How to distinguish uterine bleeding from menstruation. Menstruation and bleeding - differences and characteristic signs

By the regularity of menstruation, the amount of blood loss, and pain, one can judge a woman’s health. Normally, menstruation lasts up to 7 days; they should not be accompanied by a pronounced disturbance of well-being or loss of strength. During this time, up to 150 ml of blood is lost. This volume manages to be compensated by the body’s internal reserves and is not reflected in the tests. But what to do if you have heavy periods that deplete you and disrupt your normal rhythm of life?

What is considered pathology?

The duration of the cycle is on average 28 days, but the duration can vary individually. Directly during menstruation there are 4-7 days. If discharge is observed for more than the maximum period, pathology should be suspected.

Menstruation may be accompanied by minor painful sensations, but should not disrupt the usual rhythm of life. If you are forced to take time off from work or spend time lying in bed, then this is also a reason to consult a doctor.

The amount of blood loss is critical. It should not lead to the development of anemia, the signs of which are dizziness, tachycardia, darkening of the eyes, and shortness of breath. How to determine whether it is heavy periods or bleeding: you need to calculate how often the pads are changed. If a tampon or sanitary pad overflows within an hour, this is not normal.

The separated endometrium may look like small strands or clots. But sometimes bleeding occurs with the release of large dark clots and a small amount of light blood. This condition also has its reasons.

Why does the nature of the discharge change?

The reasons for heavy periods can be different - from minor functional disorders to severe pathologies.

Pathology of the uterus

With severe myomatosis, the internal area of ​​the uterus increases and its shape changes. Therefore, the endometrium separates longer, there is more of it, and therefore bleeding is more profuse. Endometriosis is a pathological growth of the endometrium. It grows into the muscular layer of the uterus. The separation is accompanied by pain and heavy blood loss. Both pathologies develop against the background of hyperestrogenism, which contributes to endometrial hyperplasia. This condition is also characterized by intermenstrual bleeding.

The reasons for heavy periods with clots may be a change in the shape of the uterus. If there are any that interfere with the normal outflow of blood, it lingers inside, manages to coagulate and comes out in the form of clots.

You should be wary when heavy periods with clots appear after 45 years. Especially if a woman has already entered menopause and has not had menstruation for a long time. The cause of such changes may be cancer.

Abortion and childbirth, the presence of an IUD

If there were complications during the birth of the child or in the postpartum period, for example, bleeding or inflammation, the former can be very profuse. After a caesarean section, such changes in the nature of the discharge are also a consequence of trauma to the uterus. When breastfeeding, menstruation is absent for a long time. But at the initial stage of cycle recovery, periods may last longer than usual.

Changes in the duration and intensity of menstruation are observed after intrauterine manipulation:

• abortion:
• scraping;

We should also not forget about the possibility of spontaneous abortion. Sometimes a woman is unaware of her pregnancy. This situation often occurs with an irregular cycle. Then a delay of several days is perceived as the norm. But the fetus does not attach to the uterine cavity, and after a short delay, more pronounced bleeding than usual begins.

The presence of an intrauterine device increases the likelihood of changes in the amount of blood loss. Only if the intrauterine system with gestagens is used for endometriosis and fibroids, the volume of lost blood will decrease and the number of critical days will be reduced.

Medications

Taking medications that thin the blood can make menstrual bleeding longer. This applies to Aspirin, a group of antiplatelet and anticoagulant drugs that are used in the treatment of thrombosis and blood clotting pathologies.

Medical abortion is carried out using drugs that lead to the death of the fertilized egg and its natural rejection. Sometimes with incomplete periods there are heavy periods. This condition must be monitored using ultrasound, and if complications develop, medical attention will be required.

Heavy periods after a course of Duphaston are a consequence of the drug’s effect on the endometrium. Under the influence of the hormone, vascular growth increases in it. The looser mucous membrane is actively rejected during menstruation.

Hormonal changes

During the period of formation of the monthly cycle in adolescents, bleeding of different types may alternate. The same can be said about women who are on the verge of menopause.

Diseases and hypovitaminosis

Pathologies of the endocrine organs and blood coagulation system, including congenital ones, can affect the amount of blood loss during menstruation. A lack of vitamins C, K, P, as well as calcium, disrupts the blood clotting process, which threatens to worsen the condition during menstruation.

There is also evidence of the influence of dietary patterns. A diet with a predominance of lactic acid products - kefir, cottage cheese, yogurt - leads to increased synthesis of substances in the liver that thin the blood. The consequence is a deterioration in its coagulability.

Principles of therapy

The gynecologist chooses treatment tactics only after establishing the cause of the pathological condition. It is unacceptable to decide on your own what to drink during heavy menstruation. Self-medication will lead to the progression of the pathology and its transition to a severe form.

Medications

Hemostatic drugs belong to different groups. The choice of a particular remedy may depend on the cause of heavy menstruation.

