Causes of bleeding from the uterus. When should you see a doctor? Examination and treatment for uterine bleeding

External bleeding is considered one of the most favorable because it is quickly and easily diagnosed. Bleeding from the uterus can also be called external, but experts classify it as a separate group. This is due to its special nature and source, which is the uterus. This organ has such a good blood supply that if the integrity of its vessels is compromised, this is manifested by profuse bleeding, which is extremely difficult to treat and often leads to severe blood loss with dangerous consequences.

Most common reasons

All women at any stage of life may experience bleeding from the uterus. They can be either organic or functional. In the first case, we are talking about a violation of the normal structure of the endometrium or the muscular layer of the uterus and its appendages, in the second, a violation of the hormonal regulation of their growth and menstrual function. Thus, all uterine bleeding can be classified in the form of a table.

Uterine fibroids are one of the most common causes of uterine bleeding in women of reproductive age.

Uterine bleeding is always just a symptom. You cannot remain idle to stop it. It is imperative to determine the true causes of the occurrence in order to remove the symptom and get rid of the disease that became its source.

Variants of clinical manifestations

Bleeding from the uterus cannot be considered unambiguously. Every woman of reproductive age has menstrual ability, which can indirectly be considered a kind of bleeding. But it has its own individual differences. Some women have scanty and short periods, while others, on the contrary, have long and heavy periods. The most important thing is their regularity in any case. If this indicator is violated, this indicates uterine bleeding. In other words, uterine bleeding can rightfully be called only the appearance of bloody discharge from the genital tract outside of menstruation or its prolonged course, which has not been observed before. Otherwise, it’s just a variant of the individual norm.

Therefore, the symptoms and clinical picture of this condition are presented:

1. Constant spotting and spotting from the uterus that does not affect the general condition;
2. Bleeding from the uterus during menstruation, leading to large blood loss and moderate anemia;
3. Bloody discharge in the middle of the menstrual cycle for no apparent reason;
4. Active flow of bright or dark fresh blood with clots, general impairment and shock.

Each of these clinical options has its own origin and focus of treatment measures aimed at stopping bleeding and blood loss.

Signs of heavy uterine bleeding

It is extremely important to know the warning signs of uterine bleeding with massive blood loss. After all, they signal an impending threat to a woman’s life. These include:

1. Heavy bleeding in a short period of time;
2. General weakness and dizziness;
3. Severe pallor of the skin;
4. A decrease in blood pressure below the numbers that are usually typical for a woman;
5. Frequent pulse and heartbeat;
6. Drowsiness and apathy.

The appearance of at least some of the listed symptoms is a reason to immediately seek medical help. Otherwise, there is a risk of developing hemorrhagic shock and death of the patient.

Interesting video:

Danger of uterine bleeding

Uterine bleeding is characterized by the ability to rapidly increase, last a long time, and have relatively poor ability to stop it. In this regard, the development of different scenarios for the outcome of this condition is possible:

1. Regular moderate blood loss, leading to bleeding of patients and anemia of varying severity. Does not pose a direct threat to life. Characteristic of small but prolonged bleeding from the uterus;
2. Bleeding with massive simultaneous blood loss. As a rule, it is very difficult to stop him. Often ends in a serious condition for patients and requires surgical treatment with removal of the bleeding uterus;
3. Minor bleeding from the uterus, which was not paid attention to for a long time, due to its commonality for patients. They do not pose an immediate threat and do not cause severe anemia. The danger is that in this case the underlying disease progresses, which acts as the cause of bleeding. This, sooner or later, will end in profuse bleeding or the development of severe and advanced forms of primary diseases;
4. Bleeding during pregnancy or the postpartum period. They are characterized by high intensity and severity compared to other reasons for their development. This is due to the poor ability of the uterus to contract and stop bleeding on its own. Therefore, they often end in severe shock and the use of surgical treatment to stop.

Embolization of uterine vessels is an alternative modern method of planned treatment of uterine bleeding

How can you help?

Stopping bleeding from the uterus is not easy. Here a clear algorithm of actions must be followed, both by the specialized gynecological service and the ambulance, and even by the patients themselves. All that is required of women with signs of uterine bleeding is to seek early medical help from a gynecologist. The sooner this is done, the better the prognosis for a full recovery. Ambulance workers or nearby people should provide the following measures:

1. Place the patient in a horizontal position;
2. Carrying out constant monitoring of blood pressure and pulse parameters;
3. Cooling the lower abdomen and uterus with an ice pack or a cold heating pad;
4. Transportation to the nearest medical facility.

In a gynecological hospital, medical care should be provided step by step, which includes the following treatment:

• Hemostatic and hemostatic therapy. It is carried out by intravenous administration of drugs: dicinone, etamsylate, aminocaproic acid, vikasol, tugina, novoseven (coagulation factor 7), cryoprecipitate, platelet mass;
• Infusion therapy. Designed to restore lost volume of circulating blood. For these purposes, the following are used: rheosorbilact, trisol, hemodez, refortan, washed red blood cells, fresh frozen plasma and other infusion media;
• Vitamin preparations that help stop bleeding: ascorbic acid, calcium gluconate or chloride;
• Hormonal hemostasis. Involves the use of high doses of estrogen or progesterone hormones. Indicated in case of dysfunctional bleeding from the uterus and is not effective if it is of organic origin;
• Diagnostic and therapeutic curettage from the uterine cavity. It is one of the most effective techniques for quickly stopping uterine bleeding of any origin. By means of fractional curettage, the endometrium is collected from different parts of the uterus, which makes it possible to identify the exact nature and localization of the source of bleeding in the uterus under a microscope. The therapeutic goal of this event is to remove the bleeding endometrium, which causes powerful contraction of the uterus and compression of the bleeding vessels;
• Temporary clipping of the uterine arteries. Indicated in cases where there is no effect from the above methods and bleeding continues. It involves the application of special soft clamps to the uterine ligaments through the vagina;
• Surgical treatment. Refers to forced measures in case of ongoing bleeding from the uterus of any origin and the impossibility of stopping it using a set of conservative methods. The operation involves only one thing - removal of the uterus as a bleeding organ. Indeed, in such cases, it is not so much about preserving it, but about saving the life of a woman.

