Unexpected bleeding in women. Pathological uterine bleeding: signs. Dysfunctional uterine bleeding

All representatives of the fair sex are well aware that menstruation is a normal physiological process. However, not everyone is always able to distinguish normal menstruation from pathological uterine bleeding. Incorrect diagnosis and late presentation to the hospital jeopardizes the possibility of having children in the future. In addition, this is dangerous due to the development of massive uterine bleeding, which without timely medical intervention leads to death. So how can you tell the difference between menstruation and bleeding?

Bleeding during menstruation is normal

The release of blood during a normal menstrual cycle has its own characteristic features, well known to every girl:

1. The duration of menstruation ranges from 3 days to 1 week and does not exceed the specified periods.
2. Menstruation occurs after a certain period of time (from 21 to 35 days), which is individual for each girl.
3. Menstruation begins with scanty, spotting bloody discharge. On days 2-3, more heavy bleeding is observed, which subsides by the end of menstruation.
4. The color of the bloody discharge is scarlet at first, then bright red. At the end of menstruation, the blood turns dark burgundy or black.
5. During normal periods, blood clots disappear, however, in small quantities and mainly on the 1st-2nd day of menstruation.

Important! It is important for every girl to know the difference between normal menstrual bleeding and pathological bleeding. This way you can consult a doctor in time if you suspect uterine bleeding.

You also need to know that with normal menstruation, no more than 4 pads are required per day. In this case, menstruation is considered to be of physiological volume, not abundant.

Painful symptoms are present only at the beginning of menstruation, then the pain and discomfort in the lower abdomen goes away. The pain is easily relieved by taking antispasmodics and painkillers, and does not interfere with the performance of usual, everyday activities.

Pathological uterine bleeding: signs

To distinguish bleeding from menstruation, pay attention to the nature of the spotting, its quantity and time of onset. Uterine bleeding is characterized by the following symptoms:

• Premature or late onset of “menstruation”.
• Heavy bleeding. One day requires up to 10 or more pads.
• The bleeding lasts for more than a week, the volume of blood loss does not decrease.
• During menstruation, a large number of bright red blood clots are released.
• Menstruation is accompanied by symptoms of weakness and fatigue. Drowsiness, thirst and dry mouth, increased sweating are noted. The girl, as a rule, complains of intense pain in the lower abdomen of a tightening or pulling nature. The pain syndrome can be so excruciating that it forces you to take a forced position: with your knees brought to your stomach. Pain interferes with daily activities.

How to distinguish periods from bleeding after childbirth

Bleeding after childbirth is a normal physiological process. Normally, a woman will experience spotting and spotting, called lochia, for at least 4 weeks postpartum. It is quite simple to distinguish the beginning of bleeding from lochia.

For each woman, the process of menstrual bleeding is completely individual, depending on the characteristics of the female body. The average duration of the menstrual period is determined to be up to five days. At the same time, if there are any atypical discharges, then it is worth thinking about pathology. However, bleeding should not be ruled out, which can easily be confused with menstruation. Therefore, to provide timely assistance, it is necessary to have an understanding of the distinctive features.

During menstruation, a woman begins to secrete blood in average quantities per day (about 50 ml.). The first days of menstruation are characterized by bright-colored bloody discharge, then in subsequent days the discharge becomes darker and is released in portions. The shades of the blood that comes out also differ for each woman individually. Subsequent discharge may occur during sudden rise or movement or physical activity.

Additionally, mucus or blood clots appear in menstrual flow. At the same time, the smell of discharge is also present. Menstrual blood is characterized by an odor reminiscent of fresh meat.

Attention! If the discharge during menstruation has an atypical brown color or the discharge is scanty, it is recommended to consult a gynecologist for advice.