• Askorutin

It is a vitamin preparation whose action is aimed at strengthening the walls of blood vessels. But the effect develops gradually, not earlier than after 3 weeks of regular use. Therefore, it is used for prophylactic purposes, as well as after intrauterine manipulation. An analogue is the drug Rutascorbin.

• Vikasol

A vitamin preparation, a source of vitamin K. It is a component of prothrombin, a protein that ensures blood clotting. To prescribe a medication, it is necessary to provide a diagnosis and prove that the cause of bleeding is a vitamin deficiency.

• Hemostatic tablets Dicynon (Etamzilat)

Accelerates blood clotting, but does not affect thrombus formation and does not constrict blood vessels. It is allowed to use it for metrorrhagia, heavy bleeding in women with. But the drug is prohibited for use in pregnant and breastfeeding women. Despite the fact that Etamzilat does not increase the likelihood of blood clots, it is not used for thrombosis. The drug increases coagulation due to the platelet component, so in patients with thrombocytopenia the effect of therapy will not appear. In mild cases, Dicinon can be used in the form of tablets; in case of severe blood loss, treatment begins with intravenous injections, then switches to intramuscular and oral tablets.

• Tranexam

In the form of tablets, it is used in cases of bleeding associated with the activation of fibrinolysis - the dissolution of a clot that has formed at the site of a bleeding vessel.

Additional effects of the drug are: analgesic, anti-inflammatory, anti-allergic and anti-infective.

Tranexamic acid is used for heavy menstruation and uterine bleeding. But it can cause thrombosis. Therefore, in case of pathologies of the coagulation system or the presence of thrombosis in the past, its use is not recommended.

For symptomatic therapy, iron supplements, folic acid, and vitamin C are used. They are necessary to restore blood and treat anemia. Iron and ascorbic acid are antagonists - in the presence of vitamin C, the absorption of ferrum occurs more actively. Folic acid affects the division of new red blood cells and the formation of complete hemoglobin.

Phytotherapy

With heavy and prolonged periods, the use of herbs can help reduce the amount of blood loss, improve blood clotting, and compensate for the deficiency of certain substances. But they are not a panacea, the effect of herbal remedies is mild, and the exact dosage cannot be calculated: the amount of active substances varies greatly depending on the collection period, drying conditions and storage of the substances. Herbal preparations may slightly reduce the severity of symptoms, but will not cure endometriosis, fibroids and endometrial hyperplasia, and will not cut intrauterine adhesions.

To reduce blood loss, traditional medicine suggests using nettle. A decoction or infusion is prepared from it, which is taken several days before the onset of menstruation.

Corn silk has a hemostatic effect. A decoction is prepared from them, which is taken several times during the day.

Water pepper extract is sold in pharmacies in the form of an alcohol solution. It is able to reduce the duration and severity of bleeding. Take it as prescribed by a doctor with a slight increase in blood loss, as well as after an abortion. The duration of treatment is determined individually.

Yarrow has a similar effect to nettle. For medical use, it is better to buy ready-made pharmaceutical raw materials, which are collected in compliance with all sanitation requirements, and the concentration of useful substances is maximum. Yarrow is used in the form of decoctions and water infusions.

Viburnum extract, a decoction of shepherd's purse and peppermint are used as an astringent and hemostatic agent.

Some healers suggest using homemade herbal remedies for douching. This treatment can be very harmful. Reverse flow along with menstrual blood can cause an infection, which will lead to the development of inflammation.

Lifestyle

To prevent and eliminate heavy bleeding, you need to change your lifestyle. For a while, you should completely avoid alcoholic beverages, coffee and strong tea. Those who are actively involved in sports should give up training or reduce its intensity on critical days. The same rule applies to lifting weights.

Hot baths, saunas, steam baths, and any thermal procedures increase the volume of blood loss. This also includes active insolation and many warming physiotherapy procedures.

other methods

If the bleeding has become pathological, emergency medical attention is required. Contracting drugs are not prescribed in this case. The only way to stop bleeding is curettage - mechanical removal of blood clots that prevent the uterus from contracting. In severe cases, transfusions of blood, plasma or plasma components may be required if pathological signs of blood loss develop.

In adolescence, curettage of the uterine cavity is not used. For girls, there is a way to stop bleeding using medications. Combined oral contraceptives have hemostatic properties. But they are taken not according to the usual scheme - 1 tablet per day, but according to a special system, several tablets per dose at short intervals.

How to distinguish periods from bleeding When is bloody vaginal discharge normal, and when is it pathological and requires medical attention, perhaps urgently?

To understand this, it would be correct to consider the most common situations as a result of which such questions arise.

The main differences between uterine bleeding:

• too short a period from the beginning of the last menstruation, less than 21 days, when there were no gynecological manipulations, surgeries, or taking hormonal medications;
• heavy periods lasting more than 7 days and with blood loss of more than 120 grams (you need to change pads more often than once every 2-3 hours, they get wet through), starting on time or with a delay - this should be regarded as bleeding. This is where the difference lies.