Uterine bleeding has been, is and will be one of the most difficult problems in emergency gynecology. Given this fact, you should not push yourself to an extreme state if you discover their symptoms. Early seeking medical help is the only key to successfully solving the most difficult situations.

every woman needs at least twice a year. In a woman’s life, situations often arise when good advice from an obstetrician-gynecologist, an answer to a question, or a consultation are needed. But even if a woman has no complaints, it must be borne in mind that recently the asymptomatic course of gynecological diseases, including sexually transmitted infections and gynecological tumors, has become very common. Even pathological vaginal discharge does not always occur with such diseases. Without tests, it is difficult to distinguish them from normal discharge. With the hidden course of female diseases, there is no abdominal pain, bleeding, menstrual irregularities and other symptoms. Therefore, every woman needs preventive gynecological examinations and basic tests (general blood test, urine test, smear for flora and cytology), the results of which allow us to identify the presence of hidden asymptomatic gynecological diseases and infections in the early stages. The number of preventive gynecological examinations depends on previous diseases and other factors.

When you need good advice from a doctor, you can come for a consultation with a gynecologist at our gynecological clinic, ask the doctor questions about your health, undergo an initial gynecological examination and, if necessary, further examination and treatment.

Consultation with a gynecologist for early diagnosis of pregnancy

A consultation with a gynecologist and a gynecological examination are also necessary for early diagnosis of pregnancy. The first signs of pregnancy are inaccurate and often mislead women. During pregnancy, menstrual-like vaginal discharge is possible, and pregnancy tests may be falsely negative. For an accurate early diagnosis of pregnancy, a consultation with a gynecologist, pelvic ultrasound and determination of the hCG level in a blood test are necessary.

A good gynecologist is, first of all, a good diagnostician. Diagnosis of gynecological diseases is based on experience and knowledge. During the initial gynecological examination, the gynecologist will determine whether there is a need for more detailed diagnostics and consultations with other doctors. According to your indications, you will receive all the necessary treatment recommendations and referrals for tests. This will allow you to dispel many fears and doubts, notice unfavorable changes in women’s health in time, take measures to correct them, and begin treatment on time.

A woman is sometimes scared or ashamed to come to a consultation with a gynecologist and a gynecological examination. She is frightened by the examination procedure, and even by the sight of the gynecological chair. However, it is advisable for even a healthy woman to visit a gynecological clinic twice a year. The main task of an obstetrician-gynecologist at a gynecological clinic is to preserve the health of a woman, which is only possible through the prevention of gynecological diseases and their timely detection in the initial stages. At an appointment with a gynecologist in our gynecological clinic, you will forget about the fear of a gynecological examination. The polite staff of the clinic does everything possible to quickly and efficiently provide you with the necessary medical services.

Features of gynecologist consultation. Gynecological examination

Every healthy woman should undergo a gynecological examination twice a year to maintain her health, prevent and identify gynecological diseases in the early stages. To avoid the development of sexually transmitted diseases, infectious diseases and gynecological tumors, it is better not to postpone a visit to the doctor, but to come for a preventive examination and consultation with a gynecologist.

The gynecologist must know the individual characteristics of your body, all the gynecological diseases that you have suffered. Communication with a gynecologist at an appointment should be easy and confidential. Every woman should have her own obstetrician-gynecologist.

It is advisable to come to a gynecologist’s consultation for the first time at the age of 15-16 years, especially if the girl has not yet started her menstrual cycle. It is also necessary to come to an appointment with a gynecologist if a woman has already begun or plans to begin sexual activity. Gynecologists advise not only to undergo a preventive gynecological examination twice a year, but also to undergo basic tests, especially when a new sexual partner appears, to do colposcopy and gynecological ultrasound, because the asymptomatic (hidden) course of gynecological diseases is very common and difficult to diagnose. Many gynecological diseases, if not treated promptly, can lead to infertility, ectopic pregnancy or miscarriage.

Stages of consultation with a gynecologist and gynecological examination

Questions for a gynecologist

You can come for a consultation with a gynecologist and a preventive gynecological examination if you have no complaints or already have certain complaints. A consultation with a gynecologist begins with a conversation. First, the gynecologist asks questions and fills out a medical record. By asking questions, the gynecologist will find out what problem the woman came to the doctor’s office with. It is important for a gynecologist to know what diseases a woman has had throughout her life, which will tell him about her predisposition to certain diseases. Some questions may seem too intimate or unnecessary, but they must be answered absolutely honestly. Answer all the gynecologist's questions and do not hesitate to ask him questions, because the state of your health depends on it.

External gynecological examination

A consultation with a gynecologist may include procedures such as measuring blood pressure, determining weight, and examining the mammary glands. After which the gynecologist proceeds to a gynecological examination of the female genital organs. To do this, the woman needs to lie down in a special gynecological chair. The gynecologist conducts an external examination to identify possible discharge, irritation, rashes, condylomas, gynecological tumors and other pathological changes in the external female genitalia. Having completed the external gynecological examination, the gynecologist proceeds to the internal gynecological examination.

