Every woman is familiar with spotting from the genital tract. They appear regularly and last for several days. Monthly bleeding from the uterus is observed in all he althy women of childbearing age, that is, capable of bearing children. This phenomenon is considered the norm (menstruation). However, there are also abnormal uterine bleeding. They occur when disturbances occur in the body. Most often, such bleeding occurs due to gynecological diseases. In most cases, they are dangerous, as they can have serious consequences.
Determination of abnormal uterine bleeding
Abnormal uterine bleeding is a condition in which there is a tear in the vascular wall of the body or cervix. It is not associated with the menstrual cycle, that is, it appears independently of it. Bleeding may occur frequently. In this case, they occur between periods. Sometimes, abnormal uterine bleeding occurs rarely, such as once every few months or years. Also, this definition is suitable for long periods lasting more than 7 days. In addition, blood loss from 200 ml for the entire period of "critical days" is considered abnormal. This problem can occur at any age. Including adolescents, as well as among women in the menopausal period.
Abnormal uterine bleeding: causes of occurrence
The causes of blood from the genital tract can be different. Nevertheless, this symptom is always a reason for urgent medical attention. Often, abnormal uterine bleeding occurs due to oncological pathologies or diseases that precede them. Due to the fact that this problem is one of the reasons for the removal of the reproductive organ, it is important to identify the cause in time and eliminate it. There are 5 groups of pathologies due to which bleeding may occur. Among them:
- Diseases of the uterus. Among them: inflammatory processes, ectopic pregnancy or threatened miscarriage, fibroids, polyps, endometriosis, tuberculosis, cancer, etc.
- Pathologies associated with the secretion of hormones by the ovaries. These include: cysts, oncological processes of the appendages, early puberty. Also, bleeding can occur due to dysfunction of the thyroid gland, stressful situations, taking contraceptives.
- Pathologies of the blood (thrombocytopenia), liver or kidneys.
- Iatrogeniccauses. Bleeding caused by surgery on the uterus or ovaries, the introduction of the IUD. In addition, iatrogenic causes include taking anticoagulants and other drugs.
- Dysfunctional uterine bleeding (DUB). Their etiology is not completely clear. These bleedings are not associated with diseases of the genital organs and are not caused by other listed reasons. It is believed that they occur due to a violation of hormonal regulation in the brain.
The mechanism of development of bleeding from the genital tract
The pathogenesis of abnormal bleeding depends on what exactly caused it. The mechanism of development in endometriosis, polyps and oncological processes is similar. In all these cases, it is not the uterus itself that bleeds, but pathological elements that have their own vessels (myomatous nodes, tumor tissue). Ectopic pregnancy can proceed as an abortion or rupture of the tube. The latter option is very dangerous for a woman's life, as it causes massive intra-abdominal bleeding. Inflammatory processes in the uterine cavity cause tearing of the endometrial vessels. In violation of the hormonal function of the ovaries or the brain, changes occur in the menstrual cycle. As a result, there may be several ovulations instead of one, or, on the contrary, a complete absence. The same mechanism has the use of oral contraceptives. The introduction of an intrauterine device can cause mechanical damage to the organ, thereby leading to bleeding. In some casesthe cause cannot be established, so the development mechanism also remains unknown.
Abnormal uterine bleeding: classification in gynecology
There are a number of criteria according to which uterine bleeding is classified. These include the cause, frequency, period of the menstrual cycle, as well as the amount of fluid lost (mild, moderate and severe). By etiology, there are: uterine, ovarian, iatrogenic and dysfunctional bleeding. DMC differ in the nature of menstrual irregularities. Among them:
- Anovulatory uterine bleeding. They are also called single-phase DMC. They occur due to short-term persistence or atresia of the follicles.
- Ovulatory (2-phase) DMC. These include hyper- or hypofunction of the corpus luteum. Most often, this is abnormal uterine bleeding of the reproductive period.
- Polymenorrhea. Blood loss occurs more than once every 20 days.
- Promenorrhea. The cycle is not broken, but the "critical days" last more than 7 days.
- Metrorrhagia. This type of disorders is characterized by irregular bleeding, without a certain interval. They are not related to the menstrual cycle.
Symptoms of uterine bleeding
In most cases, it is impossible to immediately determine the cause of the appearance of blood from the genital tract, since the symptoms are almost the same for all DMC. These include pain in the lower abdomen, dizziness and weakness. Also, with constant blood loss, there is a decrease in blood pressure and pallor of the skin. In order to distinguish DMC among themselves, it is necessary to calculate: how many days it lasts, in what volume, and also set the interval. To do this, it is recommended to mark each menstruation in a special calendar. Abnormal uterine bleeding during puberty is characterized by a duration of more than 7 days and an interval of less than 3 weeks. Women of childbearing age usually experience menometrorrhagia. In menopause, bleeding is profuse, prolonged. The interval is 6-8 weeks.
Diagnosis of bleeding from the uterus
To detect abnormal uterine bleeding, it is important to monitor your menstrual cycle and visit your gynecologist periodically. If this diagnosis is still confirmed, it is necessary to be examined. For this, general urine and blood tests (anemia), a smear from the vagina and cervix are taken, and a gynecological examination is performed. It is also necessary to do an ultrasound of the pelvic organs. It allows you to determine the presence of inflammation, cysts, polyps and other processes. In addition, it is important to take tests for hormones. This applies not only to estrogen, but also to gonadotropins.
What is dangerous bleeding from the uterus
Abnormal bleeding from the uterus is a rather dangerous symptom. This symptom may indicate a disturbed pregnancy, tumors and other pathologies. Massive bleeding leads not only to the loss of the uterus, but even to death. They are found in diseases such as ectopicpregnancy, torsion of the pedicle of the tumor or myomatous node, ovarian apoplexy. These conditions require immediate surgical attention. Slight short-term bleeding is not so terrible. However, their reasons may be different. They can lead to malignancy of the polyp or fibroids, infertility. Therefore, the examination is extremely important for a woman of any age.
How to treat uterine bleeding?
Treatment for abnormal uterine bleeding should begin immediately. First of all, hemostatic therapy is necessary. This applies to heavy bleeding. An ice pack is applied to the area of the uterus, saline or erythrocyte mass is injected intravenously. Surgical treatment is also performed (most often the removal of one of the appendages). With mild bleeding, conservative therapy is prescribed. It depends on the cause of DMC. In most cases, these are hormonal drugs (drugs "Jess", "Yarina") and hemostatic drugs (solution "Dicinon", tablets "Calcium Gluconate", "Ascorutin").