Exactly the same signs distinguish cyclic spotting from bleeding in women during menopause. After the onset of menopause (this is the absence of menstruation for 12 months), there can be no menstruation. The ovaries are gone. And all spotting is uterine bleeding, most often associated with precancerous or cancerous diseases.

Discharge after an abortion or miscarriage can be considered menstruation and a new cycle can be counted from this day. The next critical days will be in about 1-1.5 months.

Blood during pregnancy

A pregnant woman cannot have any periods. Remember this! If you are sure that you are carrying a child, and you start bleeding or have spotting, you should regard this as a pathology.

Possible options.

1. Threat of miscarriage. In the early stages, miscarriages occur very often. At least one in eight expectant mothers lose a child in the first trimester. This cannot always be prevented. Sometimes progesterone medications help. But if the embryo has severe developmental defects, a miscarriage will occur in any case. This is how nature has programmed it so that the strongest survive.
2. Ectopic pregnancy. In addition to blood, the woman notes pain from one of the ovaries. A deadly condition if surgery is not performed and the fertilized egg is not removed. Possible rupture of the fallopian tube (the most common location of the fertilized egg).
3. Frozen pregnancy. If the embryo dies, sooner or later, the fertilized egg will be rejected and bleeding will occur. But, at least in Russia, they won’t expect a spontaneous miscarriage. The woman will be referred for curettage to avoid an infectious process and for psychological comfort.

Discharge after childbirth

Normally, postpartum discharge lasts 4-6 weeks. Immediately after birth they are very abundant. But after 3-5 days they become similar to moderate menstrual ones. After which they normally decline.

It is bad if the discharge stops after a short period of time, but it is noticeable that the uterus has not yet returned to its original size (the tummy remains). This means that there are still lochia in the uterus, it’s just “lazy”, it doesn’t want to contract, or perhaps the cervical canal is in spasm and doesn’t release them. An ultrasound will help figure this out. Often in such a situation, blood still appears, but it is very dark (since it has been in the uterus for a long time, it has had time to oxidize and darken), there may be large clots. This is not menstruation, and not the norm. If there is subinvolution of the uterus (slowing down of the reverse development of the uterus), intramuscular injections of Oxytocin for three days are usually sufficient, even if they were previously given in the maternity hospital. If an inflammatory process, endometritis, is diagnosed, antibiotics are required.

Another situation is when the uterus seems to have contracted, the lochia has almost stopped, but suddenly it begins to pour. Moreover, less than 5 weeks have passed since birth. This is real bleeding. And it is most likely caused by a placental polyp - a piece of placenta remaining in the uterus. The diagnosis is made using ultrasound and confirmed by histological material. It is taken during hysteroscopy or curettage. Unfortunately, we can’t do without them.

The earliest time real menstruation can begin after childbirth is 6 weeks. Moreover, regardless of whether there was a caesarean section or the woman gave birth naturally. With breastfeeding (BF), menstruation usually begins later than with artificial or mixed feeding. But not always.

After 6-8 weeks, you can expect your period for those who breastfeed their babies according to the schedule, once every 3-4 hours and with long breaks at night. Those who feed very often, on demand, should expect their critical days a few months after the introduction of complementary foods. Sometimes they are not present until the very end of lactation, even if it lasts 2 years or more. This is due to hormonal levels.

Blood after obstetric manipulations and operations

With any invasive gynecological procedure associated with penetration into the tissue of the cervix or body of the uterus, vagina, there will be bleeding due to the formation of a wound surface. But in different ways.

Cervical biopsy

After this procedure, bloody or bloody discharge occurs for 2-5 days, but in volume no more than menstruation. It is carried out in a hospital setting and the woman is left under observation for several hours. If heavy bleeding suddenly opens up, this happens if a large vessel is touched, it is coagulated (“cauterized”) or the woman is given a hemostatic sponge (to stop bleeding). There is no need to remove it; it dissolves itself into the vagina. But on top of the sponge, so that it holds better, insert a cotton swab. You need to get it yourself after a few hours.

Typically, a cervical biopsy is performed midway through the menstrual cycle. After it, bleeding occurs that is not related to the functioning of the reproductive organs and hormonal levels. And menstruation, essentially a new cycle, begins approximately two weeks from the day of the procedure.

Cauterization of erosion

It should be done immediately after menstruation so that the wound has time to heal before the next menstruation. The discharge after cauterization is usually sanguineous - that is, like blood diluted with water. However, sometimes severe bleeding occurs, then doctors use hemostatic sponges to stop it and coagulate the bleeding vessels.

Approximately 10-14 days after cauterization of the erosion, bloody or spotting discharge may occur again. But they stop within 1-2 days (if they are not the beginning of menstruation). They occur due to the removal of a scab (a crust from a wound).