Internal gynecological examination

During an internal gynecological examination, an obstetrician-gynecologist inserts disposable plastic speculum into the vagina to examine the cervix. The gynecologist also evaluates the presence of discharge and other pathological processes. After removing the speculum from the vagina, the gynecologist performs a vaginal examination. The gynecologist inserts the fingers of one hand, dressed in sterile disposable gloves, into the vagina. The gynecologist places his other hand on the anterior abdominal wall. Thus, the doctor notes the size, shape, position, mobility, pain of the uterus and appendages, and draws attention to the presence of pathological space-occupying formations in the pelvis. If you experience pain when palpating, you should immediately inform your gynecologist, as this may be a sign of an inflammatory or other gynecological disease. Sometimes a gynecologist can perform a rectal examination (for example, when examining virgins) when the data from other examinations is insufficient.

Taking a smear for flora during an internal gynecological examination

A mandatory stage of a preventive gynecological examination should be taking a smear. A bacteriological study is a study of a smear of gynecological discharge. The number of leukocytes is counted in the smear and pathogens are looked for. More than 10 leukocytes in the field of view may indicate the presence of a sexually transmitted infection or inflammation of the female genital organs. Based on the results of the smear, fungi (candidiasis), “key cells” (bacterial vaginosis), changes in the normal flora in the discharge due to vaginal dysbiosis can be detected. The gynecologist prescribes culture of discharge and PCR diagnostics of discharge to clarify the causative agent of the infectious process if a smear shows the presence of infection, but does not identify its causative agent.

Taking a smear for cytology during an internal gynecological examination

Cytological examination (cytology) is a mandatory stage in the early diagnosis of cervical diseases and a mandatory analysis carried out before its treatment. Even if nothing bothers the woman and the cervix seems unchanged to the naked eye, the woman should regularly (every year) undergo a cytological examination of cervical scrapings. The gynecologist takes a scraping during an internal gynecological examination. The scraping is taken with slight pressure, while the deeper layers of cells are scraped off. This is a painless procedure. This is done because the malignant process begins from the lower layers of the cervical epithelium and progresses to the surface of the mucous membrane. Therefore, if only the superficial layer is included in the analysis, a diagnosis can only be made when the disease is already at a late stage of development.

Colposcopy

Colposcopy is an examination of the cervix under a special microscope - a colcoscope. The gynecologist uses colposcopy during an internal gynecological examination in order not to miss the initial signs of a malignant tumor, if nothing bothers the patient and the cervix seems unchanged to the naked eye.

Colposcopy has enormous diagnostic value in cases of suspected cervical cancer, for diagnostics erosions cervix, dysplasia, leukoplakia. Only extended colposcopy can help make an accurate diagnosis of cervical disease in the early stages and determine its malignancy.

Extended colposcopy is an examination of the cervix after treatment with a 3% acetic acid solution. The action of acetic acid lasts about 4 minutes. After studying the collopscopic picture of the cervix treated with acetic acid, the gynecologist performs the Schiller test - smearing the cervix with a cotton swab moistened with 3% Lugol's solution. The iodine contained in the solution stains glycogen in the cells of healthy, unchanged squamous epithelium of the cervix dark brown. Thinning cells (atrophic age-related changes), as well as pathologically altered cells in various dysplasias of the cervical epithelium (precancerous conditions) are poor in glycogen and are not stained with iodine solution. Thus, a gynecologist during colposcopy identifies areas of pathologically altered epithelium and, if necessary, marks areas for cervical biopsy.

Ultrasound of the pelvis and fetus

In gynecology, pelvic ultrasound complements the gynecological examination and is used very widely, because with its help, with a high degree of reliability, you can examine the pelvic organs and monitor the development of pregnancy (fetus). Pelvic ultrasound is an examination method that allows a gynecologist to get an idea of ​​all the pelvic organs, including the uterus and ovaries, which is of great importance in the diagnosis of gynecological tumors and inflammation of the female genital organs, and abnormalities of the uterus.

A pelvic ultrasound makes it possible to determine the causes of pathological discharge, uterine bleeding, pain in the lower abdomen and menstrual irregularities that are not visible during a routine gynecological examination.

Ultrasound allows you to determine the presence of pregnancy and fetal abnormalities. Ultrasound also plays a decisive role in the diagnosis of ectopic pregnancy and is necessarily performed before the abortion procedure to confirm the presence of a fertilized egg in the uterine cavity.

Consultation with a gynecologist based on the results of a gynecological examination and tests

To make a diagnosis, a gynecologist compares the results of a gynecological examination with data from anamnesis (the history of the woman’s life and illness), gynecological tests, complaints and the results of other examinations. Therefore, in order to make a diagnosis or ensure the absence of gynecological diseases, a woman needs at least two consultations with a gynecologist.

At the first consultation, the gynecologist performs the gynecological examination described above, colposcopy, pelvic ultrasound and collects material for gynecological tests. If a woman has complaints and symptoms of gynecological diseases, the gynecologist, during the first consultation, recommends to the woman what tests (except smears) she needs to undergo and prescribes symptomatic treatment to reduce the symptoms of the disease (pain in the lower abdomen, bleeding, itching, etc.).

A woman can take many tests during her first gynecological examination, but to take some tests she needs to come to the gynecologist again for fence material for analysis on a certain day of the menstrual cycle, after the necessary preparation or on an empty stomach.

At a follow-up appointment, the gynecologist advises the woman on the results of smears and other tests, if they were taken during the first gynecological examination. Test results may indicate the presence of a gynecological disease in the absence of symptoms, confirm a preliminary diagnosis made during the first examination, or indicate the need for further examination to make a diagnosis.

