Uterine bleeding. One symptom - several reasons - “I’m healthy!”

There is probably no person in the world who has never experienced external bleeding in their life - for example, from careless handling of a knife when cutting food or from an unfortunate fall from a bicycle that ends in broken knees. The rules of first aid in such situations are simple and well known to everyone. You need to disinfect the wound and stop the bleeding with a bandage or plaster. And if a large vessel (artery) is hit and blood spurts out, then it is necessary to clamp the vessel above the wound site to avoid large blood loss.

Obviously, any bleeding occurs due to the fact that the integrity of the blood vessels is disrupted. Blood stops circulating in the closed space of the vessels and flows out of them. If the integrity of the uterine vessels is compromised, blood flows out through the vagina. It is this external sign that is the reason to suspect something is “off” and consult a doctor.

Uterine bleeding is a symptom of many diseases. These may be gynecological or oncological diseases, as well as complications of pregnancy and childbirth.

In case of uterine bleeding, it is very important not so much to stop the blood loss - this, by the way, is not always the first priority measure - but to identify the cause of the bleeding and, if possible, eliminate it. If this is not done, then there is a high probability of relapse and other manifestations of the disease, as well as its complications. Manipulations aimed at stopping bleeding are carried out in cases where the process of blood loss occurs at a high rate - in this case there is a direct threat to life. After the bleeding has been eliminated, in addition to treatment, restorative procedures must be prescribed: regimen, nutrition, maintaining water balance in the body, vitamin therapy.

Dysfunctional uterine bleeding

Dysfunctional uterine bleeding is bleeding associated with dysfunction of organs, in the absence of any organic pathology (uterine fibroids, internal endometriosis, pathology of the cervix, tumors of the uterus and ovaries).

Ovarian dysfunction is caused by a violation of their hormonal function and occurs quite often. Many women take this disease lightly and do not see it as a direct threat to health. In addition, there is a very common opinion that dysfunction is just a minor malfunction of the body, with which you can live safely, but it is useless to treat it. This approach is fundamentally wrong. Firstly, ovarian dysfunction may be a manifestation of some deep hormonal imbalances that require certain correction. Not to mention that it is unlikely that you will be able to “live well,” because dysfunction is almost always accompanied by physical and moral discomfort and pain. A woman is forced to constantly use analgesics, the body gradually gets used to them, the pain intensifies again... It turns out to be a vicious circle.

The main symptom of dysfunctional bleeding is irregular menstrual cycle. The reason to consult a doctor is when the interval between menstruation is less than 21 days and more than 35 days. It is also not considered normal if:

• menstruation lasts more than 7 days;
• menstrual bleeding is very heavy, a woman is forced to change pads or tampons every hour, including at night;
• Menstruation is accompanied by severe nagging pain in the lower abdomen.

If such symptoms recur over three or more menstrual cycles, then you need to visit a doctor as soon as possible.

Endocrine causes are not always the cause of dysfunction. The functioning of the ovaries can also be affected by factors such as:

• overweight or underweight;
• diabetes;
• frequent stress and depression;
• infectious diseases (flu, pneumonia, sore throat);
• strict diet and fasting;
• genital infection;
• sudden climate change.

Therefore, when going to see a doctor, be prepared that he will ask you questions about your diet, nervous stress, previous diseases and changes in the climatic environment.

Diagnosis of ovarian dysfunction includes a gynecological examination, smear analysis, blood test for hormones, ultrasound of the thyroid gland, adrenal glands and pelvic organs. The doctor may also prescribe magnetic resonance imaging of the brain and separate diagnostic curettage of the uterus.

Treatment is selected individually in each case. First of all, it is aimed at normalizing hormonal levels and correcting lifestyle. In any case, the doctor tries to choose the most gentle therapy. In cases where adolescents or premenopausal women suffer from dysfunction, it is often enough to reduce the level of tension, review the diet and allocate time for active rest and good sleep. The body reacts sensitively to changes that are favorable to it and successfully self-regulates without drug treatment.

