causes related to pregnancy:

In the initial stages - problems with pregnancy (natural and ectopic), pathologies of the fetal egg, for example, cystic drift.
Late terms - presentation, scarring in the tissues of the uterus, placental abruption, destruction in the tissues of the cervix, other problems associated with gynecology and obstetrics.
During labor activity - placental abruption, low location of the placenta, presentation, rupture of the uterus, trauma to the soft tissues of the birth canal, various injuries of the vulva and vagina, delayed postpartum discharge of the afterbirth, infringement, problems with the attachment of the afterbirth.
Postpartum period - injuries associated with the soft genital tract, lowering the tone of the uterus, endometritis, fibroids, delayed release of the placenta.

Reasons not related to gestation:

puberty;
reproductive;
period of menopause;
various neoplasms, tumors of the uterus and ovaries;
rupture of a cyst or the ovary itself;
damage to the uterus;
inflammatory and infectious diseases;
erosion, cervicitis, vaginitis, endometritis.

Uterine bleeding is only a symptom. You can not delay and do nothing. It is imperative to establish the true cause, eliminate it, and then the symptom of manifestation in the form of bleeding will disappear. Therefore, the source must first be eliminated.

Uterine bleeding - signs of manifestation

Such types of allocations cannot be considered unambiguously. Since the body of each of the women is individual and special, the menstrual cycle differs in its duration, intensity and character. There is a category of women whose periods are meager, short, while others, on the contrary, are plentiful and long.

One of the clear signs of the norm is the regularity of menstruation. If the system is broken, and also, if bleeding began to occur between menstruation, then this can already be called bleeding. In other, more understandable words, we can say that bleeding is menstruation that lasts longer than usual or occurred before the expected menstruation. Otherwise, it can be considered within the normal range.

The clinical picture is represented by the following symptoms:

systematic meager discharge (daub) that does not affect overall well-being;
discharge during menstruation, in which a large amount of blood is lost, leading to anemia;
bleeding of unknown etiology in the middle of the cycle not associated with menstruation;
copious discharge of dark or bright fresh blood, with clots, with shock and aggravation.

Each of these symptoms is subject to treatment, which will be aimed at stopping blood loss. Signs of severe bleeding that are life-threatening for a woman:

profuse discharge with a stream or large drops of blood, a sanitary napkin or tampon is changed about 2 times per hour;
general malaise, drowsiness, weakness, dizziness;
skin blanching;
pressure drop;
rapid heartbeat and pulse;
manifestation of apathy.

If you have at least one symptom, you should urgently call an ambulance. Otherwise, there is a threat of hemorrhagic shock and subsequently death.

How to stop bleeding: methods of treatment

An important issue that every woman should pay attention to is how to stop uterine bleeding. It was noted above that blood loss can be life-threatening and lead to death.

All types of bleeding in gynecology are treated in a hospital with initial diagnostic measures to establish the causes.

Methods and methods of treatment directly depend on the age category of the patient, the stage of severity and the reasons that provoked blood loss.

The main method is considered to be cleaning (scraping), after which it is easy to establish the true cause with the help of hysteroscopic analysis. This method is rarely used, during puberty, only if there is simply no other way out.

You can also stop bleeding with the use of hormonal drugs in large doses. These include oral contraceptives: "Non-ovlon", "Regevidon".

In the case of symptomatic therapy, apply:

drugs with hemostatic properties - "Vikasol", aminocaproic acid;
"Oxytocin" for uterine contraction;
in case of severe anemia, iron-containing agents - "Fenuls";
necessarily vitamin complexes and vasoconstrictive agents - folic acid, Ascorutin, vitamins of group B.

After such therapy, prophylaxis is carried out to avoid relapse. During dysfunctions, a second course of hormone replacement therapy can be performed. It is possible to install an intrauterine device. If concomitant intrauterine disorders are detected, appropriate treatment is carried out, for example, a polyp, fibroids, hyperplasia, endometritis.

