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Uterine bleeding: causes, symptoms, types, first aid and treatment

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Uterine bleeding in medicine is usually called dysfunctional uterine bleeding - this is a pathological abundant uterine bleeding. They are one of the most striking manifestations of hormonal dysfunction in women. Therefore, the main cause of uterine bleeding is most often the violation of the production of female sex hormones. This pathology can be in any woman, at any age, so uterine bleeding is classified according to the age criterion as follows:

  • Uterine bleeding at the age of 12-18 years - during puberty or juvenile age
  • During the reproductive age of 18-45 years
  • In the menopause of 45-55 years, when ovarian function fades

Symptoms or signs of uterine bleeding are expressed either by a significant release of blood during menstruation, or an increase in the duration of menstruation, as well as acyclic bleeding or metrorrhagia, when menstruation is absent for 6 to 8 weeks or more, and then bleeding of various intensities develops.

How to independently determine uterine bleeding - symptoms of blood loss

  • At any age, a typical symptom of a woman's bleeding is prolonged, profuse discharge lasting more than a week with signs of anemia, confirmed by a blood test and the following symptoms:
    • Weakness, fatigue
    • Dizziness, headaches
    • Pallor of the skin
    • Hypotension - low blood pressure
  • What does abundant discharge mean when the swab is filled in an hour or the pads get completely wet, if you have to change the pads even at night. Sometimes a woman is not able to go to work, cannot carry out household chores, and most of the time she is forced to lie and rest.
  • In addition to intensity, with bleeding, discharge is distinguished by the presence of a significant number of blood clots.
  • Bleeding is also the allocation of blood after intercourse.
  • If menstruation lasts more than a week with significant lower abdominal pain and lower back pain.

Uterine bleeding at the age of 12-18 years

In this period, uterine bleeding appears in almost 20% of all gynecological pathologies in girls, this is due to a violation of the formation of hormonal regulation for a number of reasons:

  • Provoking factors are mental or physical trauma.
  • Hypovitaminosis, malnutrition
  • Dysfunctions of the adrenal cortex and thyroid gland
  • Various serious childhood infectious diseases also affect the occurrence of signs of uterine bleeding in adolescent girls - influenza, chronic tonsillitis, chickenpox, measles (see measles symptoms in adults), mumps, whooping cough (signs of pertussis in a child), etc.
  • If the girl was born to a mother with a complicated pregnancy and pathological birth.
  • Rarely, but there are cases when bleeding disorders are caused by bleeding disorders or tuberculosis of the female genital organs.

Causes of uterine bleeding in women of reproductive age

In childbearing age, this pathology among all gynecological diseases makes up only 5% of cases. As a rule, uterine bleeding is accompanied by ovarian dysfunction, the causes of which are a number of provoking factors:

  • Stressful situations, chronic neuropsychic stress, overwork
  • Occupational hazards, living in cities with developed chemical and metallurgical industries
  • Changing of the climate
  • Various inflammatory and infectious diseases of the female reproductive system, which lead to a thickening of the capsule of the ovaries, and also reduce the sensitivity of their tissues to gonadotropins, as well as:
    • Chronic endometritis, uterine endometriosis
    • Myoma
    • Polyps and malignant neoplasms of the cervix and the uterus
    • Ovarian Tumors
  • Surgical or medical termination of pregnancy, miscarriage, ectopic pregnancy (signs)
  • The use of drugs that cause dysfunctions of the hypothalamus-pituitary system.

Uterine bleeding of the menopause

This is the most common pathology that occurs in premenopausal women - 15% of all gynecological diseases of this age category. This is due to the natural decrease in gonadotropins secreted by the pituitary gland, therefore, during menopause, hormone release occurs irregularly, disrupting the cycle of ovulation, development of the corpus luteum, folliculogenesis. Especially often, uterine bleeding accompanies climacteric syndrome - in 30% of cases when the signs of menopause in women are significantly pronounced and intense. With a progesterone deficiency characteristic of the climacteric period, hyperestrogenism and proliferation of the endometrium develop.

