How to stop uterine bleeding at home? Menstruation and bleeding - differences and characteristic signs How long does breakthrough bleeding last.

Uterine bleeding is profuse bleeding from the uterine cavity. In most cases, this pathology is caused by a failure of hormonal functions in the female body. Uterine bleeding poses a serious threat to a woman's health, they are 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:

Diseases of the hematopoietic system.
thrombocytopenia.
Pathologies that develop during pregnancy.
Traumatic injuries of the genital organs.
Pathological processes in the uterus, as well as its appendages.
Various gynecological diseases.
The presence of tumor neoplasms, both benign and oncological.
Complications arising after childbirth.
Pathology of the liver.
Endocrine diseases.
Miscarriage.
The use of intrauterine contraceptives
Long-term use of hormonal contraceptives.
Endometriosis.
Changes in climatic conditions.
Frequent stressful situations.
Tuberculosis of the genital organs.
hypovitaminosis,
Disorders of the adrenal cortex
Pathologies thyroid gland.
The presence of inflammatory processes in the reproductive system.

Symptoms

A characteristic feature of this pathology is considered to be abundant bleeding, lasting more than a week. In addition, uterine bleeding is characterized by the presence of such symptoms:

Hypotension.
General weakening of the body.
Dizziness.
The presence of blood clots in the discharge.
Sanitary napkins should be changed every hour or more.
Pain in the lower abdomen.
development of anemia.
Paleness of the skin.
Tachycardia.
Slow pulse.
Loss of consciousness.

How to remove bleeding from menstruation?

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

A significant increase in the volume of allocated blood (over eighty milliliters per day).
Passion for the duration of the discharge (menorrhagia).
Bleeding is observed in the intermenstrual period (polymenorrhea).
Bleeding also occurs during menopause, which is not typical for menstruation.
Metrorrhagia, characterized by failures in the regularity of the menstrual cycle, is also a pathological manifestation.
If there are at least a few of the above signs, we are talking about uterine bleeding.

Kinds

The presented pathology may differ in a number of signs due to the causes of occurrence, as well as some concomitant factors. The classification distinguishes the following varieties:

Dysfunctional bleeding is a pathology that occurs due to a violation 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.
Obstetric bleeding usually occurs during pregnancy, during the birth process, as well as the early postpartum period. This type bleeding is considered one of the most dangerous, as it is distinguished by suddenness and intensity. In fifteen percent of cases, in the absence of timely assistance, obstetric bleeding can lead to the death of a woman.
Organic bleeding occurs due to various anomalies of the female genital organs, as well as in the presence of systemic types of diseases.
Iatrogenic bleeding. Their appearance leads to prolonged and uncontrolled use of hormonal contraceptives, as well as improper installation of an ectopic device.
Menopausal bleeding - occur during menopause, as a result of hormonal failure in the body.
Juvenile bleeding occurs mainly in adolescent girls during puberty.
Diffuse bleeding occurs due to nodular adenomyosis of the uterus and associated changes in the myometrium.

Diagnostics

In case of suspicion, it is necessary, without delay, to 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. Diagnosis is also necessary because the presence of pathology in the form of bloody discharge from the uterus can be a sign of enough serious illnesses in need of immediate treatment.

For uterine bleeding, the following diagnostic procedures are used:

General blood analysis.
Studies of smears from the cervix (in case of suspected cancer).
Ultrasound procedure.
Biopsy - taking suspicious tissue for further research.
Blood chemistry.
Analyzes for the content of hormones.
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 blood clots are removed during scraping, as well as defective epidermis.

How to stop bleeding?

In case of uterine bleeding, an ambulance should be called immediately. And before the doctors arrive, everything possible should be done to alleviate the condition of the woman. Remember that not only 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 must do the following:

Give the victim hemostatic drugs (Etamzilat, Dicyon, etc.).
After the medicine is taken, the patient should be laid down, and a pillow should be placed under her legs.
It is recommended to apply a heating pad with ice or just something cold to the lower abdomen.
With a sharp fall blood pressure, let the patient drink sweet hot tea.

Bleeding in women, the causes of which may be different, is divided into several types depending on the provoking factors. Based on the type of such pathology, the doctor prescribes the necessary therapy. Bleeding in women is not always the result of a serious illness.