Sometimes minor spotting persists for longer than 1-2 weeks. It is explainable. For example, after diathermocoagulation (cauterization with electric current), the cervix heals in 6-8 weeks. The same amount of discharge can be observed if there is no other reason for its appearance.

Conization of the cervix

This is the removal of the affected part of the cervix in the form of a cone. The intensity and duration of bleeding depends on the area of ​​the wound surface. There is usually light red discharge for a couple of weeks.

Conization is usually performed immediately after menstruation, in the first half of the menstrual cycle. That is, you need to wait for your period on the normal days of your cycle. If the discharge from conization remains by the time it starts, you will notice an increase in it. Don't be alarmed, everything is normal.

Curettage or hysteroscopy

They are done on the last day of the menstrual cycle, but before the onset of menstrual bleeding, so as not to disrupt the cycle. The day on which the procedure was performed can usually be considered the first day of a new cycle. The discharge is bloody, the same in abundance as normal menstruation, lasting up to 7 days.

If the procedure was performed urgently, for example, on the 10-14th day of the cycle, then the woman will first expect postoperative bleeding (similar in nature to menstruation), and then, 2-3 weeks later, again, but now menstruation according to the calendar.

Discharge when taking birth control pills

In the first months of taking a contraceptive (meaning regular, regular contraception with pills), women may experience light bleeding before the pills in the package run out, that is, before the break. In this way, the body “gets used” to the drug. But if this continues for more than 3-4 months, it makes sense to change the contraceptive to one that has a different composition.

Normally, in women taking oral contraceptives according to a regimen that does not skip pills, discharge begins during the break between packs of the drug. This is not even real menstruation, but so-called withdrawal or menstrual-like bleeding. However, despite the menacing name - “bleeding”, blood loss during it is less than during normal menstruation. All thanks to the hormonal action of tablets that block ovulation and prevent the endometrium from growing too much.

If a woman stops taking pills without finishing the pack, she will experience spotting within 7 days. This is also withdrawal bleeding, which should be regarded as menstruation. Even if it started 2 weeks after the previous one. It is provoked by your actions - premature termination of taking the pills. But it usually lasts no more than 5-7 days, not too much.

A reader contacted us with the following problem: “I started getting smudges while taking hormonal medications. I thought it was my period. I quit taking pills. Two days later the bleeding started. What to do?"

The gynecologist’s answer: “Initially it was discharge associated with “getting used to” the drug. But since the woman stopped taking the pills, she experienced withdrawal bleeding (menstruation began). Thus, the cycle is broken. But it doesn’t matter if it doesn’t happen again in the future. If no more than 5 days have passed since the start of bleeding, you can start taking pills. But don’t stop taking them until the end of the package, even if a spot appears.”

When taking an emergency contraceptive drug (for example, Escapelle or Postinor), many women experience menstrual-like bleeding after 1-3 days, which gynecologists consider to be a new menstrual cycle. Even if it started 2 weeks after your period. See a doctor if it lasts more than 7 days and is unusually heavy. Because of such cycle disturbances, emergency contraception should be used as little as possible.

Implantation bleeding, ovulation or periods

Around the middle of the menstrual cycle, ovulation occurs in women of reproductive age - the follicle ruptures in the ovary and releases a mature egg, ready for fertilization. This is accompanied by a short-term drop in progesterone levels, which in some women causes short-term spotting.

About a week after ovulation or 3 weeks from the first day of your last menstrual period, you may start to bleed a little again. This happens with implantation bleeding, that is, when an already fertilized egg tries to penetrate the mother’s tissue for further development.

With late ovulation, implantation bleeding can begin on days when your next period was expected or even occur when there is already a slight delay. This happens with late ovulation, with an irregular cycle.

How to distinguish discharge during implantation from normal menstruation? The volume of discharge differs significantly. When pregnancy begins, this is literally a few drops. The woman thinks that she is beginning to have red days, but the discharge suddenly stops and does not return. And another 3 days after this, you can take a pregnancy test, since the hCG hormone will already be produced. In this case, the test done earlier, on the first day of the delay, as recommended by gynecologists, may be negative.

How to stop bleeding

Since it leads to iron deficiency anemia, in addition to the enormous inconvenience experienced by a woman who is forced to constantly change tampons and pads, urgent measures are needed.

The method to stop the bleeding will be chosen depending on its cause. Earlier in the article, we briefly reviewed them, as well as the measures that doctors take.

Let’s summarize everything point by point and add additional information.

• Spotting in a healthy woman does not require treatment, as it is most often a reaction to hormonal birth control (if taken), ovulation, or implantation of the fertilized egg.
• If ultrasound shows a pathology, for example, placental polyp or endometrial polyp, endometrial hyperplasia, curettage is performed while simultaneously taking histological material. Thus, the bleeding stops, and the exact cause of what happened is clarified.
• If bleeding is associated with endometriosis (adenomyosis), hormonal drugs are prescribed.
• If the cervix bleeds, a thorough examination and treatment is carried out. In turn, treatment in the form of cauterization, conization, or even amputation of the cervix again leads to bleeding. But this is absolutely normal and does not last long.
• Heavy postpartum bleeding is usually associated with poor uterine contractility. Treatment is intramuscular injections of Oxytocin.
• Bleeding during pregnancy is a sign of a threatened miscarriage. Requires hospitalization in a hospital, the prescription of progesterone and hemostatic drugs.