A complete treatment regimen for a gynecological disease is signed by a gynecologist after diagnosis. After treatment, and sometimes during treatment, a woman needs to come for a consultation with a gynecologist and take gynecological tests again to monitor the results of treatment.

Preparing for a gynecological examination

A woman needs to visit a gynecologist’s office several times a year if she cares about her health. The most optimal period for a preventive examination by a gynecologist is after menstruation. One day before consulting a gynecologist, it is not recommended to be sexually active. It is necessary to take a shower before examining a gynecologist, but douching has a negative effect, because... the doctor needs to see the real condition of the vaginal discharge and take a swab. There is no need to shave your hair before examining a gynecologist. If a woman has taken antibiotics and other medications, then it is necessary to warn the doctor about this. Sometimes testing for infections should take place no earlier than two weeks after the end of treatment in order to get the correct results. If you have to get tested for chronic infections, it is better to do this before or immediately after your period.

A consultation with an obstetrician-gynecologist and examination usually takes about 30 minutes. Try not to be nervous during the examination. Answer all the doctor's questions and do not hesitate to ask him questions, because... The state of your health depends on this.

It is necessary to come to see a gynecologist in the following situations:

Recently, the asymptomatic course of gynecological diseases, including sexually transmitted diseases, has become very common. Vaginal discharge occurs in such diseases, but more often they are the only symptom and appear periodically. Without analyzes It is difficult to distinguish them from normal discharge. Therefore, every woman needs a preventive examination by a gynecologist at least twice a year.

Pathological vaginal discharge is the main symptom of almost all gynecological diseases, including sexually transmitted diseases. If they appear, it is necessary to consult a gynecologist with an examination and tests for determining infections, including sexually transmitted ones.

Uterine bleeding in the middle of the cycle, increased and prolonged bleeding during menstruation. Consultation with a gynecologist with examination and Ultrasound in this case, they are necessary to determine the source of bleeding. Bleeding that occurs during pregnancy requires immediate hospitalization.

Abdominal pain. In female gynecological diseases, it is most often observed in the lower abdomen. A consultation with a gynecologist with an examination, tests and other examinations are necessary to identify the cause of the pain.

Problems with conception. Conceiving a child requires preparation. Gynecological diseases can negatively affect pregnancy and the unborn baby. Therefore, it is very important to come for a consultation and examination with a gynecologist to identify and treat them before conception.

At planning pregnancy a woman needs to come for an examination and consultation with an obstetrician-gynecologist, be examined and take a test in advance tests to identify infections, including - ureaplasmosis. Planning your pregnancy and performing a gynecological examination during pregnancy allows you to avoid complications and unpleasant surprises during pregnancy.

Diagnosis of pregnancy. The first signs of pregnancy before a missed period are inaccurate and often mislead women. During pregnancy, menstrual-like discharge is possible. In order to diagnose pregnancy in a timely manner, at the slightest suspicion, you need to consult a gynecologist, do an ultrasound and a blood test for hCG.

Termination of pregnancy (medical abortion). In the event of an unwanted pregnancy, you will receive qualified advice from an obstetrician-gynecologist on how to terminate it. Medical abortion is the least traumatic for a woman.

Contraception. Every woman should, with the help of a gynecologist, choose the most suitable means of protection against unwanted pregnancy for her. This requires a consultation with a gynecologist with an examination, ultrasound, and, if necessary, hormonal studies and other tests.

Hormonal disbalance. Often the main cause of diseases of the female reproductive system is hormonal changes (hormonal imbalance). During your consultation, your gynecologist will prescribe the necessary examinations to diagnose hormonal disorders.

Menstrual irregularities. Ovarian dysfunction is most often a symptom of serious gynecological diseases. A consultation with a gynecologist and an examination is necessary to identify these diseases.

From symptoms of premenstrual syndrome ninety percent of all women are affected. Before your period a woman may experience many unpleasant and painful sensations that should not normally exist. A woman should not put up with these sensations and suffer in silence; she must come for a consultation with a gynecologist.

Tides and painful sexual intercourse are the most common symptoms of menopause. During the consultation, the gynecologist will tell the woman how to alleviate the pathological menopause. A very dangerous symptom is the appearance of bloody discharge from the genitals after menopause. When they appear, a woman should consult a gynecologist for an examination immediately.

Cervical erosion. One of the most common diseases, which may not manifest itself in any way and can only be detected during a preventive gynecological examination.

Uterine fibroids. It may also not manifest itself in any way and be detected only during a preventive gynecological examination. Asymptomatic progression can lead to severe growth of the node, bleeding and surgical intervention.

Endometrial hyperplasia often asymptomatic, but more often manifests itself as dysfunctional uterine bleeding. Often the diagnosis of endometrial hyperplasia is made when a woman comes to see a gynecologist about infertility.

Polyps of the uterus (endometrium) and cervix(cervical canal). In recent years, polyps of the uterus and cervix have been found even in teenage girls. They do not manifest themselves in any way for a long time and over time can become malignant. For their timely detection, every woman needs a consultation with a gynecologist and a preventive examination twice a year.

Ovarian cyst. During a routine ultrasound examination, a gynecologist may detect an ovarian cyst in a woman. Some cysts may disappear on their own, but in many cases a course of hormonal treatment is required, and in some cases surgery is required to get rid of the source of the danger.

Spikes are formed when an acute inflammatory process in the female genital organs becomes chronic and the healing process extends over time. Adhesive disease is practically untreatable. Therefore, to avoid the formation of adhesions, if symptoms occur inflammation Immediately come for an appointment with a gynecologist.