Bleeding in women is divided into several types depending on the causes that cause them. Signs of obvious pathology can be recognized by long-term incessant discharge. Uterine bleeding is not uncommon and occurs more often in women of reproductive age, but it also occurs with menopause and in girls. The appearance of such a situation requires a visit to a doctor, especially if the discharge is abundant and not associated with the menstrual cycle.

Uterine bleeding according to the time of occurrence can be divided into 2 types:

Menorrhagia is a condition in which menstrual flow is lengthened and intensified. In some way, this is considered a variant of the physiological norm.
Metrorrhagia is intercyclic uterine bleeding of various etiologies.

The occurrence of such a pathology has its own reasons:

Dysfunction of the ovaries often provokes uterine menstrual bleeding.
Imbalance of sex hormones. In this case, uterine bleeding occurs, which can occur at any age. Because of this, the menstrual cycle is often disturbed in women.
Cervical erosion. One of the provoking factors are various pathologies of the female reproductive organs. Upon contact with a similar defect, for example, during a gynecological examination or during intercourse, uterine bloody issues. As a rule, they are not plentiful, but they bring discomfort to a woman. This condition is sometimes accompanied by pain in the lower abdomen.
Injuries during sexual intercourse in some cases lead to the appearance of blood in women. This can occur with accidental damage to the vessels of the cervix and does not pose a serious danger when the uterine discharge of blood passes during the day and is not plentiful. If the situation does not change, but only progresses, it is urgent to consult a doctor.
Endometrial polyps, especially if they are damaged (for example, during sexual contact), can exfoliate, then profuse uterine bleeding occurs. That is why it is so important to diagnose and remove them in time.
Endometriosis. Foci of this pathology, resulting from the growth of endometrial cells in wrong place, bleed quite often. The uterine secretions are thick and chocolate-colored.
Stressful conditions can lead to heavy bleeding.
Miscarriage. Its main symptoms are pain in the lower abdomen and heavy uterine bleeding.
The consequences of an abortion. When this manipulation takes place in the form of scraping, the bloody uterine discharge is quite abundant. If they don't pass long time and progress, then you should call ambulance, since fragments of the fetal egg remaining in the uterine cavity can lead to quite serious consequences.

As you can see, bleeding in women can occur due to different reasons and quite often are a symptom of various diseases of the reproductive system.

Depending on age, such a pathology can be divided into 3 types:

juvenile uterine bleeding occurring in girls under 18 years of age. Often they coincide in terms with menstruation, but are more abundant and occupy a slightly longer time interval;
uterine bleeding of the reproductive period. It can occur for a number of reasons caused by various diseases of the reproductive system;
uterine profuse bleeding sometimes occurs during menopause. During this period, such conditions are especially dangerous, as they can be a sign of malignant degeneration of cells.

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How is the treatment carried out

Treatment of bleeding first of all begins with the diagnosis. To do this, the doctor collects the necessary tests and, summing up all the symptoms, determines a particular disease.

First aid in such conditions can be traditional medicine recipes, but this will not help to cure the cause itself, but will only slightly stop uterine bleeding. If it is not possible to immediately consult a doctor, then you can brew nettles and, after drinking the broth, lie down for a bit.

If the ovarian function is impaired due to hormone failure, the doctor may prescribe special drugs that can regulate the balance between estrogen and progesterone. If the uterine bleeding is not too abundant, then in some cases herbal remedies are offered. However, if the pathology is serious, then the gynecologist may advise taking oral contraceptives, which will help not only to balance the balance of hormones, but will also be an excellent means of preventing unwanted pregnancy.

Uterine discharge of blood during erosion is treated by eliminating the damaged area. To do this, the pathological area is cauterized with a laser or cryodestruction is performed.

If during a rough intercourse a vessel accidentally breaks through and a blood clot does not form for a long time, then the doctor stops the uterine bleeding in a hospital.

Polyps and endometriosis, the signs of which are often similar and are manifested by discomfort during intercourse, as well as spotting, require mandatory treatment. Uterine bleeding may be different intensity. In any case, the doctor must eliminate the pathological formation. This is often done with a laser.

Under stress, bleeding often occurs in women. In this case, the gynecologist uses drugs that accelerate blood clotting and hot injections.

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If the pathology arose as a result of a miscarriage or after an abortion, then in no case should you postpone a visit to the doctor, because the consequences can be fatal.