A good article on the topic - the most modern hemostatic drugs, folk remedies and dosage regimens. .

Characteristics of normal menstrual flow. Causes and types of bleeding. Signs of uterine bleeding.

On average, menstruation begins at age 12. Within 2 years, the cycle stabilizes, and girls already know the characteristics of their body.

Sometimes on critical days the uterus opens, and due to inexperience the thought arises that menstruation is heavy and not the same as always. A late visit to the gynecologist is fraught with the development of severe bleeding and problems with conception in the future.

Therefore, all girls after menarche should be aware of how to distinguish periods from bleeding.

Characteristics of normal menstrual flow

During the normal course of the cycle, menstruation in each specific case has physiological characteristics. The woman knows that the duration of discharge falls within 3 to 7 days and never exceeds this period.

Bleeding begins after the same period of time, for example, after 21, 28, 30 or 35 days. Menstruation begins with scanty spotting, on days 2–3 the mucous-bloody mass becomes abundant, after which the volume of discharge gradually decreases.

Small blood clots during menstruation are normal if they come out in small quantities in the first days of bleeding. The color of the discharge is initially scarlet and bright red. By the end of the critical days, the blood becomes dark burgundy (occasionally black). The smell of menstrual blood is reminiscent of fresh meat.

As for the volume of discharge, normally the body should lose about 50 ml over all days of menstruation. This is easy to calculate using the gaskets. If 2–4 products are used during the day, then everything is in order and your periods are not heavy.

Abdominal pain is acceptable at the beginning of menstruation. You can get rid of it with the help of painkillers and antispasmodics. If discomfort does not interfere with daily activities, there is no cause for concern.

Minor spotting may occur in the middle of the cycle. They indicate rupture of the follicle at the time of ovulation.

Dysfunctional bleeding: causes and types

Menstruation that is associated with improper functioning of the ovaries, adrenal glands and pituitary gland, as well as with a variety of diseases, are considered pathological.

Heavy periods or bleeding - how to determine the pathology:

• Menorrhagia is long, heavy periods with a short cycle. Blood loss exceeds 100 - 150 ml. Anemia develops.
• Polymenorrhea – cycle duration is less than 21 days.
• Metrorrhagia is irregular intermenstrual discharge not associated with the cycle. Duration and volume are variable.
• Menometrorrhagia – periods are prolonged, but occur irregularly.

Why do uterine bleeding occur instead of menstruation?

Doctors consider diseases of the thyroid gland, ovaries, adrenal glands and pituitary gland to be the functional causes of anomalies. Improperly functioning organs disrupt the process of hormone production, provoke diseases and change the nature of menstruation.

Iatrogenic causes of heavy menstruation, which turn into uterine bleeding, are medical procedures and medications. Medicines affect blood clotting, hormonal and nervous systems.

Organic causes are associated with diseases that disrupt the structure of the genital organs, change the functioning of the kidneys, liver and negatively affect the processes of hematopoiesis.

Let's look at the types of bleeding that occur during menstruation:

1. Juvenile – characteristic of adolescence. The problem arises against the background of poor nutrition, vitamin deficiency, and due to emotional and physical stress. The characteristics of menstruation are also determined by a history of diseases - measles, rubella, whooping cough, mumps.
2. Reproductive - bleeding worries adult women suffering from diseases of the cardiovascular and endocrine systems, endometriosis and inflammatory diseases of the genital organs.
3. Ovulatory - characterized by heavy, prolonged bleeding against the background of adhesions, pathologies of the uterus and appendages. Women complain of brown spotting before and after menstruation. This indicates an incorrect ratio of progesterone and estrogen.
4. Anovulatory - progesterone deficiency with excess estrogen leads to endometriosis, endometrial hyperplasia and the development of tumors. Anovulatory bleeding worries adolescents and women in menopause. Patients complain of delays in menstruation, heavy blood loss and bleeding lasting longer than a week.
5. Profuse - occur during menstruation and in the intermenstrual period. Bleeding of this type is dangerous due to anemia and hemorrhagic shock. They are removed by surgery.
6. Breakthrough bleeding occurs in women taking hormonal birth control pills. Their appearance indicates a restructuring of the body due to changes in hormonal levels. The volume of discharge is scanty, but with abrupt discontinuation of the drug, blood loss becomes significant.

The development of dysfunctional bleeding is facilitated by stress, strict diets, excessive physical activity, low social status, age and general condition of the body.