Cervicitis- inflammation of the mucous membrane of the cervix. May manifest as pathological discharge, burning, itching. If the flow is hidden, it may not manifest itself in any way. Therefore, every woman needs a preventive consultation with a gynecologist with an examination at least twice a year. The causative agents of infection are often gonococci and Trichomonas.

Thrush (or vaginal candidiasis) Caused by yeast-like fungi of the genus Candida. It often becomes chronic due to improper self-medication. To select the correct treatment and identify infections that often accompany exacerbation of thrush, which a woman may not even suspect (including sexually transmitted infections), it is necessary to consult a gynecologist for an examination.

Vaginal dysbiosis- this is a violation of the normal microflora of the vagina. This disease affects most women; it is often the result of improper self-medication. Dysbacteriosis can lead to the development of inflammatory gynecological diseases. Before prescribing medications to normalize the vaginal microflora, a consultation with a gynecologist, examination and tests is necessary.

For examination on syphilis a woman can also come for a consultation and examination with a gynecologist . Syphilis is a chronic venereal disease that affects the skin, mucous membranes, many internal organs, bones and the nervous system. Recently, it has often been completely asymptomatic. The RW (Wassermann reaction) used to diagnose syphilis is often false-positive and false-negative and is very outdated.

Advantages of the Demetra Gynecological Clinic

• The consultation is conducted by highly qualified gynecologists with extensive experience.
• Considering the frequent imitation of gynecological diseases in the pathology of other organs, close cooperation is carried out between gynecologists and the therapist for the benefit of patients
• Modern methods of diagnosis and treatment of diseases, incl. laboratory tests, pelvic ultrasound and pregnancy ultrasound, colposcopy
• Treatment of diseases without hospitalization (outpatient)
• Convenient location of the clinic in Kyiv: Darnitsky district, near Poznyaki metro station
• Convenient working hours by appointment only
• If you have any questions, call us, our employees will provide all the necessary information

Uterine bleeding is profuse bleeding from the uterine cavity. In most cases, this pathology is caused by a malfunction of hormonal functions in the female body. Uterine bleeding poses a serious threat to a woman’s health; it is fraught with numerous complications, and in some situations can even cause death.

The main cause of bleeding is considered to be a disorder in the production of female sex hormones. In addition, there are many factors that can provoke bleeding from the uterus. These include:

1. Diseases of the hematopoietic system.
2. Thrombocytopenia.
3. Pathologies developing during pregnancy.
4. Traumatic injuries to the genital organs.
5. Pathological processes in the uterus, as well as its appendages.
6. Various gynecological diseases.
7. The presence of tumor neoplasms, both benign and oncological.
8. Complications arising after childbirth.
9. Liver pathologies.
10. Endocrine diseases.
11. Miscarriage.
12. Use of intrauterine contraception
13. Long-term use of hormonal contraceptives.
14. Endometriosis.
15. Changes in climatic conditions.
16. Frequent stressful situations.
17. Tuberculosis of the genital organs.
18. Hypovitaminosis,
19. Disorders of the adrenal cortex
20. Pathologies of the thyroid gland.
21. The presence of inflammatory processes in the reproductive system.

Symptoms

A characteristic feature of this pathology is copious bleeding that lasts more than a week. In addition, uterine bleeding is characterized by the presence of the following symptoms:

1. Hypotension.
2. General weakening of the body.
3. Dizziness.
4. Presence of bloody clots in the discharge.
5. The sanitary pad should be changed once an hour or more often.
6. Pain in the lower abdomen.
7. Development of anemia.
8. Pallor of the skin.
9. Tachycardia.
10. Slow heart rate.
11. Loss of consciousness.

How to stop bleeding from menstruation?

Uterine bleeding differs from typical menstruation in a number of characteristic signs. These include the following factors:

1. A significant increase in the volume of blood released (over eighty milliliters per day).
2. Increased duration of discharge (Menorrhagia).
3. Bleeding is observed during the intermenstrual period (Polymenorrhea).
4. Bleeding also occurs during menopause, which is not typical for menstruation.
5. Metrorrhagia, characterized by disruptions in the regularity of the menstrual cycle, is also a pathological manifestation.
6. If at least a few of the above signs are present, we are talking about uterine bleeding.

More on the topic: Ovarian apoplexy: vascular pathology

Kinds

The presented pathology may differ in a number of characteristics due to the causes of its occurrence, as well as some associated factors. The classification identifies the following varieties:

1. Dysfunctional bleeding is a pathology that occurs due to disruption of the ovulation process, as well as the activity of the organs responsible for regulating the menstrual cycle. Most often observed in women aged thirty to forty years.
2. Obstetric hemorrhage usually occurs during pregnancy, during the birth process, as well as the early postpartum period. This type of bleeding is considered one of the most dangerous because it is characterized by suddenness and intensity. In fifteen percent of cases, in the absence of timely assistance, obstetric hemorrhage can lead to the death of a woman.
3. Organic bleeding occurs due to various anomalies of the female genital organs, as well as in the presence of systemic types of diseases.
4. Iatrogenic bleeding. Their appearance is caused by prolonged and uncontrolled use of hormonal contraceptives, as well as incorrect installation of the ectopic device.
5. Menopausal bleeding – occurs during menopause, as a consequence of hormonal imbalance in the body.
6. Juvenile bleeding occurs mainly in teenage girls during puberty.
7. Diffuse bleeding occurs due to nodular adenomyosis of the uterus and accompanying changes in the myometrium.