Finally

If the symptoms of uterine bleeding are progressive, then this should be taken seriously. It must be remembered that it is important to eliminate not the manifestation of the pathology itself, but its cause. And here you can not do without an experienced specialist. Quite often, bleeding is accompanied by the following symptoms:

dizziness;
pallor;
weakness;
numbness.

In any case, the danger increases with an increase in the volume of fluid lost.

Periodic acyclic discharge of blood can lead to anemia and the development of infertility. If they are caused by hyperplastic processes in the endometrium, then it is impossible to do without curettage. At the same time, new cells begin to form in place of the modified cells.

Drugs that are an auxiliary method of therapy for this condition: Dicinon, Tranexam, Vikasol, Askorutin, etc.

With uterine bleeding, you can not take a bath, especially hot.

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Before visiting a doctor, you can:

lie on your back and put your legs slightly above body level, for example, on a roller or a low pillow;
drink as much liquid as possible;
you can take a tablet of Vikasol or Dicinon, as well as brew nettles.

In any case, self-medication is by no means impossible!

This is due to its special nature and the source, which is the uterus. This organ has such a good blood supply that if the integrity of its vessels is violated, this is manifested by profuse bleeding, which is extremely difficult to treat and often leads to severe blood loss with dangerous consequences.

Most Common Causes

All women at any stage of life can experience bleeding from the uterus. They may have like organic nature as well as 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.

fibromyoma of the uterus;
Bleeding polyps of the uterus and its cervix;
Cancers (cancer of the vulva, cervix, endometrium);
Traumatic ruptures of the vagina, cervix and its body;
Intrauterine device and medical manipulations;
medical abortion;
Ectopic pregnancy;
Threat of abortion and miscarriage;
postpartum period;
Endometriosis.

polycystic ovaries;
Solitary follicular ovarian cysts;
Lack of ovulation and weakness of the corpus luteum;
Diseases of the pituitary gland, thyroid gland and other endocrine glands;
Menopause and puberty;
Stress and poor nutrition.

Uterine fibromyoma is one of the most common causes of uterine bleeding in women of reproductive age.

Variants of clinical manifestations

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

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

Constant spotting bloody discharge from the uterus, which does not violate general condition;
Bleeding from the uterus during menstruation, leading to large blood loss and moderate anemia;
Bloody discharge in the middle of the menstrual cycle for no apparent reason;
Active flow of bright or dark fresh blood with clots, impaired general condition and shock.

Each of these clinical options has its origin and purposefulness of therapeutic measures aimed at stopping bleeding and blood loss.

Signs of severe uterine bleeding

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

Abundant spotting in a short period of time;
General weakness and dizziness;
Sharp pallor of the skin;
Decrease in blood pressure below those figures that are typical for a woman usually;
Frequent pulse and heartbeat;
Drowsiness and apathy.

The appearance of at least some of the listed symptoms is a reason for immediate treatment for medical care. Otherwise, there is a threat of development of hemorrhagic shock and death of the patient.

Danger of uterine bleeding

Uterine bleeding is characterized by the ability to rapidly increase, prolonged flow and relatively poor ability to stop them. In this regard, the development of different scenarios for the outcome of this state is possible:

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;
Bleeding with massive simultaneous blood loss. As a rule, it is very difficult to stop him. Often ends in a serious condition of patients and requires surgical treatment with removal of the bleeding uterus;
Small bleeding from the uterus, which for a long time did not pay attention, because of their routine for patients. They do not pose an immediate threat and do not cause severe anemia. The danger is that in this case the progression of the underlying disease occurs, 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;
Bleeding in pregnancy or in the postpartum period. They are characterized by high intensity and severity compared to other causes of their development. This is due to the poor ability of the uterus to contract and stop bleeding on its own. That's why they often end up bad. shock states and using surgical treatment to stop.

Embolization of uterine vessels - alternative modern method 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 observed, both for a specialized gynecological service, and for an ambulance, and even for the patients themselves. All that is required of women with signs of uterine bleeding is an early request for medical help from a gynecologist. The sooner this is done, the better the prognosis for a full recovery. Ambulance workers or nearby people should be provided with the following measures:

Lay the patient in a horizontal position;
Continuous monitoring of blood pressure and pulse parameters;
Cooling the lower abdomen and uterus with an ice pack or cold heating pad;
Transportation to the nearest medical facility.