If a woman aged 45-55 years has uterine bleeding, other pathologies that can cause them should be excluded, therefore, a woman should undergo hysteroscopy twice - both before and after diagnostic curettage. The most common causes of uterine bleeding in this case are:

  • Endometriosis
  • Uterine fibroids
  • Uterine Polyps
  • Rarely, ovarian hormone tumors

Common causes of uterine bleeding

  • Disorders of the thyroid gland - in diseases such as hyperthyroidism and hypothyroidism, the risk of uterine bleeding symptoms increases.
  • Disruption of the hormonal background. This is the most common cause of uterine bleeding in young girls and women after 45 years. With a normal hormonal background, when the balance between progesterone and estrogen is optimal, blood loss during menstruation is usually minimal. When this imbalance is violated, uterine bleeding occurs.
  • Diseases of the circulatory system. With a decrease in platelet count, as well as with other blood diseases, bleeding in women is also possible.
  • Uterine fibroids. Especially severe bleeding occurs in women with internal uterine myoma, when the only way out is surgery.
  • Adenomyosis This disease is characterized by fusion of the internal and muscle layer of the uterus, menstruation with adenomyosis becomes painful, long and plentiful, since the menstrual area grows significantly.
  • Polyps. These are benign formations that are often found in women of childbearing age. With a significant number or size, their removal is indicated, since they are the cause of uterine bleeding and soreness of menstruation.
  • Ectopic pregnancy, miscarriage, premature detachment of the placenta. These complications during pregnancy are in women recently quite common. With any bloody discharge during pregnancy, a woman needs to immediately call an ambulance, since bleeding can threaten the life of not only the baby, but also the expectant mother.
  • Malignant neoplasms of the genitals. This is the most serious reason for possible bleeding, and regardless of the location of the tumor - the uterus, cervix, ovaries, for any bleeding, a woman should first exclude cancer, since nowadays oncological tension increases every year, and already has no clear age limits , oncology is found both in very young women and in women during menopause.
  • Breakthrough uterine bleeding. This reason is directly related to the use of intrauterine contraceptives - spirals or the use of hormonal contraceptives. Especially increases the risk of bleeding after taking both contraceptives and anticoagulants (aspirin). Breakthrough bleeding can be minor, when you start using hormonal contraceptives, as an adaptation to the drug. In these cases, the dosage should be revised or the drug should be canceled, if this does not help, then another reason for uterine bleeding should be sought. Blood loss also occurs against the background of damage to the uterus by the intrauterine device, and it should be removed as soon as possible.

If something unusual happens during menstruation, in the middle of the cycle, during pregnancy or the premenopausal period, with the slightest suspicion of starting bleeding, a woman should immediately contact her gynecologist for advice, examination and establishing the true cause of uterine bleeding, since only knowing the exact the diagnosis can begin adequate and timely treatment.

For emergency symptomatic treatment of uterine bleeding, experts recommend the following hemostatic drugs: ethamzilate, vicasol, dicinone, aminocaproic acid, calcium preparations.

Causes of Uterine Bleeding

The likelihood of uterine bleeding depends on the age of the patient. In girls from 12 to 18 years, abundant discharge of blood from the vagina is a consequence of hormonal imbalance. And hormonal disruptions at a young age arise due to:

  • physical trauma or emotional upheaval,
  • deterioration of the endocrine glands,
  • malnutrition, deficiency of vitamins in the body,
  • pregnancy with complications, difficult birth,
  • genital tuberculosis
  • bleeding disorders
  • transferred serious infectious diseases.

In women of mature age, uterine bleeding is a rare phenomenon, usually associated with impaired ovarian function. In this case, the provocateurs of the pathological condition are:

  • stress, overwork, nervous strain, mental disorders,
  • uterine fibroids,
  • endometriosis
  • advanced endometritis
  • uterine polyps
  • oncology of the uterus or cervix,
  • tumor formations in the ovaries,
  • ectopic pregnancy, miscarriage, medical or instrumental abortion,
  • infectious diseases of the reproductive organs,
  • climate change, adverse environmental situation in the place of residence, harmful working conditions,
  • taking medications that can disrupt the systemic work of the hypothalamus and pituitary gland.

Uterine bleeding is often observed in women during menopause. This is due to a decrease in the synthesis of the pituitary gonadotropin.

As a result, the level of sex hormones begins to jump in the female body, the menstrual cycle goes astray, the formation of follicles in the ovaries is disrupted. Common causes of uterine bleeding at the age of extinction of reproductive function are:

  • uterine fibroids,
  • endometriosis
  • uterine polyposis,
  • hormone-dependent ovarian tumors.

Symptoms of uterine bleeding

Common signs of pathological bleeding from the uterus are:

  • weakness,
  • fainting state
  • dizziness,
  • nausea,
  • blanching of the skin,
  • heart tachycardia
  • lowering blood pressure.

Specific symptoms of uterine bleeding are:

  • profuse flow of blood from the vagina,
  • the presence of clots in the blood discharge,
  • gasket change every 2 hours, even more often,
  • bleeding duration more than 8 days,
  • increased bleeding after intercourse,
  • painless discharge of blood with a dysfunctional origin of the pathology,
  • mismatch in the onset of bleeding with a period of menstruation.