Effective drugs with hemostatic properties:

aminocaproic acid;
"Vikasol";
"Etamzilat";
"Dicinon";
preparations containing calcium.

To quickly achieve blood arrest, uterine contractions can be used: Oxytocin, Pituitrin, Hyfototsin. Sometimes they are prescribed in addition to hormone therapy.

They can also use folk methods in the form of infusions of yarrow, nettle, shepherd's purse, but a specialist consultation is necessary before use.

What to do with prolonged bleeding?

Many women ask how to stop prolonged bleeding? Here we pay attention, if this is a menstruation that lasts more than 7 days - this is no longer normal, you need to visit a gynecologist.

Especially if you notice signs of anemia, urgently call an ambulance and undergo observation in stationary conditions.

Signs of anemia:

severe weakness, drowsiness and lethargy;
low pressure;
very pale skin;
dizziness;
fainting state, fainting.

Content

There are many reasons leading to bleeding from the uterus, but experts divide them into two main groups: those associated with pathologies of the genital tract and those caused by diseases of other organs and systems. Signs, regardless of the provoking factor, have a similar clinical picture. In order to recognize the cause and choose the right treatment tactics, a thorough diagnosis is required in each case.

Etiological factors of extragenital uterine bleeding caused by diseases of various organs and systems, excluding the genital tract:

infectious diseases leading to blood thinning (sepsis, influenza, measles, typhoid fever, toxic shock in severe infections of any origin);
hemophilia;
hemorrhagic vasculitis;
an overdose of drugs that thin the blood;
hypovitaminosis C and K;
liver disease, leading to a lack of blood clotting factors;
arterial hypertension;
hypothyroidism.

It is possible to recognize such types of pathologies with complex diagnostics, as well as on the basis of collecting the patient's history. Diseases of an extragenital nature are accompanied not only by gynecological signs. The presence of various types of vascular rashes, dysregulation of blood pressure, symptoms of lesions of the gastrointestinal tract and liver are noted. You can recognize a skin rash of a vascular nature using a transparent glass object: if you press on the area with the rash, it will not disappear, which is visible through transparent glass.

Uterine bleeding associated with pathologies of the reproductive tract is divided into two groups: due to a violation of the course of pregnancy and not associated with it.

Bleeding during pregnancy may be due to:

ectopic pregnancy;
bleeding after an abortion;
cystic skid;
chorionepithelioma;
spontaneous abortion;
a scar in the wall of the uterus;
detachment of a normally located placenta;
placenta previa.

Uterine bleeding due to labor and in the postpartum period can be triggered by the following factors:

placental abruption;
abnormal location of the placenta;
soft tissue ruptures during childbirth;
pathology of placenta attachment;
incomplete separation of the placenta;
slowing down the involution of the uterus;
uterine rupture.

Bleeding that is not related to pregnancy is initiated by various causes:

uterine fibroids;
endometriosis;
pathology of the cervix (cervicitis, erosion, ectopia, dysplasia, cancer);
dysfunctional pathologies in adolescence, reproductive, menopause;
endometritis;
endometrial cancer;
ovarian tumors;
polyps of the endometrium and cervical canal;
endometrial hyperplasia.

After stopping the hemorrhage, the cause is determined using various methods: ultrasound of the small pelvis and abdominal organs, blood tests for thyroid hormones, sex steroids, coagulation rates, x-ray studies, MRI of the brain, computed tomography.

Menstrual irregularity

Dysfunctional uterine bleeding is a type of pathology in which there is a violation of the production of female sex hormones under the influence of various factors, which leads to a change in the menstrual cycle. Recognizing the signs of this type of hemorrhage can be difficult. Often, the disease is regarded by a woman as a cycle failure or irregular periods. Often, patients are admitted to the hospital on an emergency basis with a copious outflow of blood, in addition, signs of pathology can be both long-term and short-term spotting. To recognize the disease, a thorough diagnosis is necessary, which primarily includes determining the level of hormones in the blood.