In the conditions of a gynecological hospital, medical assistance measures should be provided step by step, which include the following treatment:

Hemostatic and hemostatic therapy. It is carried out by intravenous administration of drugs: dicynone, etamsylate, aminocaproic acid, vikasol, tugin, novoseven (7 coagulation factor), cryoprecipitate, platelet mass;
infusion therapy. Designed to restore the lost volume of circulating blood. For these purposes, they use: rheosorbilact, trisol, hemodez, refortan, washed erythrocytes, fresh frozen plasma and other infusion media;
Vitamin preparations that help stop bleeding: ascorbic acid, calcium gluconate or chloride;
Hormonal hemostasis. It involves the use of high doses of estrogen or progesterone hormones. It is indicated in case of dysfunctional bleeding from the uterus and is not effective in their organic origin;
Diagnostic and therapeutic curettage from the uterine cavity. It is one of the most effective methods to quickly stop uterine bleeding of any origin. By fractional curettage, the endometrium is taken 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 the removal of the bleeding endometrium, which causes a powerful contraction of the uterus and compression of the bleeding vessels at the same time;
Temporary clipping of the uterine arteries. It is indicated in the absence of the effect of the above methods and ongoing bleeding. It is the imposition of special soft clamps on the uterine ligaments through the vagina;
Operative treatment. Refers to forced measures with ongoing bleeding from the uterus of any origin and the impossibility of stopping them with a complex of conservative methods. The operation involves only one thing - the 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 bring yourself to an extreme state in case of detection of their symptoms. Seeking medical help early is the only way to successfully deal with the most difficult situations.

After the diagnostic curettage (May 5), it bled for a week as it should be, then for 4 days everything was fine and now again at the moment there is blood, the lower abdomen hurts and a little dizziness. This is fine?

Causes, symptoms and treatment of uterine bleeding

From this article you will learn: what is uterine bleeding, the mechanism of development of pathology. His features, the main reasons for the appearance. Characteristic symptoms and methods of diagnosis, treatment and prognosis for recovery.

Uterine bleeding is a gynecological complication with the main characteristic feature - the discharge of blood from the uterus, which occurs against the background of hormonal disruptions in the body (these are dysfunctional bleedings) or changes in the structure of the uterine tissues (organic bleedings).

What happens in pathology? Under the influence of hormonal disorders (lack or excess of progesterone, estrogen, dysfunction of the adrenal cortex, thyroid gland), the inner layer of the uterus (endometrium) greatly increases in size. Since it is penetrated by many blood vessels, its increase, untimely and uneven rejection causes profuse dysfunctional bleeding (normally, a small layer is excreted regularly, at the time of menstruation).

Blood supply of the female reproductive system. Click on photo to enlarge

Surgical interventions, endocrine diseases, injuries lead to the appearance of structural changes in the uterus (scars, polyps, fibroids, oncology) and vascular pathology(weaknesses vascular walls). This combination causes organic uterine bleeding.

This condition in 95% is a serious complication of the underlying pathology (myoma, liver disease), which is dangerous for its consequences. Constant and mild bleeding threatens the development of anemia (anemia), profuse blood loss (due to injury, rupture) can lead to removal of the uterus, hemorrhagic shock and death.

Acute uterine bleeding must be stopped, do it in a surgical intensive care unit or gynecological hospital (the number of deaths is 15%).

The prognosis for the treatment of chronic uterine bleeding depends on the general hormonal background of the body and concomitant diseases, usually this symptom can be eliminated completely, this is done by the attending gynecologist.

Patients with pathology are registered throughout their lives.

The mechanism of development of uterine bleeding

The functions of the ovaries are controlled by the hypothalamic-pituitary system of the brain. For the normal maturation of the fetal egg, its release from the ovary, fertilization or excretion, a whole list of hormones is needed.

Physiology of the normal menstrual cycle. Click on photo to enlarge

Uterine bleeding develops with their excess or insufficient production.