Diagnostics

In case of suspicion, you should, without delay, contact a specialist - gynecologists and undergo a comprehensive examination. This is necessary in order to accurately establish the causes of this manifestation, as well as eliminate provoking factors. Diagnostics is also necessary because the presence of pathology in the form of bloody discharge from the uterus can be a sign of quite serious diseases that require immediate treatment.

For uterine bleeding, the following diagnostic procedures are used:

1. General blood analysis.
2. Examination of smears from the cervix (in case of suspected cancer).
3. Ultrasonography.
4. Biopsy is the removal of suspicious areas of tissue for further examination.
5. Blood chemistry.
6. Tests for hormone levels.
7. Curettage of the cervical canal and the walls of the uterine cavity for histological examination. This procedure, among other things, is characterized by a therapeutic effect, since scraping removes blood clots, as well as defective epidermis.

How to stop the bleeding?

If there is uterine bleeding, you should immediately call an ambulance. And before the doctors arrive, everything possible should be done to alleviate the woman’s condition. Remember that not only the health, but also the life of the patient depends on timely and competently provided first aid. So, in order to stop severe uterine bleeding on your own, you need to do the following:

1. Give the victim hemostatic drugs (Etamzilat, Dicion, etc.).
2. After the medicine has been taken, the patient should be laid down and a pillow should be placed under her feet.
3. It is recommended to apply a heating pad with ice or just something cold to the lower abdomen.
4. If there is a sharp drop in blood pressure, give the patient a drink of sweet hot tea.

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. To recognize the cause and choose the right treatment tactics, a thorough diagnosis is required in each specific 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, infectious-toxic shock in severe infections of any origin);
• hemophilia;
• hemorrhagic vasculitis;
• overdose of blood thinning medications;
• hypovitaminosis C and K;
• liver diseases leading to a lack of blood clotting factors;
• arterial hypertension;
• hypothyroidism

It is possible to recognize such types of pathologies with a comprehensive diagnosis, as well as based on the collection of the patient’s medical history. Diseases of an extragenital nature are accompanied not only by gynecological symptoms. The presence of various types of vascular rashes, dysregulation of blood pressure, and symptoms of damage to 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 can be seen through the transparent glass.

Uterine bleeding associated with pathologies of the reproductive tract is divided into two groups: those caused by disruption of pregnancy and those not associated with it.

Bleeding during pregnancy can be caused by:

• ectopic pregnancy;
• bleeding after abortion;
• hydatidiform mole;
• chorionepithelioma;
• spontaneous abortion;
• a scar in the wall of the uterus;
• abruption of a normally located placenta;
• placenta previa.

Uterine bleeding caused by labor and during the postpartum period can be provoked 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 not associated with pregnancy is initiated by various reasons:

• uterine fibroids;
• endometriosis;
• pathologies 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 pelvis and abdominal organs, blood tests for thyroid hormones, sex steroids, coagulation indicators, X-ray studies, MRI of the brain, computed tomography.

Menstrual irregularities

Dysfunctional uterine bleeding is a type of pathology in which the production of female sex hormones is disrupted under the influence of various factors, which leads to changes 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 profuse bleeding; in addition, signs of pathology can be both long-term and short-term spotting. To recognize the disease, a thorough diagnosis is necessary, which first of all includes determining the level of hormones in the blood.

Dysfunctional disorders develop during adolescence, reproductive age, and also during menopause.

One of the signs of pathology that makes it possible to recognize uterine bleeding is the degree of filling of the pads or the required number of them for the period of menstruation. Knowing how much blood flows during menstruation, a woman may suspect a disease.

Volume of menstrual bleeding Normally it is up to 80 ml, which requires no more than 10 sanitary pads to absorb. If the pad fills with blood within 2 hours and the situation repeats over several days, or if you use more than one standard pack of them for menstruation every month, you should consult a doctor.

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

1. Menorrhagia (menometrorrhagia) is a type of bleeding that is related to menstruation, occurs during the expected period or with a delay. Signs include excessive duration (more than 6 days) and excessive bleeding. It is often possible to recognize uterine bleeding by its profuseness - a sudden, profuse flow of blood that has no tendency to stop.
2. Metrorrhagia is uterine bleeding that is not associated with menstruation. Symptoms of this type of pathology are hemorrhages of varying intensity, which can be recognized by such a sign as the appearance of blood discharge during the intermenstrual period (previously 21 days of the cycle).

Uterine bleeding caused by hormonal imbalance is common among teenage 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 through instrumental and laboratory diagnostics.

Uterine bleeding in women

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

• scanty periods, ultimately leading to profuse bleeding;
• breakthrough hemorrhages not associated with menstruation;
• increased sebum secretion, acne, excess hair growth, decreased libido, as signs of hyperandrogenism;
• blood clots during menstruation;
• lengthening of periods;
• spotting in the middle of the cycle, bleeding after sexual intercourse, as a sign of hormonal imbalance.

It is possible to recognize provoking factors for disruption of hormonal cycle regulation in women by testing blood for hormones. Follicle-stimulating hormone, luteinizing hormone, estradiol, male hormones and their metabolites (free testosterone, DHEA 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 over time 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 subsequently lead to cycle disruption are:

• increased production of male sex hormones and metabolites, a sign of which may be polycystic ovary syndrome;
• increased estrogen production, which can be recognized by clinical signs of endometrial hyperplasia or polyposis;
• decreased 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 symptoms, women complain of infertility. This is due to the lack of ovulation against the background of increased levels of estrogen 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 slight bleeding or scanty periods, which are not inherently menstruation.