The duration of menstruation normally does not exceed 8 days, and blood discharge lasting longer than the normal period is pathological. Unhealthy should be considered vaginal bleeding, the period between which is less than 21 days.

During menstruation, 80-120 ml of blood flows out per day; in case of uterine bleeding, the daily blood volume is more than 120 ml.

Types of uterine bleeding

Hemorrhages from the uterus are divided into five types, depending on the age of the patients.

  1. During infancy. In the first week of life in a newborn girl, minor blood discharge can go from the vagina. This is not a pathological phenomenon, the child does not need medical intervention. Infant bleeding due to a sharp change in the hormonal background in a born girl, disappear on their own.
  2. In the period before puberty. During this period, vaginal bleeding in girls is rare. The cause of the pathological condition is most often a hormone-dependent ovarian tumor, due to which the sex gland synthesizes too many hormones. As a result, the girl has a false maturation of the reproductive system.
  3. In the puberty. Uterine bleeding during puberty, occurring in 12 - 18 years, are called juvenile.
  4. In the reproductive period. Hemorrhages from the uterus, observed in the period 18 - 45 years, are organic, dysfunctional, breakthrough, as well as due to pregnancy and childbirth.
  5. In the menopause. During the extinction of the reproductive function, vaginal bleeding is most often associated with pathologies of the genital organs or with a decrease in the synthesis of hormones.

Dysfunctional bleeding

This type of uterine bleeding observed during the reproductive period is the most common. The pathological condition is diagnosed in both girls and elderly women during menopause. The cause of dysfunctional blood secretions is the failure of the synthesis of sex hormones by the endocrine glands.

The endocrine system, including the pituitary, hypothalamus, ovaries and adrenal glands, controls the production of sex hormones. If the work of this complex system fails, then the menstrual cycle is disrupted, the duration and abundance of menstruation changes, the likelihood of infertility and spontaneous abortion increases. Therefore, with any changes in the menstrual cycle, you should immediately consult a gynecologist.

Dysfunctional uterine bleeding is ovulatory and anovulatory. Ovulatory bleeding is manifested by a change in the duration and profusion of blood flow during menstruation. Anovulatory bleeding is observed more often, due to the lack of ovulation due to impaired synthesis of sex hormones.

Internal

Bleeding are called outsideif blood is poured into the environment directly from the wound or through the natural openings of the body.

Internal

With internal bleeding, blood accumulates in body cavities that do not communicate with the environment. These are pleural, pericardial, abdominal cavities, joint cavities, cerebral ventricles, interfascial spaces, etc. In this case, the following symptoms appear: pallor, cold sweat, pulse increases and weakens. The most dangerous type of bleeding.

  • Hidden bleeding - bleeding in the body cavity, communicating with the external environment - gastric bleeding, bleeding from the intestinal wall, pulmonary hemorrhage, bleeding into the bladder cavity, etc. Sometimes it happens so little that it is determined only by special research methods. It can be significant with the accumulation of blood in the intramuscular spaces and serous cavities.
  • Explicit bleeding - bleeding that is easily determined upon examination.

Breakthrough bleeding

Such uterine bleeding is also called iatrogenic. They are diagnosed after exceeding the dosage and course of taking certain medications, the frequent use of hormonal contraceptives, as well as after the operation to install the spiral and after other surgical procedures on the organs of the reproductive system.

When taking hormonal drugs, scanty blood discharge is usually noted, which means that the body adapts to synthetic hormones. In this situation, it is recommended to consult a doctor about changing the dosage of the medication.

In most cases, with breakthrough bleeding, gynecologists advise patients to increase the dosage of the hormonal drug for a certain time. If after this measure the amount of blood released does not decrease, but increases, then an urgent need to undergo a medical examination. In this case, the cause of the pathological condition may be a serious disease of the reproductive system.

If uterine bleeding occurred after the installation of the spiral, then the contraceptive device most likely injured the walls of the uterus. In this situation, you should immediately remove the spiral and wait for the healing of the uterine walls.

Pregnancy and childbirth bleeding

In the first months of pregnancy, uterine bleeding is a sign of either a threat of spontaneous abortion or an ectopic fetus. With these pathological conditions, severe pain in the lower abdomen is noted.

A pregnant woman who has started uterine bleeding should immediately consult an observing doctor.

When a spontaneous abortion begins, the fetus can be saved if proper treatment is started on time. At the last stages of a miscarriage, you will have to say goodbye to pregnancy, in this case, curettage is prescribed.