FSH (follicle-stimulating) and LH (luteinizing) hormones are responsible for the formation of the corpus luteum (temporary ovarian gland) and the maturation of the follicle (unfertilized egg). With their deficiency or excess, the follicle does not mature or matures, but does not leave the ovary (there is no ovulation phase).
Since there is no ovulation phase, the corpus luteum does not form or does not mature (these are hormonally dependent processes).
At this point, the amount of progesterone (a hormone that regulates the menstrual cycle and ovarian function) is reduced in the body, but the amount of estrogen is increased (responsible for increasing the endometrial layer for a fertilized egg).
Under the influence of hyperestrogenia, vascular disorders appear, the endometrium grows intensively, unevenly, in a thick layer and is excreted irregularly (cycle disturbances).
Extraordinary rejection occurs in layers (under the influence of progesterone compensation mechanisms and estrogen reduction) and is accompanied by bleeding from the endometrium remaining in the uterine cavity and open vessels.
Prolonged hyperestrogenism is a risk factor and a trigger for the development of structural changes in the uterus, the appearance of polyps, fibromyomas, and neoplasms. They begin to bleed when they increase in volume, are damaged or injured in any way.
Structural (organic) bleeding includes damage due to mechanical rupture, decreased uterine tone, usually very heavy.

The nature of bleeding largely depends on the viscosity and rate of blood clotting, the ability of the vessels inside the uterus to contract. It can be plentiful, not plentiful, extended over time (up to several weeks), it may stop on its own, but it must be repeated after a while.

The reasons

The causes of uterine bleeding are hormonal disorders and changes in the structure of the organ.

The most common pathologies and conditions against which bleeding may occur:

Spontaneous termination of pregnancy (miscarriage) or its threat

Placenta adherence or defects in its location during pregnancy

Pathological, difficult childbirth

Postpartum deformity, decreased uterine tone

Mechanical damage (tissue rupture)

Cervical cancer

Chorionepithelioma (neoplasm in the uterine cavity)

Vascular pathologies (atherosclerosis, vasculitis)

Polycystic ovaries. Click on photo to enlarge

Thyroid disease (thyrotoxicosis)

Diseases of the pituitary gland (Itsenko-Cushing's disease)

Infectious and inflammatory diseases (cervicitis,

Sexual infections (gonorrhea)

The use of oral contraceptives

At what age does bleeding occur?

Uterine dysfunctional bleeding due to hormonal disorders may appear:

At the age of 12 to 18 years (juvenile, 20% of cases). Common causes of hormonal disorders during this period are stress, vitamin deficiency, poor nutrition, physical injury, thyroid dysfunction, infectious diseases(measles, chickenpox, rubella).
At the age of 18 to 45 years (reproductive, up to 5%). The cause of bleeding is inflammatory processes (colpitis, cervicitis), stress, poor nutrition, oral contraceptives.
At the age of 45 to 55 years (climacteric, 15%), a regular decrease in the production of sex hormones, the development of benign (polyps) and malignant (cervical cancer) neoplasms lead to disorders.

Organic bleeding occurs in women of reproductive and menopausal age (in 95%), in children and adolescents of the most common cause become mechanical tissue damage.

Symptoms

Uterine bleeding of any kind - dangerous symptom, their appearance is a reason for treatment. Emergency treatment requires acute blood loss (sudden profuse bleeding), they are accompanied by severe symptoms (weakness, pressure drop, increased heart rate, loss of consciousness, disability), sometimes sharp pains in a stomach. In this case, the life of a person depends on the timely provision of assistance.

With mild but frequent bleeding, the symptoms are not so pronounced, although weakness and progressive anemia gradually worsen the quality of life and reduce the ability to work. The patient develops fatigue, dizziness, decreased blood pressure.

Bleeding is characterized by the release of any amount of blood (not necessarily abundant):

between cycles or during menstruation;
during menopause, after a steady absence of menstruation for more than 12 months;
after medical procedures and childbirth in combination with high temperature and pain in the abdomen.

Typical signs of uterine bleeding:

bleeding;
lowering blood pressure;
increased heart rate;
weakness;
increased fatigue;
drowsiness;
dizziness;
headache;
pallor of the skin.

With a large blood loss, the main symptoms replace each other quickly enough, the condition is complicated by loss of consciousness, hemorrhagic shock. With prolonged, incessant bleeding (after an abortion) in combination with high fever (up to 40 ° C) and sharp pains in the abdomen, purulent postoperative complications and sepsis (general purulent infection) may develop.