Against the backdrop of prolonged growth of the endometrium, necrotic changes occur in the blood vessels feeding the inner layer. The endometrial tissue begins to be shed. A sign of this is scanty menstruation, which after 2-3 months can turn into profuse uterine bleeding. Hyperplastic endometrium can be recognized on ultrasound. As a rule, the thickness of the M-echo is more than 15 mm in the second phase of the cycle or during a long delay.

Uterine bleeding can be recognized by the following signs:

• weakness and dizziness;
• fainting;
• bleeding 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 periods are a reason to consult a doctor. In addition to hormonal analysis, an ultrasound is performed to determine intrauterine pathology. Ultrasound examination can identify fibroids, polyps, and endometriosis, which are also a common etiological factor of the disease.

Bleeding due to uterine pathology

Diseases caused by 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. Formations in the uterine cavity can be recognized using ultrasound, which is performed in both phases of the cycle.

Signs of hemorrhages with fibroids are:

• heavy, prolonged periods with blood clots;
• chronic anemia of varying degrees of severity, symptoms of which are dizziness, weakness, brittle hair and nails, pale skin;
• infertility and miscarriage;
• periodic aching pain in the lower back and abdomen, which are signs of medium and large fibroids.

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

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

Signs of uterine bleeding with endometriosis:

• severe pain before, during and after menstruation;
• heavy menstruation;
• infertility;
• adhesive process;
• spotting before and after menstruation.

In order to recognize endometriosis, ultrasound, laparoscopy, hysteroscopy are performed, and the level of hormones and tumor marker CA-125 in the blood is determined. With this disease, disruptions 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 abundant against the background of a long delay in menstruation. A sign of hyperplasia is also spotting on different days of the cycle. Against the background of this disease or in isolation, polyps can develop, which are described as spotting in the middle of the cycle, after sexual intercourse, before and after menstruation. The pathology can be recognized by hysteroscopy; it is also necessary to determine the level of estrogen and progesterone. In addition, histological and immunohistochemical studies of the endometrium are carried out.

Hemorrhages during menopause

The most common causes of hormonal imbalance in premenopausal women are:

• obesity;
• liver diseases;
• chronic stress;
• immunological disorders leading to changes in endometrial receptivity.

Against the background of increased estrogen content, hyperplasia of the internal uterine layer develops, which leads to abnormal bleeding that is not regular.

Uterine bleeding in women during menopause, an immediate visit to a gynecologist is required in order to exclude malignant tumors of the uterus.

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

Signs of bleeding in girls

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

Stress and infections experienced during puberty have a serious impact on the hypothalamic-pituitary-adrenal-ovarian system. Disturbed hormonal levels lead to changes in the menstrual cycle in a girl. Normally, establishing the duration of the cycle lasts about 2 years. Dysfunctional uterine bleeding in teenage girls is not uncommon.

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

• premature puberty (breast growth, pubic hair growth, early menstruation);
• psycho-emotional disorders, infantility;
• acne;
• sudden changes in body weight.

Signs of bleeding from the genital tract are:

• bleeding from the vagina of varying volumes, 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.

Pathology of the reproductive tract in girls can be recognized using ultrasound, MRI of the sella turcica, radiography of the wrist bones, and blood tests for hormones. The degree of ossification makes it possible to recognize increased estrogen levels in a teenager. The hormone content in the blood is also determined; in addition, the amount of thyroid hormones (excluding hypothyroidism), cortisol, FSH, LH, and male sex hormones is measured.

Signs of uterine bleeding in teenage girls most often develop after psychoemotional stress or severe infectious diseases.

Period after cleaning

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

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

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

Normally, bloody discharge should gradually decrease. The discharge of fresh blood continues for up to 10 days, taking on the character of ichor.

Pregnancy and childbirth

Uterine bleeding during pregnancy can occur at all stages and pose a danger to both the woman and the fetus. Every pregnant woman must be able to recognize the signs of bleeding in order to seek medical help in a timely manner. Most often they occur in the early stages when there is a threat of miscarriage, in the case of placenta previa, or premature detachment. But there are often situations 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 is the preceding signs of pain in the lumbar region and lower abdomen.

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

• nagging pain in the lumbar region;
• pink, brown discharge from the genital tract;
• sudden profuse bleeding;
• discharge of fresh blood in small quantities with increasing 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, and gross malformations of the fetus.

Uterine bleeding with a threat of miscarriage due to progesterone deficiency, as a rule, begins gradually. With placenta previa, sudden and profuse bleeding may occur. If pregnancy is accompanied by uterine fibroids or a polyp, signs of bleeding may accompany the gestational process.

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.

Unlike the release of a mucus plug, bleeding either increases over time or occurs suddenly. The mucus plug may partially come off starting at 36 weeks.

After childbirth or during natural delivery, uterine bleeding may occur in case of incoordination of labor or disruption of uterine contractions. The main cause is premature placental abruption.

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

The pathological development of signs after childbirth can be recognized by the degree of filling of the pad. Filling several pads within an hour during the first 24 hours after delivery indicates the likelihood of an emergency. Doctors recognize danger by the degree of uterine contraction. The faster the myometrium undergoes reverse development, the lower the likelihood of pathology.

Before a woman is discharged from the hospital, a pelvic ultrasound is performed to recognize and visualize the remnants of the placenta, as well as to determine the rate of uterine contraction. If ultrasound results are unsatisfactory, medicinal treatment of uterine atony or hypotension and curettage are 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 in the early postpartum period.

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

First aid

If a woman manages 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;
• place any cold object (water bottle, ice pack) on the lower abdomen;
• drink liquid;
• do not take painkillers, aspirin;
• do not apply warm objects to the stomach;
• don't 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 the postpartum period can develop at a rapid pace and threaten the life of the woman and child. If there are signs indicating incipient bleeding that can be recognized independently, you should seek medical help within the next few hours.