Uterine bleeding and menstruation: main differences

In order to identify pathology, you should interview the patient, who can easily characterize the typical menstrual flow that is characteristic of her. Therefore, any changes should alert the woman. The nature of menstruation can change dramatically, therefore, it is necessary to pay attention to the following warning signs:

1. The volume of menstrual flow increases significantly.
2. The release of blood does not occur in batches, but occurs almost continuously.
3. The outgoing discharge is characterized by a too liquid consistency.
4. There are no blood clots.
5. The color of the discharge becomes deep red.
6. There is no specific odor characteristic of blood.
7. Signs of anemia are observed.
8. There is severe weakness.
9. Possible pain in the lower abdomen.
10. Before the onset of menstruation, sexual intercourse may cause pain.

Carefully! If the above symptoms are observed, then you should not hesitate to visit a specialist.

Causes of bleeding

For the body, blood loss is a rather dangerous manifestation. Almost a third of all uterine bleeding is explained by a pathological process that arose in the female reproductive system. Basically, pathologies of this kind do not pose a threat to life, but lead to poor health, anemia, low levels of iron in the blood, as well as problems with sexual life. Therefore, in order to prevent the occurrence of pathology, you need to know the main reasons that provoke it.

The root causes of bleeding are as follows:

• termination of pregnancy, occurring artificially (abortion) or naturally (miscarriage);
• if delivery occurred by caesarean section;
• frequent diets, which lead to complete intoxication of the entire female body;
• problems with general hormonal levels, sudden disruptions;
• iron deficiency or vitamin deficiency;
• blood diseases;
• blood clotting disorder;
• long-term depressive states, stressful situations;
• illnesses of an infectious nature;
• excessive physical activity and heavy lifting;
• inflammatory process in the reproductive system;
• gynecological pathologies;
• pathological neoplasms.

Classification of discharge

Experts classify uterine bleeding into three types.

More details about the types of bleeding

Dysfunctional

The main signs of this type of bleeding are heavy blood loss or prolonged bleeding. Adolescent girls and menopausal women are at risk. The provoking factor of the pathology is an excessive amount of estrogen or progesterone. To eliminate this pathology, hormonal therapy is used.

There are two types of dysfunctional blood loss:

• ovulatory. They are characterized by manifestations of an abnormal cycle, that is, over the course of a month, a woman experiences slight discharge of a scanty nature or, conversely, short menstruation that have an interval of more than one month;
• anovulatory. They are characterized by significant blood loss, cycle disruption, poor health, loss of appetite and a constant desire to sleep.

It is important! Primary pathology can be determined using a gynecological examination, supplemented by ultrasound.

Juvenile

May appear seasonally. This is explained by the fact that the corpus luteum does not form due to hormonal imbalance. If a teenage girl is diagnosed with neoplasms in the reproductive system, then juvenile bleeding cannot be ruled out.

Breakthrough

A third of cases of breakthrough bleeding occur due to problems with the uterus, which are provoked by the intrauterine device. Bleeding can also be caused by the consequences of taking hormonal contraception. To prevent subsequent bleeding, it is recommended to remove the IUD and select the correct dosage of contraceptives.

Profuse

Profuse blood loss is difficult to distinguish from menstrual discharge, since it is also characterized by menstrual pain. The only symptom is increased blood loss, which is characterized by scarlet discharge. The exact period of occurrence is difficult to determine because it varies.

Is it dangerous! Profuse bleeding is difficult to diagnose and requires urgent hospitalization of the woman. In this case, surgical treatment in the form of uterine curettage is mandatory.

Video - How to distinguish menstruation from bleeding?

Bleeding and menopause

During menopause, a woman cannot exclude the risk of developing neoplasms of various types (fibroids, polyps). This is explained by a decrease in the level of estrogen, which is responsible for the normal menstrual cycle. It is distinctive that a woman will experience severe pain during sexual intercourse, as well as an interval between menstrual cycles of more than three months.

Blood loss during pregnancy

If a woman experiences any bleeding after conception, this is a direct threat to her life and to the fetus. If you notice a woman’s bright bloody discharge, you should immediately call an ambulance. The discharge is accompanied by the following symptoms:

1. The occurrence of severe pain in the lower abdomen, which resembles contractions.
2. Nausea leading to vomiting.
3. Increased level of sweating.
4. The appearance of dizziness.