Small uterine bleeding slowly leads to the development iron deficiency anemia. After a decrease in hemoglobin values less than 50 G / l, the condition is complicated by metabolic and gas exchange disorders, the development of heart failure and other pathologies.

At the same time, the underlying disease progresses, against which bleeding arose as a symptom, leading to the appearance of polyps, fibroids, and other neoplasms. But the most life-threatening complication is the danger of acute blood loss.

How to distinguish from menstruation

By what signs to distinguish uterine bleeding from menstruation, especially if the discharge coincided with the cycle:

The cycle of menstruation is broken.
The intervals between bleeding increase (up to 1.5 months) or decrease (less than 20 days).
Allocations can be plentiful or moderately plentiful, meager.
Last more than 7 days.
With bloody secretions, large pieces of the endometrium are excreted.

The blood has a bright scarlet (arterial) or dark color(venous)

Decrease in blood pressure

Tachycardia (increased heartbeat)

The result can be hemorrhagic shock (due to blood loss), and if the blood is not stopped in time, death as a result of blood loss.

Diagnostics

To diagnose the pathology that provoked the appearance of uterine bleeding, sometimes a whole range of methods is needed:

The gynecologist collects information about the pathology and performs an external examination, the following information enters the medical history:

about the cyclical nature of menstruation;
start and end date of the last menstruation;
about physical development and age;
results of consultation of the endocrinologist, neurologist.

To confirm the diagnosis:

using ultrasound (ultrasound) of the pelvic organs and hysteroscopy, they draw conclusions about the state of the ovaries and the inner layer of the uterus - the endometrium, identify concomitant pathologies (myoma, polyps), control the process of ovulation;
to determine the size of the ovaries in the period between menstruation, an echogram is prescribed;
draw up a graph of basal temperature (changes in body temperature under the influence of the production of sex hormones throughout the cycle);
to exclude the pathology of the pituitary and hypothalamus, echoencephalography, radiography, MRI or CT of the brain are performed;
with the help of ultrasound, the condition of the adrenal glands and the thyroid gland is checked;
in the laboratory, they check the hormonal profile (donate blood for LH, FSH, estrogen, progesterone, prolactin);
determine the level of other hormones (TSH, T3, T4, cortisol, testosterone);
general blood counts (hemoglobin, white blood cell count);
coagulation factors (prothrombin index, coagulogram, platelet count in the blood count, bleeding time and coagulability);
analysis of a smear from the vagina and cervix for the presence of inflammatory process, pathogenic microflora or oncological cells;
part of the endometrium is examined for the presence of cancer cells.

Based on these studies, a conclusion is made about the causes of uterine bleeding in women.

Ultrasound of the pelvic organs. Click on photo to enlarge

Treatment Methods

Bleeding can be stopped, it is vital, especially when the blood loss is acute and life-threatening, in 85% of cases this can be done (in 15% the pathology ends in death).

Treatment of any bleeding is carried out in a hospital, acute blood loss requires emergency first aid measures and an ambulance call.

Stop the blood.
Replenish bleeding.
Eliminate the cause of the symptom.
Prevent recurrence of bleeding.

They use drug therapy, infusion methods to restore blood volumes and surgical methods, the latter are used if the bleeding does not stop with medications.

How to give first aid

How to help before the arrival of doctors:

Drug therapy

The causes and treatment of uterine bleeding are directly dependent on each other: by identifying and curing the underlying disease, you can permanently get rid of life-threatening consequences.

Infusion methods

Infusion methods (transfusion) are used to restore the volume of lost fluid, the number of red blood cells and platelets.

Surgical treatments

It is used if it was not possible to stop uterine bleeding in other ways (the patient's condition worsens, hemoglobin drops below 70 g / l, blood volume is rapidly decreasing).

Procedures are performed on a gynecological chair, the introduction of local or general anesthesia. With the help of gynecological instruments (dilators), access to the uterine cavity is opened, before the operation, the state of the inner layer is determined using a hysteroscope ( optical instrument in a tube that is inserted into the uterine cavity).

Prevention

Prevention of rebleeding consists of observing several rules:

mandatory elimination of the underlying cause of the symptom;
regular examinations (at least 2 times a year);
contacting a gynecologist if any changes in the menstrual cycle and other warning signs appear;
prescribing and taking oral contraceptives only on the recommendation and under the supervision of the attending physician;
pregnancy planning;
healthy eating and lifestyle;
elimination of stressful situations.