How to distinguish periods from bleeding - important signs

Every representative of the fair sex must know the signs of uterine bleeding during menstruation. Moreover, it is important to pay attention to the regularity of monthly discharge, its quantity and nature.

Dysfunctional uterine bleeding (DUB) can be recognized by the following criteria:

• Time of onset of menstruation – early or late.
• Intensity of discharge – 10 or more pads are used during the day.
• Duration – menstruation lasts for more than a week with the same volume of discharge.
• Consistency – the mucous-bloody mass contains red clots.
• PMS persists - abdominal pain, weakness, drowsiness, and fatigue continue. The discomfort is so excruciating that everyday activities become an overwhelming task.
• Blood test - the result shows anemia.

How to distinguish menstruation from bleeding based on general health? With significant bleeding, paleness of the skin and mucous tissues is observed, the woman is worried about chills, dizziness, tachycardia, and decreased blood pressure. Loss of consciousness and increased gag reflex are possible.

External signs of regular uterine bleeding are manifested by changes in the condition of the skin, hair, and nails. The covers acquire a marbled hue and maintain high humidity. Nails quickly break and hair falls out.

Bleeding during pregnancy

During a normal pregnancy, there should be no periods. In the early stages, scant implantation bleeding is allowed. Occasionally, expectant mothers experience brown spotting, which is not menstruation. This is the body's reaction to a decrease in progesterone levels.

Bloody discharge that resembles menstruation during pregnancy may indicate pathology:

1. Risk of miscarriage. Against the background of heavy bleeding, cramping pain occurs in the lower abdomen. Gestation ends spontaneously before 22 weeks.
2. Uterine rupture. Increased uterine tone, excessive fetal activity and abdominal trauma cause this condition. Trouble happens in the 2nd – 3rd trimester.
3. Damage to small vessels. The causes of bleeding are rough sexual intercourse, vaginal ultrasound, pseudo-erosion of the cervix, inaccurate gynecological examination.
4. Placenta previa. The low location of the placenta does not allow the growing baby to remain in the uterine cavity. Placental abruption is accompanied by heavy bleeding.

During an ectopic pregnancy, bleeding is characterized by dark-colored discharge and clots. Sharp pain occurs from the location of the embryo. The woman is worried about nausea and vomiting.

Postpartum period

In the first 8 weeks after childbirth, female bleeding is defined by the term “lochia.” Immediately after delivery, blood loss is 500 ml, after cesarean section - up to 1 liter. After 4 – 10 days, the lochia lighten and are secreted less.

Climax

After 45–50 years of age, menopause causes menstruation to become irregular and stop completely. If after a year menstrual-like discharge appears or uterine bleeding begins, for a woman in menopause this is a sign of the disease. Seeing a doctor in a timely manner will help avoid complications.

Monthly menstruation is a natural phenomenon for a woman. But sometimes it is difficult to determine whether menstruation has begun or bleeding.

What are the symptoms?

1. The amount of blood released is more than 80 ml (which is considered normal). You have to change more than 8-10 gaskets per day.
2. Blood is released for more than seven days.
3. Disruptions in the monthly cycle.
4. The bleeding occurred after menopause.
5. There was blood after sex.

Analyze your feelings:

• weakness;
• fatigue;
• pallor;
• hair loss;
• irregular menstruation;
• blood between periods;

Bleeding during menstruation

• Menorrhagia is fairly heavy and prolonged bleeding.
• Metrorrhagia is when blood is released irregularly between periods.
• Menometrorrhagia is prolonged but irregular bleeding.
• Polymenorrhea - menstruation occurs earlier than three weeks have passed since the end of the previous one.

Implantation bleeding

What exactly are the differences?

1. In the duration of bleeding. The second does not last long: at most, up to a day.
2. In intensity. During implantation bleeding, very little blood is lost, unlike menstruation.
3. In coloring. Implantation discharge is pinkish or yellowish with streaks of blood.

Feel

1. During implantation, a woman feels a slight nagging pain in the lower abdomen.
2. During implantation, the basal temperature drops below 37°, after which it rises sharply.

Discharge after childbirth

1. Scarlet lochia on the fifth day after birth.
2. The woman in labor suffers from chills and fever.
3. The gasket must be changed every hour.
4. The discharge is accompanied by an abundance of clots.
5. The lochia has already stopped, but scarlet spotting has reappeared.
6. After childbirth, the discharge smells bad.

What should I do?

• Drink plenty of still water.
• Get more rest.
• Don't lift heavy things.
• Don't go to the bathhouse.
• Avoid alcoholic drinks and coffee.

Medications

1. "Dicynon." It is prescribed five days before menstruation, not to stop, but to prevent bleeding.
2. "Vikasol". It is administered intramuscularly together with Oxytocin.
3. "Tranexam." It is used with caution, as in some diseases it can form blood clots.