Dysfunctional disorders develop in adolescence, reproductive age, as well as during menopause.

One of the signs of pathology that allows you to recognize uterine bleeding is the degree of filling of the gasket or the required number of them for the period of menstruation. Knowing how much blood expires during menstruation, a woman may suspect a disease.

Volume of menstrual bleeding normally is up to 80 ml, for the absorption of which no more than 10 sanitary pads are required. In the case of filling the pads with blood in 2 hours with a repetition of the situation for several days or if they are used monthly for menstruation for more than one standard pack, you should consult a doctor.

Gynecologists distinguish between two concepts that characterize the signs of uterine bleeding and allow you to recognize the pathology.

Menorrhagia (menometrorrhagia) is a type of bleeding that relates to menstruation, occurs during the expected period or with a delay. Signs are excessive duration (more than 6 days) and an abundance of bleeding. It is often possible to recognize uterine bleeding by its profuseness - a sharp, profuse flow of blood that does not tend to stop.
Metrorrhagia is uterine bleeding that is not associated with menstruation. Symptoms of this type of pathology are hemorrhages of different intensity, which can be recognized by such a sign as the appearance of blood secretions in the intermenstrual period (earlier than 21 days of the cycle).

Uterine bleeding due to hormonal imbalance is common among adolescent girls, women of reproductive age, and menopause. The signs of such a pathology can be different and depend on the cause, which can be recognized with instrumental and laboratory diagnostics.

Uterine bleeding in women

Signs of uterine bleeding and causes initiating pathology at the age of maximum fertility may be as follows:

scanty menstruation, resulting in a profuse outflow of blood;
breakthrough hemorrhages not associated with menstruation;
increased sebum secretion, acne, excessive hair growth, decreased libido, as signs of hyperandrogenism;
blood clots during menstruation;
lengthening of menstruation;
spotting in the middle of the cycle, bleeding after intercourse, as a sign of hormonal imbalance.

It is possible to recognize the provoking factors of violations of the hormonal regulation of the cycle in women with a blood test for hormones. Follicle-stimulating hormone, luteinizing hormone, estradiol, male hormones and their metabolites (free testosterone, DEA-sulfate, 17-OH-progesterone) are subject to analysis on days 2-5 of the cycle. If there are signs of a long delay, donate blood any day. It is also necessary to determine the level of progesterone, which is analyzed a week after ovulation or twice in dynamics with a pronounced delay and an anovulatory cycle. In addition, on any day of the cycle, the level of thyroid hormones, as well as cortisol, is determined.

Signs of hormonal imbalance that lead to a violation of the cycle later are:

increased production of male sex hormones and metabolites, a sign of which may be polycystic ovaries;
increased estrogen production, which can be recognized by clinical signs of endometrial hyperplasia or polyposis;
decrease in progesterone levels;
a decrease in free thyroxine with a parallel increase in thyroid-stimulating hormone, a sign of which is hypothyroidism.

The most common reason diseases in women of reproductive age are anovulatory cycles.

In addition to these signs, women complain of infertility. This is due to the lack of ovulation against the background of an increased content of estrogens or male sex hormones. Hyperestrogenism does not allow the onset of the second phase of the cycle, and there is also no possibility of ovulation. The endometrium grows, the luteal phase does not occur, which leads to a lengthening of the cycle. Against this background, there may be signs of minor spotting or scanty periods, which are not inherently menstruation.

Against the background of a long-term growth of the endometrium, necrotic changes occur in the blood vessels that feed the inner layer. Endometrial tissue begins to be shed. A sign of this is meager menstruation, which after 2-3 months can turn into profuse uterine bleeding. Hyperplastic endometrium can be recognized by ultrasound. As a rule, the thickness of the M-echo is more than 15 mm in the second phase of the cycle or with a long delay.