Forecast

In 85% of cases, medications stop bleeding in a period of 3 to 7 days, surgical methods make it possible to do this almost instantly, only residual effects (small spotting) remain for 2-3 days.

15% of bleeding cannot be stopped and ends in death. This is due to a combination of numerous factors and causes of the symptom (long-term progressive underlying disease, comorbidities, development of malignant complications, late treatment).

Bleeding is one of the most common gynecological pathologies (from 20%), menopausal women (15%) and juvenile girls (12–18 years old, 20%) are more likely to suffer.

Signs of uterine bleeding: what happens and how to treat

Uterine bleeding is a condition manifested by the release of blood from the internal genital organs. Menstruation is also manifested by the release of blood, but this natural process, genetically programmed by nature.

Distinctive features of monthly discharge from uterine bleeding in women are profusion and duration increases, there is no consistency.

What causes uterine bleeding?

The causes leading to the development of uterine bleeding are diverse, and a classification has been created to understand them.

Uterine bleeding causes, main categories:

bleeding caused by pathologies that do not affect the reproductive system or extragenital conditions. Their reasons: infectious diseases(typhoid fever, sepsis, dysentery), blood diseases (genetic vasculitis, hemophilia), cirrhosis of the liver, cardio- vascular system, violation of the functions of hormonal organs;
bleeding caused by genital pathologies. These can be: rupture of the ovary or cysts, tumor of the uterus or ovary, infectious diseases of the genital organs, menopause or puberty.

Genital pathologies of uterine bleeding

This group of causes is divided into two broad categories: uterine bleeding associated with the course of pregnancy and independent of it.

Uterine bleeding associated with childbearing and delivery:

Ectopic pregnancy or interrupted classic;
Premature placental abruption, violation of the integrity of the surgical scar on the uterus, violation of the integrity of its walls;
Traumatization of the external genital organs of women during actions in the delivery room, and other soft birth canals;
Incomplete allocation of the placenta, its infringement;
The muscle tissue of the uterus has lost strength, elasticity and endurance after childbirth;

Chorioepithelioma, hydatidiform drift and other diseases of the fetal egg.

Uterine bleeding that occurred regardless of pregnancy:

Discirculatory uterine discharge. They are classified according to age categories: juvenile (at puberty), reproductive (period favorable for the birth of children), menopausal (during menopause);
Neoplasms of the internal genital organs of women - the uterus, ovaries;
The superficial shell of the tumors is broken, as well as cysts on the genitals;
Inflammatory processes of the uterus - endometritis, cervicitis, erosive processes affecting the cervical canal, etc.

Juvenile bleeding - causes, symptoms

During the transformation of a little girl into a beautiful girl, the appearance of intermenstrual bleeding or an increase in blood volume during menstruation is often noticed. Most often, the cause of this is ovarian dysfunction, which is directly affected by frequent psychological stress, excessive physical exercise, malnutrition, constant colds.

When examining teenage girls with uterine bleeding, a lack of ovulation is found due to a violation of hormone production. Often, the causes are insufficiency of blood clotting factors, tuberculosis internal organs reproductive system, tumor formations of the cervical canal and the walls of the uterus.

Regardless of the cause, uterine bleeding during puberty is dangerous to health and life, and an urgent visit to the doctor is necessary.

Bleeding in the active period of reproduction

In this variant, the number of causes that cause bleeding is much greater.

dysfunction of the hormonal system against the background of an abortion, taking a number of medicines, "games" with hormonal oral contraceptives;
on the early dates pregnancy, bleeding is the result of spontaneous abortion;
ectopic pregnancy - after a rupture of the fallopian tube;
cystic drift, presentation and abruption of the placenta;
decline muscle tone uterus;

after childbirth, bleeding due to incomplete discharge of the placenta;

fibroids, endometriosis, uterine tumors, endometritis.

Danger during menopause

Menopause is not the easiest time in a woman's life - the reorganization of the hormonal sphere, which is why bleeding is not rare. Among other reasons, neoplasms with and without malignancy should be distinguished. Particular attention of women is necessary in the post-menopausal period, when periodic periods have long ceased, and blood suddenly appeared.