Note! The occurrence of bleeding during pregnancy is considered a dangerous sign that threatens life.

How to help

First of all, it is necessary to minimize all physical activity. Then review your diet and include beef, offal (liver), and foods high in iron.

If a woman begins to experience heavy blood loss, she urgently needs to lie down in a position so that the pelvis is slightly elevated. To do this, you can place a pillow or slightly raise your lower limbs. In this way, loss of consciousness can be avoided and symptoms can be reduced.

To reduce bleeding, you will need to apply a cold compress so that the vessels of the uterus constrict and the muscle layer of the uterus contracts.

You should not ignore any pathological discharge, because it can be a sign of a serious illness. A specialist will tell you about the causes of uterine bleeding in a video commentary.

Video - Why do uterine bleeding occur?

A certain amount of vaginal discharge (fluid that leaks from the vagina) is normal. The vaginal walls and cervix contain glands that produce small amounts of fluid that help keep the vagina clean. This is a normal fluid that is usually clear or milky white and does not have a foul odor. Vaginal discharge at certain times of the menstrual cycle (during ovulation), during breastfeeding, or during sexual arousal is normal.

Abnormal vaginal bleeding is the flow of blood from the vagina that occurs at the wrong time during the month or in inappropriate amounts.

Uterine bleeding can occur in physiological and a number of pathological conditions. Since a woman herself cannot determine the source of bleeding, vaginal bleeding is a manifestation of uterine bleeding. Uterine bleeding can be an absolutely physiological phenomenon in two cases: during menstruation, if its duration is no more than 7 days and the frequency of occurrence is not less than once every 25 days. Also, uterine bleeding in the form of short-term spotting may be normal during ovulation.

What uterine bleeding is considered pathological?
Uterine bleeding can occur in women of different ages. Pathological vaginal bleeding occurs in the following cases:
Increased length of periods (menorrhagia), increased bleeding (menorrhagia and hypermenorrhea) and too frequent periods (polymenorrhea)
Bleeding not associated with menstruation, occurring irregularly - metrorrhagia
Bleeding in the postmenopausal period (if more than 6 months have passed since the last normal menstruation
Bleeding can also occur in pregnant women in the early and late stages.

Why does uterine bleeding occur?
The main mechanisms for the development of uterine bleeding are as follows:
Hormonal dysregulation of the relationship between elements of the hypothalamic-pituitary-ovarian-endometrial axis
Structural, inflammatory and other gynecological disorders (including tumors)
Blood coagulation disorders
The most common mechanism of uterine bleeding is this: during the anovulatory cycle (the follicle does not mature), the corpus luteum does not develop. As a result, progesterone (one of the female sex hormones) is not produced in sufficient quantities during the second phase of the cycle. At the same time, estradiol (another female sex hormone) continues to be produced in excess. Under the influence of estradiol, increased growth of the endometrium (the inner layer of the uterus) occurs, which becomes so thick that the blood vessels no longer adequately supply it with blood. As a result, the endometrium dies and undergoes desquamation. The desquamation process is not complete, is accompanied by uterine bleeding and is delayed for a long time.