1. Ascorbic acid.
2. Products containing iron.
3. Vitamins of groups A and B.

Folk remedies

1. Drink half a glass of nettle decoction 5 times a day.
2. Take diluted nettle juice.
3. Pour one and a half liters of boiling water over the orange peel (from 5-6 fruits) and boil to half a liter. Take a decoction.
4. Water pepper herb is taken during discharge after childbirth, with heavy menstruation, uterine bleeding.
5. Viburnum in the form of a decoction.

Menstruation occurs in a woman as a result of physiological processes occurring in the reproductive organs. Normally, they are repeated at approximately equal intervals, last several days and are practically not bothersome. But in some situations (after childbirth, during menopause), when blood discharge appears, doubts arise about its origin. Uterine blood loss has very dangerous consequences. You need to know how to distinguish it from menstruation in order to prevent complications and find out the cause of the pathology.

1. Period. Their duration is 3-5 days, volume 50-80 ml. They occur regularly with a deviation of 2-3 days. The interval between them is 21-35 days. The color of the discharge ranges from red (at the beginning) to burgundy or dark brown (on the last day), the consistency is mucous with clots of coagulated blood.
2. Minor spotting in the middle of the cycle. They occur when the follicle ruptures.
3. Implantation bleeding. Appear if conception occurs. They are caused by slight damage to the endometrium at the time the embryo attaches to the wall of the uterus. Scanty discharge of this kind appears on the 7th day after fertilization. If they intensify, this indicates detachment of the fertilized egg and the threat of miscarriage. If a woman is looking forward to pregnancy, then such discharge should alert her and force her to urgently go to the doctor.
4. Obstetric – bleeding during childbirth.

It is important to know how to distinguish menstruation from pathological bleeding in order to take timely measures and begin treatment.

Addition: Any deviations from the norm, as well as increased pain in menstruation, are a pathology. In rare cases, deviations are due to the characteristics of the body and heredity. Most often the cause is serious illness.

Dysfunctional bleeding

This is uterine bleeding that occurs as a result of hormonal imbalance associated with impaired functioning of the ovaries, pituitary gland and adrenal glands. Depending on the nature of the manifestation, they are divided into the following types:

1. Menorrhagia. This is the name for regular, long and heavy periods with a short gap between them. The bleeding continues for more than a week. During this time, blood loss is 100-150 ml or more, which leads to anemia.
2. Metrorrhagia. This is irregular bleeding between periods. They have nothing to do with the processes of the menstrual cycle. Their duration and volume are variable.
3. Menometrorrhagia. Irregular long periods.
4. Polymenorrhea. Frequent periods less than 21 days apart.

Causes

There are functional, organic and iatrogenic causes.

Functional. These include diseases of the ovaries, pituitary gland, thyroid gland, adrenal glands, which lead to disruption of hormone production. These include inflammatory diseases of the genital organs, ovarian dysfunction, hypothyroidism and others.

Organic. Associated with diseases in which not only the production of hormones is disrupted, but also the structure of organs (tumors, cysts, polyps, endometrial hyperplasia, endometriosis, fibroids, uterine cancer, as well as liver cirrhosis, pyelonephritis, hematopoietic disorders).

Iatrogenic. The reasons are medical manipulations or taking medications (hormonal drugs, antidepressants, anticoagulants).

Types of dysfunctional bleeding

Factors such as emotional stress, physical overload, poor living conditions, and poor nutrition contribute to the occurrence of dysfunctional bleeding. In addition, an important factor is the age and general condition of the body, its functioning.

Video: Uterine bleeding. Types and reasons

Juvenile bleeding

It occurs in girls during puberty, when hormonal levels become established. The development of reproductive organs in adolescents is influenced by living conditions, emotional and physical stress, and nutritional patterns. The appearance of unusual uterine blood discharge is promoted by malnutrition, vitamin deficiency, abnormalities in the functioning of the thyroid gland and adrenal glands.

Puberty and reproductive health are also affected by previous infectious diseases (measles, mumps, whooping cough, rubella), and the presence of diseases of the liver and other organs. Juvenile bleeding is anovulatory and may be distinguished by the fact that it occurs primarily in winter and spring.

Dysfunctional bleeding of the reproductive period

They occur in women of reproductive age with endocrine disorders, heart and vascular diseases, in the presence of inflammatory diseases of the genital organs, endometriosis or uterine tumors, as well as as a result of stress and physical fatigue. This group also includes bleeding that occurs only in women who are sexually active.

Ovulatory. They appear during menstruation. In this case, ovulation occurs. Characteristic fluctuations in the intervals between menstruation. They are abundant and long lasting. The cause is usually inflammatory diseases of the uterus and appendages, the formation of adhesions. Often, in addition to heavy periods, a woman also experiences spotting brown discharge before and after them. Such discharge is associated with impaired ovarian function, leading to an imbalance of estrogen and progesterone. They are typical for young women.