Uterine bleeding can be recognized by the following signs:

weakness and dizziness;
fainting;
outflow of blood from the genital tract with clots;
sticky sweat;
metallic taste in the mouth;
tachycardia;
drop in blood pressure;
nausea;
in rare cases, signs of pain in the lumbar region.

Signs such as irregular periods, scanty or heavy in nature, are the reason for going to the doctor. In addition to the analysis for hormones, ultrasound is performed to determine intrauterine pathology. With ultrasound, it is possible to recognize fibroids, polyps, endometriosis, which are also a common etiological factor in the disease.

Bleeding in the pathology of the uterus

Diseases against the background of increased estrogen production - endometriosis, uterine fibroids, endometrial polyps and hyperplasia - are accompanied by uterine bleeding of varying severity. Often, pathologies occur in a combined form. You can recognize formations in the uterine cavity using ultrasound, which is carried out in both phases of the cycle.

Signs of hemorrhage in fibroids are:

copious, prolonged periods with blood clots;
chronic anemia of various degrees of severity, the signs of which are dizziness, weakness, fragility of hair and nails, pallor of the skin;
infertility and miscarriage;
periodic aching pains in the lumbar region and abdomen, which are signs of medium and large fibroids.

Uterine bleeding most often they are a sign of submucosal fibroids located in the submucosal layer. Interstitial and subserous fibroids rarely initiate bleeding.

Recognizing fibroids is not difficult, as tumors are visualized on ultrasound. The larger the size of the submucosal fibroid, the more pronounced the hemorrhage. This type of pathology can lead to conditions that are life-threatening for a woman. Benign tumors should be identified and treated in time.

Signs of uterine bleeding with endometriosis:

severe soreness before, during and after menstruation;
abundant nature of menstruation;
infertility;
adhesive process;
daub before and after menstruation.

In order to recognize endometriosis, ultrasound, laparoscopy, hysteroscopy are performed, the level of hormones and the CA-125 tumor marker in the blood is determined. With this disease, failures occur only during menstruation, emergency situations are not recorded.

Endometrial hyperplasia often occurs in older women. One of the main signs of excessive growth of the endometrium is uterine bleeding. They can be profuse and plentiful against the background of a long delay in menstruation. A sign of hyperplasia are also spotting on different days of the cycle. Against the background of this disease or in isolation, polyps can develop, which are described by daubing in the middle of the cycle, after sexual intercourse, before and after menstruation. You can recognize the pathology with hysteroscopy, it is also required to determine the level of estrogen and progesterone. In addition, histological and immunohistochemical studies of the endometrium are carried out.

Bleeding in menopause

The most common cause of hormonal imbalance in premenopausal women is:

obesity;
liver disease;
chronic stress;
immunological disorders leading to a change in the receptivity of the endometrium.

Against the background of an increased content of estrogens, hyperplasia of the inner uterine layer develops, which leads to abnormal blood outflows that do not have a regular character.

Uterine bleeding in women in the period of menopause, they require an urgent visit to the gynecologist in order to exclude malignant tumors of the uterus.

Any bloody discharge from the genital tract during the period when menstruation has stopped requires a visit to the doctor. Signs of cancer of the cervix, body and endometrium should be identified or excluded.

Signs of bleeding in girls

In adolescence, uterine bleeding occurs against the background of follicle atresia - a condition in which the follicle does not reach the size necessary for ovulation. This leads to persistently elevated estrogen levels, endometrial thickening, and culminates in signs of bleeding.

Stress and infections during puberty seriously interfere with the hypothalamus-pituitary-adrenal-ovarian system. A disturbed hormonal background leads to a change in the menstrual cycle in a girl. Normally, the establishment of the cycle duration lasts about 2 years. Dysfunctional uterine bleeding in adolescent girls is not uncommon.