The most common causes of uterine bleeding
Bleeding during early pregnancy occurs during spontaneous abortion. In this case, vaginal bleeding begins immediately or some time after the start of the abortion due to the leakage of accumulated blood. Bleeding can also occur during ectopic (ectopic) pregnancy.
Bleeding in late pregnancy can be associated with placental rupture, hydatidiform mole, placental polyps, and placenta previa.
Uterine bleeding can be symptoms of diseases associated with changes in the structure of the reproductive organs, such as adenomyosis (endometriosis of the uterus), cancer of the uterus, cervix or vagina, endometrial hyperplasia, submucosal nodes with uterine fibroids or nascent nodes, cervical and endometrial polyps.
Vaginal bleeding may be a sign of atrophic vaginitis, cervicitis, a foreign body in the vagina, or damage to the cervix, uterus or vagina.
Pathology in ovarian dysfunction can occur in the following conditions: dysfunctional uterine bleeding, functional ovarian cysts, polycystic ovary syndrome (polycystic).
Endocrine disorders: hypothyroidism or hyperprolactinemia.
Vaginal bleeding due to blood clotting disorders develops with hereditary diseases of the coagulation system, liver diseases, and when taking certain medications.
Uterine bleeding may occur when using contraceptives and hormonal therapy. Most often in cases of prescription of drugs such as Depo Provera, with hormone replacement therapy, in the presence of an intrauterine device, with levonorgestrel implants and in case of long gaps in taking contraceptives.

When should you see a doctor if you have uterine bleeding?
In cases where menstruation lasts more than 7 days, if the amount of discharge during menstruation is greater than usual, if menstruation occurs more often than once every 25 days, if you have bleeding outside of menstruation, you should consult a doctor. When examined in a chair, you can see damage to the vagina and cervix, the onset of vaginitis, and erosion of the cervix. Also, upon examination, you can see a nascent submucosal node with uterine fibroids or a cervical polyp. Pathologies often accompany infertility, since they are always based on a violation of the structure of the endometrium or a violation of the hormonal regulation of ovulation and the menstrual cycle. In addition to the examination on the chair, it is often necessary to do a transvaginal ultrasound, since with this method it is possible to evaluate changes in the ovaries and in the uterine cavity. Often, a uterine ultrasound is critical to diagnosing the causes of uterine bleeding. If an ultrasound of the uterus reveals structural changes that do not have clear signs, a blood test may be prescribed to measure the content of sex hormones and thyroid hormones. Whenever there is uterine bleeding, a pregnancy test is performed. To assess the degree of acute or chronic blood loss, a general blood test is prescribed, where the indicators of red blood cells, hemoglobin, hematocrit, platelets and ESR are monitored.

Treatment of uterine bleeding
Treatment of uterine bleeding depends on the cause that causes it. Most often, treatment is conservative and consists of the use of drugs that increase the ability of blood to clot and drugs that correct hormonal imbalances. The correct choice of these medications takes into account many factors, which are brought together by the doctor. If the bleeding is not eliminated by medication or has an underlying cause that cannot be eliminated conservatively, surgical treatment is performed. Surgical treatment can consist of both therapeutic and diagnostic curettage of the endometrium and hysterectomy (removal of the uterus).

Naturally, the main thing you should do is immediately contact a gynecologist who can identify and solve your problem.

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

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

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

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

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

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

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

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

Causes of uterine bleeding

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

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

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

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

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

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

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

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

Symptoms

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

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

Diagnostics

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

Additional diagnostic methods include:

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

Treatment

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

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

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

How to stop uterine bleeding

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

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

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

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

Uterine bleeding should be understood as the discharge of blood from the uterine cavity. They are distinguished from menstruation by the intensity, volume, duration of blood loss, as well as regularity.

Causes of uterine bleeding.
Uterine bleeding occurs due to a malfunction of the hypothalamic-pituitary-ovarian system, which regulates the functions of the ovaries; these are the so-called dysfunctional bleeding. Disruption of the process of production of gonadotropic hormones of the pituitary gland, which affect follicle maturation and ovulation, leads to disturbances in folliculogenesis and menstrual function. Moreover, the follicle in the ovary does not mature or matures without ovulation, but. This means that the corpus luteum is not formed. As a result, the uterus is affected by estrogens (hyperestrogenism), since the production of progesterone stops and its cycle is disrupted. Hyperplasia occurs (when the endometrium grows too much), and subsequently rejection of the endometrium, which is accompanied by uterine bleeding, which is profuse and prolonged.

It is important to note that hyperestrogenism with dysfunctional uterine bleeding greatly increases the risk of developing adenocarcinoma, fibrocystic mastopathy, diseases of the uterus and appendages, and breast cancer.