Anovulatory. Cycles without ovulation occur when there is insufficient progesterone and excess estrogen. This leads to pathological growth of the endometrium (hyperplasia, endometriosis), the appearance of benign and cancerous tumors. Such bleeding is characteristic of menopause, and also occurs in adolescents. At the same time, menstruation comes with a delay. The intensity of blood loss may be too great, and the duration of menstruation exceeds 7 days. This affects the woman’s well-being, as anemia occurs.

Breakthrough bleeding. It occurs as a result of taking hormonal oral contraceptives. Usually, spotting and spotting appear in the first months after starting to take the pills due to the body’s adaptation to changed hormonal levels. They can be scarce. Their volume may increase if the drug is abruptly stopped. If the patient complains of breakthrough bleeding, the doctor changes the dose or recommends another contraceptive.

Profuse bleeding. This is the most dangerous type of internal or external heavy bleeding. It can occur both during and between periods. Leads to anemia, hemorrhagic shock (acute blood loss). Occurs due to injuries to the genital organs (for example, during curettage, removal of fibroids). Often, such bleeding can only be eliminated through surgery.

Video: How dysfunctional bleeding occurs

Features of bleeding during pregnancy

Normally, once pregnancy occurs, a woman should not have periods until she gives birth. The only exception is scanty implantation bleeding.

In rare cases, on the days of normal menstruation, pregnant women may experience spotting brown discharge in the first months, which must be distinguished from menstruation. They are caused by low levels of progesterone. Gradually the condition returns to normal.

Blood discharge during pregnancy can appear as a result of various pathologies.

Miscarriage. Accompanied by heavy bleeding and spasmodic pain in the lower abdomen. A miscarriage is considered to be a spontaneous termination of pregnancy up to 22 weeks inclusive.

Ectopic pregnancy. There is abundant dark discharge with clots. A woman experiences sharp pain on one side of her abdomen, nausea and vomiting. If the fallopian tubes rupture, immediate surgery is necessary.

Contact damage to small vessels. It can occur during pseudo-erosion of the cervix, sexual intercourse, gynecological examination, as a result of vaginal ultrasound.

Placenta previa. Bleeding appears in the 2nd or 3rd trimester due to the position of the fetus and placenta being too low, as a result of which the growing fetus is not retained in the uterine cavity. Detachment may begin, which is accompanied by heavy loss of blood. There is a threat of death of the child.

Uterine rupture. Occurs in the 2nd or 3rd trimester of pregnancy due to abdominal trauma, increased uterine tone, or fetal activity.

Warning: In any case, if bleeding occurs, a pregnant woman should immediately consult a doctor in order to eliminate dangerous blood loss and possibly maintain the pregnancy.

Video: How to find out if a miscarriage has occurred in early pregnancy

Bleeding after childbirth

Within approximately 8 weeks after birth, the uterus is restored in size and cleared of blood and placental debris. At this moment, the woman develops so-called lochia, red discharge. After 4-10 days they lighten, become less abundant and slimy. The total blood loss in the first days is approximately 500 ml, with a caesarean section - about 1000 ml. The timing of a regular period depends on how long a woman breastfeeds her baby.

Bleeding during menopause

After 40 years, women experience a gradual decrease in the level of sex hormones. Hormonal imbalances increase the risk of tumors and other pathologies in the uterus. It is important for women to know exactly how to distinguish between menstruation and bleeding during this period.

Any bleeding that occurs after you have not had a period for 1 year cannot be menstruation because the ovaries have stopped functioning. Bloody discharge now acts only as a sign of the disease. The sooner a woman sees a doctor, the greater the chance of avoiding serious complications.

Video: Features of blood discharge during menopause

How to distinguish menstruation from pathological blood loss

There are signs that will indicate how to distinguish menstruation from bleeding of a pathological nature:

• bleeding is indicated by bleeding that does not stop for more than a week;
• the intensity of the discharge is such that the pad has to be changed every 1-2 hours;
• there are many clots in the blood;
• symptoms of anemia appear (nausea, weakness, headache, rapid heartbeat);
• there are pains in the lower abdomen that are constant or cramping in nature;
• blood discharge appears after sexual intercourse;
• increased bleeding appears after a long delay or much earlier than usual, perhaps between periods;
• spotting begins a few days before menstruation and continues for another 3-4 days after the cessation of menstrual bleeding;
• If there is bleeding, the discharge may have an unpleasant odor.

The nature of the discharge helps to distinguish bleeding from menstruation after childbirth. When several weeks have already passed after the cessation of lochia and bright red profuse discharge appears again (while the woman is breastfeeding), this is not menstruation.

What to do if there is heavy or suspected bleeding

If signs of blood loss are detected, a woman should definitely consult a doctor; if there is severe bleeding, call an ambulance.

Before the doctor arrives, you need to lie down and remove the pillow from under your head. Your feet should be higher than your head. Ice should be placed on the lower abdomen. You can drink a decoction of nettle or yarrow, which have a hemostatic effect.