Signs of impaired production of sex hormones and uterine bleeding in adolescence are:

premature puberty (growth of the mammary glands, pubic hair growth, early menstruation);
psycho-emotional disorders, infantilism;
acne
sudden changes in body weight.

Signs of bleeding from the genital tract are:

spotting from the vagina of various sizes, lasting more than a week;
bleeding that occurred earlier than 21 days from the first day of the last menstruation;
total blood loss more than 100 ml.

You can recognize the pathology of the reproductive tract in girls with the help of ultrasound, MRI of the Turkish saddle, radiography of the bones of the wrist, and blood tests for hormones. The degree of ossification makes it possible to recognize an increased level of estrogen in a teenager. They also determine the content of the hormone in the blood, in addition, they measure the amount of thyroid hormones (excluding hypothyroidism), cortisol, FSH, LH, and male sex hormones.

Signs of uterine bleeding in teenage girls most often develop after psycho-emotional stress, severe infectious diseases.

Period after cleaning

Often, during interventions on the uterine cavity, in particular, after scraping or cleaning for various reasons, uterine bleeding develops.

You can recognize the signs of pathology after cleaning by the following symptoms:

increased bleeding;
stomach ache;
bloating;
soreness on palpation of the uterus and appendages;
dizziness and weakness;
temperature increase;
tachycardia;
nausea and vomiting.

Normally, bloody discharge should gradually subside. Allocations of fresh blood last up to 10 days, taking on the character of an ichorus.

Pregnancy and childbirth

Uterine bleeding during pregnancy can occur at all times and be dangerous for both the woman and the fetus. Signs of bleeding must be able to recognize every pregnant woman in order to seek medical help in time. Most often they occur in the early stages with the threat of miscarriage, in the case of placenta previa, its premature detachment. But situations are not uncommon when signs of the disease appear when low molecular weight heparins are used during pregnancy.

Patients with bleeding disorders should be closely monitored.

A feature of bleeding during pregnancy are the previous signs of pain in the lumbar region and lower abdomen.

You can recognize signs of pathology in the early stages by the following markers:

drawing pains in the lumbar region;
pink, brown discharge from the genital tract;
sharp profuse bleeding;
discharge of fresh blood in a small amount with an increase in symptoms;
tachycardia;
loss of consciousness.

The causes of uterine bleeding in early pregnancy are often a lack of progesterone, marginal placenta previa, non-developing pregnancy, gross malformations of the fetus.

Uterine bleeding with the threat of miscarriage against the background of progesterone deficiency, as a rule, begins gradually. With placenta previa, a sharp and profuse outflow of blood can occur. If pregnancy is accompanied by uterine fibroids or polyps, signs of bleeding may accompany the whole process of gestation.

In the later stages, bleeding can be recognized by the following signs:

weakening of fetal movements;
false or true contractions;
lower back pain of varying intensity;
bleeding from the genital tract, both profuse and intense.

In contrast to the discharge of the mucous plug, bleeding either increases with time, or immediately comes on abruptly. The mucus plug may come off partially starting at 36 weeks.

After childbirth or during natural delivery, uterine bleeding may occur in case of discoordination of labor, violation of uterine contractions. The main reason is premature detachment of the placenta.

After childbirth, bleeding from the uterus occurs due to a violation of its contractile involutive ability, when blood bleeds from the vessels of the placental site.

You can recognize the pathological development of signs after childbirth by the degree of filling of the pad. Filling several pads within an hour during the first day after delivery indicates the likelihood of an emergency. Doctors recognize the danger by the degree of uterine contraction. The faster the reverse development of the myometrium, the lower the likelihood of pathology.

Before a woman is discharged from the hospital, an ultrasound of the pelvic organs is performed in order to recognize and visualize the remnants of the placenta, as well as to determine the rate of uterine contraction. With unsatisfactory results of ultrasound, drug treatment of atony or hypotension of the uterus, curettage is performed.