Dysfunctional uterine bleeding is divided into ovulatory, that is, associated with menstruation (deviations in the volume and duration of blood loss during menstruation), and anovulatory - observed between menstruation and occurring after a delay or less than 21 days after the last menstruation. Ovarian dysfunction often provokes the development of infertility and miscarriage. By consulting a doctor in time, namely immediately after the onset of menstrual irregularities, you will avoid dangerous consequences in the future.

Uterine bleeding can also be caused by diseases of the uterus and appendages, in particular fibroids, endometriosis, adenomyosis, and various tumors of a benign and malignant nature. In very rare cases, diseases not related to the functioning of the genital organs can contribute to the development of uterine bleeding, in particular liver diseases, blood clotting disorders). In this case, in addition to uterine bleeding, patients also note other types of bleeding (nasal bleeding, bleeding gums, severe blood loss from minor cuts, etc.). Such bleeding is classified as organic, that is, associated with the political science of the genital organs or systemic diseases.

Uterine bleeding (profuse) can also occur with hypothyroidism (hyperthyroidism) or a malfunction of the thyroid gland.

Uterine bleeding is also observed as a complication of pregnancy and childbirth. Prolonged bleeding from the uterus can occur with anemia.

Iatrogenic bleeding observed as a result of the use of intrauterine contraceptives, the use of non-hormonal and hormonal contraceptives, and blood thinners should also be highlighted.

Symptoms of uterine bleeding.
The main manifestation of this pathological condition is the discharge of blood from the vulva. What distinguishes uterine bleeding from normal menstruation is:

• Increased volume of blood loss (normal up to 40-80 ml, pathology - over 80 ml). A woman may notice a pathology due to the need to change hygiene products more frequently (every half an hour to an hour and a half).
• Increasing the duration of bleeding (over seven days).
• Menstrual cycle disorders associated with a decrease or increase in its interval.
• The occurrence of bleeding after sexual intercourse.
• Observed uterine bleeding during the postmenopausal period, after the cessation of menstruation.

• Menorrhagia (hypermenorrhea) - excessive and long-lasting menstruation while maintaining their regularity (21-35 days).
• Metrorrhagia is low-intensity bleeding in the middle of the cycle.
• Menometrorrhagia is long-term bleeding of an irregular nature.
• Polymenorrhea is a cycle disorder manifested in too frequent bleeding (less than 21 days). As a rule, prolonged and intense blood loss with this pathology provokes the development of iron deficiency anemia (low hemoglobin content in the blood), in which dizziness, weakness, pale skin, and shortness of breath are common symptoms.

Types of uterine bleeding.

Uterine bleeding in the first decade (before puberty).
They are observed very rarely and are explained by the presence of ovarian tumors that can produce increased levels of sex hormones (so-called hormonally active tumors). The result is false puberty.

Juvenile uterine bleeding.
As a rule, they occur during puberty in girls (from 12 to 18 years). The main reason that causes bleeding during this period is considered to be ovarian dysfunction. The causes of such failures may be psychological trauma, chronic infections, excessive physical activity, frequent cases of acute respiratory viral infections, and poor nutrition. In addition, such a factor as seasonality plays an important role here. Winter and spring are the periods during which bleeding is most often observed, and, as a rule, they are anovulatory, that is, when ovulation does not occur. Very rarely, but such cases occur when tuberculous lesions of the genital organs, bleeding disorders, tumors of the ovaries, cervix and uterine body can provoke bleeding. Prolonged and severe uterine bleeding during this period provokes the development of anemia. Treatment of girls during this period is carried out only in inpatient settings.

If bleeding occurs, you should definitely call an ambulance, and at this time the girl must be provided with complete rest and bed rest. She should take a hemostatic drug (this can be aminocaproic acid, Dicynon, Vikasol (one tablet), put a cold heating pad on the lower abdomen. In inpatient conditions, treatment is symptomatic. Hemostatic drugs are mainly used, drugs whose action is aimed at contracting the uterus (Oxytocin) If this is not enough, hormonal drugs are prescribed to stop the bleeding.