Diagnostics

A gynecologist is involved in identifying the cause of the development of bloody discharge from the vagina. The woman requires a comprehensive examination using physical and instrumental methods. The diagnostic search is aimed at establishing the root cause of the symptom and assessing general disorders in the body caused by blood loss. The most informative are:

• Gynecological examination.
  The study of the mucous membrane of the vagina and cervix with vaginal speculum is necessary to identify pathological changes, erosions, signs of inflammatory processes or endometriosis. More valuable methods are colposcopy, cervicoscopy and hysteroscopy, which make it possible to detect microscopic foci of epithelial change.
• Ultrasonography
  . Using an ultrasound of the pelvic organs, the uterus and appendages are visualized, voluminous neoplasms, signs of diffuse growth of the endometrium, and other causes that cause odorless or odorless bloody discharge are detected. In difficult situations, when the doctor cannot verify the diagnosis, they resort to diagnostic laparoscopy.
• Visualization methods
  . Tumor growths can be visualized by contrasting the genital tract - hysterosalpingography. To clarify the diagnosis and assess the degree of infiltrative growth of tumors, modern research methods are used - CT and MRI of the pelvic organs.
• Biopsy.
  Identification of altered areas of tissue during instrumental visualization serves as an indication for collecting endometrial and uterine cervical material. Microscopic examination of cells assesses the degree of atypia, the presence of pathological inclusions or signs of malignant growth. Immunochemical analysis of materials obtained during the biopsy is also carried out.
• Diagnostic curettage
  . A total scraping of the mucous membrane of the uterus and cervical canal is a more informative method than a conventional biopsy, since it allows one to obtain a larger amount of material for histological analysis. Separate diagnostic curettage (SDC) is also prescribed for therapeutic purposes.
• Laboratory research
  . To clarify the cause of sanguineous vaginal discharge with an unpleasant odor, it is recommended to analyze a vaginal smear for microflora and culture it on nutrient media. Be sure to evaluate the female hormonal profile. General and biochemical blood tests make it possible to clarify the degree of posthemorrhagic anemia and metabolic changes.

Consultation with a gynecologist for bloody vaginal discharge

Bleeding due to uterine fibroids, adenomyosis, endometrial and cervical canal polyps

Uterine fibroids, endometriosis and polyps and endometrial hyperplasia are diseases associated with benign growth of uterine tissue. They appear most often during reproductive age.

All this pathology is easily diagnosed using ultrasound. As a rule, no additional examination methods are required. You can read about possible treatment options for uterine fibroids in the corresponding section of the website www. ya-zdorova.ru. In the presence of pathology of the uterine cavity, hysteroscopy with the appropriate amount of surgical intervention is indicated to eliminate the cause of bleeding.

Pathological discharge

Bloody discharge in the middle of the cycle is most often a sign of pathology - important signs will be the amount of discharge, how you feel when it appears, and the phase of the cycle.

Bloody discharge between periods can be profuse - like breakthrough bleeding, this is a reason to seek immediate help. Bleeding may be brown, very dark, like clotted blood, 1-2 teaspoons on a daily napkin. This is a reason to consult a doctor.

The discharge may be spotting and pink in color - this may be a sign of defects in the cervical area.

In addition, spotting may be a sign of:

• menstrual irregularities, hormonal imbalances,
• adenomyosis of the uterus,
• ectopic pregnancy,
• - tumor process of the cervix or body of the uterus,
• uterine fibroids, polyps,
• endometrial hyperplasia,
• inflammatory processes in the endometrium.

Other causes of bleeding between periods may include problems with the thyroid gland and adrenal glands, disorders of the pituitary gland, taking oral contraceptives, using emergency contraceptives, using estrogen-containing supplements, and sudden weight fluctuations.

Bleeding in cancer

One of the first manifestations of uterine and cervical cancer is uterine bleeding, although, as a rule, the process may not be at such early stages. It may not cause the woman any painful sensations, be scanty and short-lived. If such bleeding occurs during a regular menstrual cycle, you should immediately consult a doctor.