Normal amount of blood loss during childbirth makes up 0.5% of a woman's body weight and is approximately equal to 300-400 ml. A sign of uterine bleeding after the birth of a child is the absence of a tendency to stop it in the early postpartum period.

Bloody discharge from the genital tract after childbirth (lochia) lasts up to 30 days. Signs of the normal course of the postpartum period can be recognized by the nature of the lochia. If the outflow of fresh blood gradually decreases, the discharge becomes brown, and then the character of the ichor, this development is considered the norm. Pathology can be recognized with a tendency to increase the secretions of fresh blood. Sometimes, against the background of absolute well-being, an emergency hemorrhage develops, as a rule, in the presence of a pathology of the blood coagulation system.

First aid

If a woman managed to recognize signs of bleeding at an early stage, the following rules should be followed:

call an ambulance;
take a horizontal position and raise your legs;
put any cold object on the lower abdomen (a bottle of water, an ice pack);
drink liquid;
do not take painkillers, aspirin;
do not apply warm objects on the stomach;
do not douche.

The uterus is intensively supplied with blood, so damage to the endometrial vessels by any pathological processes can result in an emergency. It should be borne in mind that bleeding during pregnancy and in the postpartum period can develop rapidly, threaten the life of a woman and a child. If there are signs indicating incipient bleeding that can be recognized independently, you should seek medical help in the next few hours.

Uterine bleeding manifests itself in the form of bloody discharge from the vagina, it can occur due to serious diseases in women. The essence of treatment lies in the diagnosis, in the correct and rapid therapy. After all, such a disease leads to complex consequences and even death.

What is uterine bleeding

Uterine bleeding - the discharge of blood from the uterus, differs from critical days in that the amount and time when the discharge occurs changes.

Rates of blood loss during menstruation

Menstruation is a physiological process that, on average, begins at age 11 and ends at 55. It lasts for 3-7 days and occurs every 28-35 days. For one menstrual cycle, a girl releases from 50 to 80 ml of blood.

Regular critical days stop during childbearing and after childbirth. They may also be absent during breastfeeding.

Types and causes of bleeding from the vagina

Type of hemorrhage	Causes of the disease
organic	fibromyoma;
	polyps;
	Cancer diseases;
	Vaginal tears after trauma; Intrauterine device;
	medical abortion;
	Ectopic pregnancy;
	Threat of abortion and miscarriage; postpartum period;
	Endometriosis.
Dysfunctional	polycystic ovaries;
	cysts;
	Lack of ovulation;
	Diseases of the pituitary gland;
	Menopause,
	puberty;
	Stress.

Also, the vagina can bleed during certain periods of a woman's life:

Juvenile- the stage of sexual development;
reproductive- childbearing age;
Climacteric- at menopause.

According to the nature of blood secretions are divided into:

The main symptoms of hemorrhage

The main signs of vaginal blood loss:

Dysfunctional hemorrhage is painless;
After childbirth up to 2 months;
Prolonged discharge after an abortion;
Blood loss while taking hormonal contraception;
With polyps in the uterus;
Myoma inside the vagina;
intrauterine pregnancy;
Bleeding is associated with cancer.

What is dangerous bleeding from the uterus?

If the uterine hemorrhage does not end for a long time, then it is difficult to stop, which is why such a pathology is very dangerous for women's health and has the following consequences:

Anemia may develop (if the volume of blood that came out is more than 80 ml);
Large blood loss due to hemorrhage, which is difficult to identify, most often requires surgery;
The risk of developing the underlying disease, which caused hemorrhage;
Risk of hemorrhage in pregnant women or in the postpartum period

Signs of uterine bleeding in the reproductive period

In the childbearing period, there are a lot of factors that can cause pathology.

This happens due to:

Disturbances in the production of hormones after termination of pregnancy;
With stress;
In the presence of infectious diseases;
intoxication;
When taking medication.