Curettage for this type of bleeding is not performed, with the exception of severe and life-threatening bleeding that even hormonal treatment could not stop. In order to prevent the development of repeated bleeding, vitamin therapy, iron supplements, as well as some physiotherapeutic procedures and acupuncture are prescribed.

After the bleeding has been stopped, specialists prescribe estrogen-progestin drugs, the purpose of which is to restore the normal menstrual cycle. During the recovery period, physical exercise, a balanced diet, and treatment of existing chronic infections play a special role.

Bleeding during the reproductive period (ages 18 to 45 years).
During this period, there may be many reasons for the development of uterine bleeding. The main influence is dysfunctional factors associated with impaired production of sex hormones due to previous abortions, endocrine diseases (obesity, diabetes mellitus, etc.) and infectious diseases, severe stress, various intoxications, as well as the use of certain medications. Bleeding of a dysfunctional nature can be observed at absolutely any age, from puberty to the menopausal period.

Dysfunctional uterine bleeding is often observed during pregnancy, in particular in the early stages of pregnancy this is most often due to the threat of miscarriage and ectopic pregnancy (pain in the lower abdomen, delayed menstruation and the usual signs of pregnancy are observed), and in the later stages this condition occurs due to placenta previa or hydatidiform mole. At the first signs of bleeding during pregnancy, no matter at what stage, you need to go to the doctor. In the early stages, with timely treatment and appropriate therapy, pregnancy can be saved, but in the later stages, there is often a need for curettage.

At the end of the second and beginning of the third trimesters of pregnancy, bleeding can threaten the lives of both mother and baby, so prompt contact with a specialist plays a huge role here. Bleeding is often observed against the background of placenta previa (when the entrance to the uterus is partially or completely blocked), placental abruption, and also in case of uterine rupture. In these situations, bleeding can be internal or external, and therefore requires an emergency cesarean section. Representatives of the fair sex who are at risk of developing such conditions should be regularly monitored by specialists. During labor, the occurrence of bleeding (mainly due to placental abruption, atony or hypotension of the uterus) is especially dangerous, since it is accompanied by large volumes of blood loss.

After delivery, the main causes of bleeding are:

• poor uterine tone and weak ability to contract;
• not fully expelled parts of the membranes;
• blood clotting disorder.

Uterine bleeding during menopause.
During menopause, such conditions develop due to disruption of hormone production or against the background of diseases of the genital organs. Since hormonal changes occur in the body during this period, bleeding is common, however, it is important to consult a doctor, since they can be harbingers of malignant or benign neoplasms. This is especially true for the postmenopausal period. Remember, timely consultation with a doctor (at the first symptoms and manifestations) is the key to the success of further treatment.

For an accurate diagnosis, separate diagnostic curettage of the cervical canal and the body of the uterus is performed, after which a histological examination of the scraping is prescribed in order to determine the cause of bleeding. For dysfunctional uterine bleeding, optimal therapy with hormonal drugs is prescribed.

Breakthrough uterine bleeding.
Such bleeding develops against the background of hormonal disorders. It is the hormones that are responsible for the normal menstrual cycle, as they maintain the balance between estrogen and progesterone. If all is well, then menstruation always begins on time and is not heavy. When the hormonal balance is disturbed, the endometrium begins to grow strongly, against which its rejection occurs in parts, and the result is breakthrough bleeding. Hormonal imbalances are most often observed in girls during adolescence and in women during the menopausal period.

Breakthrough bleeding may occur when taking hormonal oral contraceptives, which is explained by adaptation to the drug used. In this situation, you should consult your doctor regarding changing the dose used. If increasing the dosage does not stop the bleeding or it becomes more profuse, it is necessary to be examined for the presence of diseases of the reproductive organs. In addition, such conditions can develop against the background of damage to the walls of the uterus by an intrauterine contraceptive device (IUD). In this situation, the woman is advised to remove the intrauterine device.

