Every woman is familiar with bloody discharge from the genital tract. They appear regularly and last for several days. Monthly uterine bleeding is observed in all healthy women of childbearing age, that is, capable of having children. This phenomenon is considered the norm (menstruation). Nevertheless, abnormal uterine bleeding also exists. They occur when abnormalities 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.
Definition of abnormal uterine bleeding
Abnormal uterine bleeding is a condition in which tearing of the vascular wall of the body or cervix occurs. It is not associated with the menstrual cycle, that is, it appears independently of it. Spotting can be observed often. In this case, they occur between menstruation. Sometimes abnormal uterine bleeding appears rarely, for example, once every few months or years. Also, this definition is also suitable for long periods lasting more than 7 days. In addition, the loss of blood from 200 ml over the entire period of “critical days” is considered abnormal. This problem can occur at any age. Including in adolescents, as well as among women who are in menopause.
Abnormal uterine bleeding: causes
The causes of the appearance of blood from the genital tract can be different. Nevertheless, this symptom is always a reason for urgent seeking medical help. Often abnormal uterine bleeding occurs due to cancer pathologies or diseases preceding them. Due to the fact that this problem is one of the reasons for removing the genital organ, it is important to identify the cause in time and eliminate it. There are 5 groups of pathologies, due to which bleeding can occur. Among them:
- Diseases of the uterus. Among them: inflammatory processes, ectopic pregnancy or the threat of interruption, myoma, 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.
- Pathology of the blood (thrombocytopenia), liver or kidney.
- Iatrogenic causes. Bleeding caused by surgery on the uterus or ovaries, the introduction of an IUD. In addition, the use of anticoagulants and other drugs refers to iatrogenic reasons.
- Dysfunctional uterine bleeding (DMC). Their etiology is not completely clear. These bleeding is not associated with diseases of the genital organs and is not caused by the other listed reasons. It is believed that they arise due to impaired hormonal regulation in the brain.
The mechanism of development of bleeding from the genital tract
The pathogenesis of abnormal bleeding depends on exactly what reason they were caused. 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 occur as an abortion or a rupture of the tube. The latter option is very life-threatening for a woman, as it causes massive intra-abdominal bleeding. Inflammatory processes in the uterine cavity cause tearing of the endometrial vessels. If the hormonal function of the ovaries or the brain is disturbed, changes in the menstrual cycle occur. As a result, several ovulations can be observed 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 cases, the cause cannot be determined, 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. DMK differ in the nature of menstrual irregularities. Among them:
- Anovulatory uterine bleeding. They are also called single-phase DMK. They arise due to short-term persistence or atresia of the follicles.
- Ovulatory (2-phase) DMK. These include hyper- or hypofunction of the corpus luteum. Most often, this is an abnormal uterine bleeding of the reproductive period.
- Polymenorrhea. Blood loss occurs more than once every 20 days.
- Promenorrhea. The cycle is not broken, but “critical days” last more than 7 days.
- Metrorrhagia. This type of disorder is characterized by promiscuous bleeding, without a specific interval. They are not related to the menstrual cycle.
Symptoms of uterine bleeding
In most cases, it is impossible to immediately establish the cause of the appearance of blood from the genital tract, since the symptoms are almost the same for all DMK. These include pain in the lower abdomen, dizziness and weakness. Also, with constant blood loss, a decrease in blood pressure and pallor of the skin are observed. To distinguish between DMK 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 of the pubertal period is characterized by a duration of more than 7 days and an interval of less than 3 weeks. In women of childbearing age, menometorrhagia is usually observed. In the menopause bleeding is plentiful, prolonged. The interval is 6-8 weeks.
Diagnosis of uterine bleeding
To identify abnormal uterine bleeding, it is important to monitor your menstrual cycle and periodically visit a gynecologist. If this diagnosis is still confirmed, it is necessary to be examined. For this, general urine and blood tests (anemia), a swab from the vagina and cervix are taken, 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 hormone tests. This applies not only to estrogen, but also to gonadotropins.
Why are uterine bleeding dangerous?
Abnormal uterine bleeding is a rather dangerous symptom. This symptom can talk about an impaired pregnancy, a tumor and other pathologies. Massive bleeding leads not only to loss of the uterus, but even to death. They occur in diseases such as ectopic pregnancy, torsion of the legs of the tumor or myomatous node, and ovarian apoplexy. These conditions require immediate surgical attention. Non-abrupt short-term bleeding is not so terrible. Nevertheless, 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 needed. This applies to heavy blood loss. An ice bladder is placed on the uterus, saline or red blood cells are injected intravenously. Surgical treatment is also performed (most often the removal of one of the appendages). With moderate bleeding, conservative therapy is prescribed. It depends on the cause of DMK. In most cases, these are hormonal drugs (Jess, Yarina drugs) and hemostatic medicines (Dicinon solution, Calcium gluconate, Ascorutin tablets).