In ectopic pregnancy, the fetus develops in the fallopian tube or cervix. Menstruation is delayed, some symptoms of pregnancy are noted, but the embryo is not detected in the uterus.When the fetus reaches a certain stage of development, bleeding occurs. In this situation, a woman needs urgent medical attention.

In the third trimester of pregnancy, uterine bleeding is deadly for both the mother and the baby developing in the womb.

The causes of the pathological condition in the later stages of gestation are placenta previa or placental abruption, rupture of the uterine walls. In these cases, a woman urgently needs medical attention, usually a cesarean section is performed. Patients who are at high risk of the above pathologies should be on preservation.

Uterine bleeding can occur during childbirth. In this case, the following pathological conditions may be its causes:

  • placenta previa,
  • bleeding disorder,
  • low uterine contractility
  • placental abruption,
  • stuck in the uterus afterbirth.

If bleeding from the uterus occurs a few days after the birth, then you need to immediately call an ambulance. A young mother will need emergency hospitalization.

First aid before doctors arrive

Excessive bleeding from the vagina must be stopped or at least reduced before the arrival of doctors. This is a matter of life and death of a woman. In most cases, with competent first aid, bleeding stops, but in 15% of cases, the pathological process ends lethally.

Every woman should know how to help herself before the arrival of doctors, what can and cannot be done.

A sick woman, waiting for doctors at home, must do the following:

  • lie on your back, remove a pillow from under your head,
  • place a high roller made of towels or a blanket under the legs
  • put a bottle of cold water or an ice-filled heating pad on your stomach
  • drink cold still water.

With uterine bleeding, it is strictly forbidden:

  • to be in a standing and sitting position,
  • lying with your legs to your stomach
  • take a hot bath
  • do douching,
  • put a heating pad on your stomach
  • drink hot drinks
  • take any medication.

Drug therapy

The treatment of diseases that caused bleeding from the uterus is carried out in stationary conditions. In addition, the doctor prescribes medicines to the patient to help stop the blood flow.

Hemostatic drugs are taken only on the recommendation of a medical specialist, taking drugs at their own discretion is strictly prohibited.

The following is a list of medications most commonly used to stop bleeding.

  • Etamsylate. This drug stimulates the synthesis of thromboplastin, changes the permeability of blood vessels. Blood coagulation increases, as a result, bleeding decreases. The medication is intended for intramuscular injection.
  • Oxytocin. A hormonal drug often used during childbirth to improve uterine contractility. As a result of contraction of the uterine muscles, bleeding stops. The drug oxytocin is prescribed for intravenous administration with the addition of glucose, has a large list of contraindications.
  • Aminocaproic acid. This medicinal substance does not allow blood clots to dissolve under the influence of certain factors, due to this, bleeding decreases. The medicine is either taken orally or administered intravenously. Treatment with aminocaproic acid for uterine bleeding is carried out under close medical supervision.
  • Vikasol. The drug is based on vitamin K. With a deficiency in the body of this vitamin, blood coagulation worsens. The medication is prescribed to patients who have a tendency to uterine bleeding. However, vitamin K begins to act only 10 to 12 hours after ingestion, therefore, it is not advisable to use the drug to stop blood in emergency cases.
  • Calcium gluconate. The drug is prescribed for deficiency in the body of calcium. Deficiency increases the permeability of the vascular walls, worsens blood coagulation. This drug is also not suitable for use in emergency cases, but is used to strengthen blood vessels in patients prone to bleeding.

Treatment with folk remedies

To stop and prevent uterine bleeding, you can use decoctions and infusions of medicinal plants. Listed below are the most popular and effective folk recipes for stopping blood.

  • Yarrow infusion. You need to take 2 teaspoons of dried plant material, pour a glass of boiling water. The solution is infused for about an hour, then filtered. The infusion is taken in a quarter cup 4 times a day before meals.
  • Nettle broth. Take a tablespoon of dried nettle leaves, pour a glass of boiling water. The solution is boiled over low heat for 10 minutes, then filtered. Ready broth is taken in a tablespoon 3 times a day before meals.
  • Flask of a shepherd’s bag. Take a tablespoon of dried plant material, pour a glass of boiling water. The container with the solution is wrapped in a warm towel, left for an hour to insist. The finished infusion is filtered, taken in a tablespoon 3 times a day before meals.

It must be remembered that folk remedies cannot be a complete substitute for medicines, they are used only as an addition to the main therapy.

Before using herbal remedies, you should always consult with a medical specialist to exclude intolerance to the medicinal plant and other contraindications.

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