Diagnostics.
At the first suspicion of uterine bleeding, you should seek help. It is very good if a woman keeps a menstrual calendar, noting the intensity, duration and nature of bleeding. This calendar will further help the doctor in diagnosing and prescribing optimal therapy. For diagnostic purposes, smears from the cervix are tested for cancer and tests for the presence of uterine bleeding. It is mandatory to undergo an ultrasound examination, as well as measurement of the inner layer of the endometrium (its thickness). They also do a general blood test for hormones. If a woman is overweight or approaches menopause, a biopsy of the inner layer of the uterus is performed (a small fragment of the endometrium is pinched off and examined under a microscope). Accurate diagnosis is essential for prescribing further optimal therapy.

Treatment of uterine bleeding.
Therapy for such conditions has four main goals: stopping bleeding, replenishing blood loss, eliminating the root cause and prevention. I note that uterine bleeding of any nature can be treated in a hospital setting. The techniques used for this take into account the patient’s age, the cause of the bleeding, and the severity of the condition.

The main method of stopping bleeding is surgical diagnostic curettage, which also makes it possible to find out the cause of their occurrence. The use of hormonal therapy is another method of stopping bleeding. For these purposes, mainly estrogen or combined oral contraceptive drugs are used, including Marvelon, Mercilon, etc. For symptomatic treatment, hemostatic drugs are used to contract the uterus, iron supplements (for low hemoglobin levels) or blood components, vitamins and vascular strengthening drugs (Ascorutin, Folic acid, vitamins C, B6, B12). After uterine bleeding has been stopped, preventive measures are taken.
In case of dysfunction, hormonal therapy with combined oral contraceptives or gestagen-based drugs is prescribed, or a hormonal intrauterine device is installed. If intrauterine pathologies are detected during the diagnosis, appropriate treatment is prescribed.

Treatment with folk remedies.
To treat uterine bleeding, you can use traditional medicine methods, but first you should consult a doctor and identify their cause. To stop uterine bleeding, decoctions and extracts based on raspberry leaves, yarrow, nettle, burnet, shepherd's purse, etc. are effective. Here are some recipes:

Yarrow infusion: buy a box of yarrow herb at the pharmacy. Take two teaspoons of dry herb per glass of boiling water, cover the container with the liquid and leave for an hour, then strain. Drink the finished infusion four times during the day (before meals), the dosage is 50 ml or 1/4 cup.

Yarrow decoction: pour one tablespoon of the herb into a faceted glass of boiling water, simmer over low heat for ten minutes from the moment of boiling. Next, cool the broth, strain and drink. This should be done before meals three times a day, 1/3 cup. Shows its hemostatic effectiveness both in internal and external uterine bleeding.

Infusion of shepherd's purse herb: add a tablespoon of prepared herb (in dry form, purchase at a pharmacy), pour a glass of boiling water, wrap thoroughly and wait an hour. Then, after infusing the mixture, strain it and you can take the infusion one tablespoon at a time. This must be done three times a day before meals.

Stinging nettle infusion: pour a tablespoon of the raw material with a glass of boiling water, hold over low heat for ten minutes, then cool and strain. Also take a tablespoon four times a day before meals. To prevent the development of uterine bleeding, you can take an extract of this plant; it is easy to find in a pharmacy. The dosage is as follows: 30-40 drops half an hour before meals, dilute the drops with water (1/4 cup).

Pour the peels of six large oranges into one and a half liters of water, cook over low heat until the liquid is reduced to 500 ml. After this, drain the broth and take four teaspoons three times a day.

Prevention of uterine bleeding.
The best prevention is considered to be a systematic visit to a gynecologist (at least once a year), a full course of treatment for existing sexual ailments, adherence to the rules of personal hygiene and daily routine, regular sex life, and with one partner (permanent), a healthy lifestyle and strengthening the immune system.