During the bearing of the baby, and especially in the early stages, the uterus may bleed due to a miscarriage. In the later stages, the uterus may bleed due to placenta previa. It is especially dangerous when it bleeds during and after childbirth, then the amount of blood loss can be very large.

Also, the cause of bleeding can be such diseases:

Myoma;
Endometriosis of the body of the uterus;
Tumors in the cervix;
Chronic inflammation of the cervix.

Bleeding in an ectopic pregnancy

The symptoms of an ectopic pregnancy are exactly the same as with normal childbearing:

Lack of menstruation;
The uterus has increased;
The chest is poured;
Toxicosis;
Change in taste preferences.

Causes of bleeding during pregnancy

Hemorrhage during ectopic pregnancy is a common phenomenon, it happens due to the fact that pregnancy can become the main factor in the rupture of the tubes or when interrupted. The intensity of excretion does not always depend on the mechanism of abortion, although tubal ruptures are accompanied by greater blood loss than with medical abortion.

Intrauterine hemorrhages with menopause in women

With menopause in women, hormonal changes in the body occur, so the vagina often bleeds. Great care must be taken with discharge during the period when menstruation has stopped. It is important to immediately consult a doctor at the first signs, since the treatment of neoplasms in the first stages is more successful.

Causes of uterine hemorrhage in menopause:

Abundant blood discharge;
Discharge with clots;
Bleeding that occurs between critical days;
The duration of discharge is longer than usual.

Why does vaginal bleeding occur on nerves?

Dysfunctional uterine blood loss is said to be when there is no reason for the appearance of blood discharge. They can be due to strong experiences, psychological and emotional stress and on nervous grounds. The methods of therapy will be similar, perhaps the doctor will prescribe sedative medication to relieve stress.

Diagnostics

At the first suspicion of the development of the disease, it is important to immediately see a doctor.

In order to determine the source from which the pathology arose, the following measures are taken:

Consultation with a gynecologist;
Blood tests;
ultrasound of the uterus;
vaginoscopy;
Biopsy of the cervix.

Accurate diagnosis is essential in the recovery process.

How to stop bleeding from the vagina?

In order to stop, you need to diagnose the main factor in the appearance of blood loss, then experts choose a way to stop it. Most often, hemostatic agents are used, with a large loss of blood, it is transfused. Also, another way to stop (during a miscarriage, abortion, or childbirth) is the curettage of the uterine cavity, if the bleeding has not been stopped, then doctors resort to surgical interventions.

You can stop bleeding at home by following these rules:

Peace;
Cold in the lower abdomen;
Plentiful drink;
Means that restore blood.

It is important after these measures to seek the advice of a specialist.

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

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

during sexual development or juvenile age (12-18 years);
reproductive age (18-45 years);
the period of fading of ovarian function (climacteric period - 45-55 years).

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

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

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

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

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

Causes of uterine bleeding

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

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

physical or mental injury;
dysfunction of the thyroid gland and adrenal glands;
malnutrition, hypovitaminosis;
the consequences of a complicated course of pregnancy and pathological childbirth;
the presence in the anamnesis of pubertal age of childhood infectious diseases: whooping cough, mumps, measles, chickenpox, chronic tonsillitis, influenza, etc.;
sometimes tuberculosis of the female genital organs or bleeding disorders.

In reproductive age, uterine bleeding is less common and is accompanied by ovarian dysfunction. This happens for the following reasons:

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

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

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

uterine myoma;
endometriosis;
uterine polyps;
hormonally active ovarian tumors.

Symptoms

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

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

Diagnostics

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

Additional diagnostic methods include:

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

Treatment

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

stop bleeding and replenish blood loss;
elimination of the cause that caused this condition;
rehabilitation of patients.

With severe uterine bleeding, the patient must be given first aid, which is to stop the bleeding. It comes down to injections of reducing and hemostatic drugs, the introduction of tampons impregnated with special medicines, or emergency curettage. Minor spotting stops as therapy progresses.

How to stop uterine bleeding

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

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

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

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