A timely visit to a gynecologist allows you to detect a tumor at an early stage and significantly increases the chances of a successful cure. The diagnosis can be made based on a gynecological examination, ultrasound and a number of tests.

Normal vaginal discharge in women

Vaginal discharge is normal in women, but not all are considered normal. Transparent, light (from 50 mg per day) mucous discharge that is odorless and does not cause any discomfort in a woman is considered normal. In this case, a smear for microflora shows a normal number of leukocytes with a predominance of lactobacilli. Such discharge gradually increases in quantity until the day of ovulation. The mucus changes its properties during this period. A feeling of moisture at this time in the woman’s genital area is considered absolutely normal.

Obstetric hemorrhage

This term refers to intense bleeding that occurs immediately after childbirth. Their cause is a violation of the contractility of the uterus (atony or hypotension of the uterus), or a pathology associated with the blood coagulation system. Hypotony is a decrease in the tone of the uterus, which leads to its inability to actively contract. Atony is a complete loss of the ability to contract and respond adequately to medications and other types of stimulation. Obstetric hemorrhage is very dangerous because it leads to a large loss of blood in a short time. Very often the question is literally about saving a woman’s life - and then doctors decide on a hysterectomy, that is, removal of the uterus.

Bloody discharge a week before your period: should you worry?

If your period is due in about a week and you've already noticed some spotting, don't worry. It is unlikely that they are talking about any serious problem, so it is better to remain calm and try to objectively assess the situation.

To get started, check out our list of the most common causes of this type of discharge. This will give you an idea of ​​possible diagnoses and whether you need to seek medical help and, if so, how urgently.

However, there are symptoms to watch out for:

• pain in the lower abdomen;
• heat;
• spotting or other vaginal bleeding after menopause;
• spotting that gets worse or appears more frequently over time.

If you are concerned about any of these, seek professional advice as soon as possible.

Bleeding during menopause

Menopause is a natural physiological process. You shouldn’t be overly emotional or wary about him. But at the same time, a woman during menopause needs to listen to her condition so as not to miss truly significant and alarming symptoms. One of them is bleeding.

Uterine bleeding during menopause may indicate disturbances in the functioning of the hormonal system, the occurrence of tumors in the body of the uterus or in the ovaries. Only a doctor can correctly diagnose the disease using ultrasound and tests.

I would like to say a few words about bleeding during sexual intercourse. If this symptom appears, you should definitely consult a doctor. They may indicate cervical disease, be a manifestation of endometriosis, as well as vaginal pathology. In some cases, spotting during sexual intercourse may be associated with dryness of the vaginal mucosa, for example, during the postmenopausal period. In any case, to clarify the diagnosis, you must consult a doctor.

Treatment

Help before diagnosis

The appearance of bloody vaginal discharge that is not associated with uterine involution in the postpartum period or natural menstrual bleeding is an indication for immediate medical attention. Attempts to independently treat the disorder using traditional methods or medications often lead to serious complications in the genital area and other organs. If brown discharge is accompanied by pain, you should not use analgesics from the NSAID group, which increase bleeding.

Conservative therapy

Medical tactics, first of all, depend on the degree of blood loss and the cause of the formation of reddish or brown discharge. For minor brown or bloody discharge, etiotropic therapy for the underlying pathology is indicated; massive blood loss requires the use of specific hemostatic agents. Physiotherapy methods are not recommended. To treat patients with complaints of vaginal bleeding, the following are used:

• Coagulants
  . The medications are designed to stimulate the formation of blood clots and quickly stop bleeding. They are prescribed only for heavy bleeding under the control of coagulogram parameters.
• Hormonal drugs
  . Bloody discharge caused by impaired ovarian estrogen secretion requires specific therapy. Estrogen and progesterone agents are used.
• Anti-inflammatory drugs
  . Reduce the amount of inflammatory mediators. Effectively reduce pain and promote healing of defects in the epithelium of the genital tract.
• Antibacterial agents
  . Indicated for foul-smelling discharge and signs of infection. Depending on the reasons, etiotropic medications are used: antibiotics, antiprotozoal, antifungal.