Uterine bleeding includes bleeding from the uterus that varies in nature and cause.. Similar symptom testifies about hormonal imbalances in the body, the presence serious gynecological or other pathology.

And even with minor bleeding This issue cannot be ignored. The consequences can be quite dire.

Symptoms of uterine bleeding

Discharge from uterine bleeding can be as follows: insignificant, smearing, so and quite intense. In the latter case, the woman feels malaise, weakness, drowsiness, increased fatigue, dizziness, palpitations, nausea, darkening of the eyes, and headache. Decrease in circulating blood volume (CBV) leads to hypoxia of the brain and other organs, which is manifested by a drop in pressure, increased heart rate, pallor of the skin and mucous membranes, shortness of breath, sweating, fainting. If you notice these symptoms, you should not hesitate. In case of significant blood loss, feeling unwell or pregnant, it is better to call a doctor rather than go to the hospital yourself. The sooner you start treatment, the higher the chance of avoiding possible consequences.

There are cases when uterine bleeding is disguised as normal menstruation. Measures should be taken when:

Prolonged periods (more than a week),
- intense discharge (more abundant than usual),
- frequent periods that disrupt the usual schedule,
- accompanied by intense pain in the lower abdomen, lumbar department, sacrum, perineum, rectum.

Causes and types of uterine bleeding

There are several main types of uterine bleeding.

1 . Dysfunctional bleeding occurs due to a malfunction of the organs that control the menstrual cycle and related processes. This is caused by various reasons. These include :

Hormonal disorders (including during menopause),
- blood pathology,
- excessive,
- gynecological diseases (endometriosis, tumors, including fibroids, etc.),
- installed intrauterine device,
- infection of the female genital organs,
- chronic or acute stress, overwork,
- acclimatization, hypothermia,
- excess weight, strict diet,
- side effect of medications, starting or stopping contraceptives drugs,
- invasive gynecological manipulation.

To the group of dysfunctional uterine bleeding includes those that occur V menopause period, as well as those occurring in girls at the initial stage of puberty.

Distinctive feature dysfunctional bleeding is that it is often painless.

Uterine bleeding, which occurs in the middle of the menstrual cycle, occurs in about a third of women. As a rule, they have a spotting character, small duration(up to three days) and are not associated with any diseases. This phenomenon is due hormonal changes.

Uterine bleeding in young girls can be caused by mental or physical stress, poor diet, viral disease, dysfunction of the genital organs, or hormonal imbalance. It should be emphasized that you need to take the problem seriously, even if you managed to eliminate the blood loss on your own.

2. Obstetric bleeding is associated with pregnancy and childbirth. They can occur at various stages of pregnancy, during labor or after childbirth. Pregnant women may experience very light discharge without accompanied deterioration in health. Even in this case, you should immediately contact a gynecologist. The condition can worsen sharply and have serious consequences. Extremely severe, massive bleeding can occur with placental abruption or uterine rupture.

Spontaneous miscarriage is also a cause of uterine bleeding. This can also happen in the early stages, when a woman does not even suspect she is pregnant. Abortion procedure, including medicinal, is also accompanied by bleeding.

3. The development of tumors leads to uterine bleeding due to destruction of the layers of the uterine wall, damage to blood vessels. Wherein neoplasm may have like benign character, so be it malignant. It should be remembered that the earlier the disease is detected, the easier it is to fight it and the greater the chances of getting rid of it completely.

4 . Trauma to the abdomen or surrounding areas may also cause uterine bleeding Internal bleeding poses a particular danger. In this case, discharge from the genital tract may be minimal or absent altogether. In this case, the signs of blood loss indicated earlier appear in the abdominal area In this case, intense pain is disturbed, symptoms of peritoneal irritation are determined (Kulenkampf's symptom).

Sometimes bloody discharge from the genital tract occurs after intimacy. Reason occurrence of such bleeding may be:

Mechanical damage as a result of too active or rough actions,
- existing inflammatory process in the genitals,
- diseases of the genital tract leading to wall damage vagina or uterus (polyps, erosion, tumor),
- while taking certain medications, contraceptives,
- miscarriage, ectopic pregnancy,
- blood diseases.

In some cases, the spotting may be the partner's blood. This can happen, for example, when the frenulum of the penis ruptures during sexual intercourse.

It should be understood that prolonged or intense uterine bleeding can lead to anemia, the development of such a life-threatening condition as hemorrhagic shock and have other negative consequences, including death. Uterine bleeding is sometimes the first and only symptom of serious illnesses that require immediate medical attention.

Diagnosis and treatment of uterine bleeding

In case of uterine bleeding, first of all, it is necessary to replenish the blood volume, ensure reliable hemostasis, correct complications. And, of course, you should undergo an examination in order to identify the cause of the uterine bleeding and its subsequent elimination. The gynecologist will conduct an examination and will collect material for research. You will need to do a blood test and evaluate psychological woman's condition. Perhaps the doctor will prescribe an ultrasound or biopsy. In some cases, you will have to go through a procedure of mechanical cleansing of the uterus. If there was psychological factor, sedatives may be prescribed. It happens that it is not possible to avoid surgical intervention, possibly multiple ones.

Diagnosis and treatment should only be carried out by a doctor. No self-medication! The bleeding could be caused by a complex of different reasons. To effectively solve the problem and prevent relapse, they all must be eliminated. The duration of treatment depends on the cause of the bleeding and the amount of blood loss.