Surgery

The ineffectiveness of conservative therapy for extensive endometriosis is an indication for excision of endometrial growths followed by cauterization. For ovarian endometriosis and the formation of “chocolate” cysts, surgical laparoscopy and oophorectomy are indicated. For cervical erosions, cauterization is performed using laser coagulation. If polyps of the uterus or cervix are detected, they must be removed. To reduce trauma, endoscopic excision of the polyp is used.

In order to stop uterine bleeding, the main feeding arteries are ligated; if this method is ineffective, the uterus is amputated. Surgical interventions are performed for large benign fibroids to prevent malignancy or profuse bleeding. The method of choice is enucleation of pathological formations with preservation of the organ and restoration of reproductive function. In case of malignant lesion, extirpation of the uterus and appendages may be required, which is combined with antitumor treatment (radiation therapy and chemotherapy).

How to feel about “grandmothers’ recipes”?

In preparing this article, we conducted a survey and found out that, without exaggeration, a huge number of women are trying to cope with the situation of uterine bleeding on their own - using traditional medicine recipes. Naturally, in this case we are talking about moderate or scanty bleeding. The reasons for this state of affairs most likely lie in the absence of a certain culture of treatment and constant monitoring of one’s health. On the other hand, many books and brochures with various folk recipes can now be bought at any bookstore. It is also not difficult to find such information on the Internet. Recipes based on nettle, yarrow, St. John's wort, and viburnum are presented there as safe, effective, affordable, and, moreover, tested by several generations of women.

Without criticizing traditional medicine and recognizing its merits, we would like to focus your attention, first of all, on the inadmissibility of self-medication in case of uterine bleeding. As noted above, the causes of bleeding can be different. Bleeding is only a consequence, a symptom of the disease. You need to treat what caused it: tumor, dysfunction, uterine fibroids, endometriosis, etc. Therefore, it is extremely important to consult a doctor in a timely manner and correctly diagnose the causes of bleeding. And only then, in the treatment regimen, in some cases folk remedies can be used.

What to do, how and what to treat

Considering the variety of reasons that cause such symptoms, it is extremely undesirable to self-medicate at home and postpone a visit to a good gynecologist. After all, for example, constant brown spotting in girls, especially outside of menstruation, can be a sign of inflammation in the appendages, endometriosis or the presence of a polyp in the uterus. White curds with the smell of sour milk, a crumbly coating on the external genitalia - talk about thrush. White discharge on panties and a smell in the vagina that resembles the smell of “stale fish” is often vaginal dysbiosis. Green, yellow discharge mixed with mucus and blood streaks - the presence of sexually transmitted infections...

What should be done in this case? If you have similar complaints about bad smelling, strong discharge, discomfort in the intimate area, pain in the lower abdomen and/or when urinating, contact our clinic. After a comprehensive study of complaints, analysis of the possible causes of their occurrence, carrying out a full-fledged comprehensive diagnosis, our gynecologist will make the correct diagnosis, prescribe effective treatment and monitor its results. Testing will help you determine exactly how to treat the discharge and how to get rid of traces of it on your underpants, which we will discuss below.

Tests for discharge

What examination should you undergo if you are concerned about “bad” discharge and odor in the intimate area? Tests and examination by a gynecologist in our clinic will help identify the cause of these unpleasant phenomena and find the best way to get rid of them. To diagnose possible pathogens of inflammation, girls need to be tested for infections, namely:

1. Smears on flora and degree of purity;
2. PCR analysis for “hidden” infections;
3. Bacteriological seeding of vaginal flora with selection of antibiotics;
4. Florocenosis (useful analysis, given according to indications);
5. Blood tests (syphilis, HIV, hepatitis - according to indications);
6. And, of course, an examination on the chair.

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