If even a small amount of blood appears, urgently go to the doctor. Do not despair if the problem is a tumor, in the initial stages it is easily treatable. For diagnostic examination in the period of menopause, histological material is taken from the cervical canal and the body of the uterus, after which a microscopic examination of the scraping will reveal the cause of bleeding.

Dysfunctional uterine bleeding

This group of bleeding cannot be separated strictly at any age. They can be both during puberty and during menopause.

Dysfunctional uterine bleeding is a popular variety, and is characterized by dysfunction endocrine system, starting with the hypothalamus and pituitary gland, and ending with the ovaries and adrenal glands.

Gynecology highlights the main causes of dysfunctional uterine bleeding:

endocrine disorders associated with the thyroid gland,
pancreas, as well as against the background of obesity;
overwork - emotional and physical;
climate change;
artificial termination of pregnancy, often independent.

According to the time of appearance of blood in periods of the menstrual cycle:

ovulatory - depend on menstruation, the period of maturation of the egg and its release from the follicle;
anovulatory - intermenstrual bleeding that is not associated with the menstrual cycle. As a rule, with anovulatory bleeding, the duration and volume of the menstruation itself changes.

Breakthrough bleeding

They cannot be attributed to any category, as they appear against the background of the initial intake of oral hormonal contraceptives. A small amount of bloody discharge is a manifestation of the adaptation of the body of women to a new drug. But to further prevent their occurrence, contact your gynecologist for dosage adjustment.

This phenomenon is rare, but you should take it seriously and consult a gynecologist

Symptoms and first signs

All clinical symptoms divided into general and local.

weakness throughout the body, dizziness;
skin is pale;
nausea, urge to vomit;
loss of consciousness;
weakened thready pulse;
lowering blood pressure.

Local symptoms of uterine bleeding:

The appearance of bloody discharge from the vagina;
With menstruation, you notice an increase in the number of clots, the total volume of secretions has become larger, one hygiene product quickly becomes unusable;
After intercourse in women, there may be a slight tint;
Given the fact that bleeding can be profuse and not very, pain does not appear;
Signs of uterine bleeding appear regardless of menstruation.

Regularly occurring symptoms of heavy uterine bleeding indicate tumors (for example, fibroids), adenomyosis, or disorders of the body's blood system.

Treatment and first aid

It is impossible to figure out the causes of uterine bleeding on your own, for sure the gynecology department will cope with this faster and better, and therefore, if you notice strange symptoms and unplanned spotting, immediately call an ambulance. Signs of uterine bleeding are a serious signal from the body of women about global problems, and every minute can be decisive.

Treating uterine bleeding in women at home is an absurdity of the highest degree, but there are certain rules, the implementation and non-observance of which will help save a life.

apply a warm compress, a heating pad on the abdomen;
do douching;
forget about a warm bath;
take medications that affect uterine contractions.

Uterine bleeding in women - first aid at home:

Strict bed rest with raised legs. roller under lower limbs will not give the opportunity to suffer from blood loss to vital organs - the brain, kidneys, liver, which means that the likelihood of loss of consciousness is excluded;
Cold. Try to stop the bleeding yourself. Bubble, heating pad or bottle of cold water or ice place on the lower abdomen, pre-wrap with a towel to prevent frostbite. minutes of cold compress, after a five-minute break, continue for two hours. Such an unpretentious method of treatment will narrow the vessels and reduce the percentage of blood loss;
We replenish the volume of circulating blood. At home, in emergency situations, it is difficult to come up with an alternative to droppers, but plenty of warm sweet drinks can restore blood loss. Glucose will feed the brain cells;
Emergency help - medicines. Once again, we point out that taking medications should be performed only in extreme cases or after consulting a doctor. In a home medicine cabinet, the presence of aminocaproic acid, calcium gluconate, and dicynone will not be superfluous.

Uterine bleeding should be understood as the discharge of blood from the uterine cavity. They are distinguished from menstruation by the intensity, volume, duration of blood loss, as well as regularity.

Causes of uterine bleeding.
Uterine bleeding occurs due to a malfunction of the hypothalamus-pituitary-ovarian system, which regulates ovarian function, these are the so-called dysfunctional bleedings. Violation of the process of production of gonadotropic hormones of the pituitary gland, which affect the maturation of the follicle and ovulation, leads to disturbances in folliculogenesis and menstrual function. Moreover, the follicle in the ovary does not mature or matures without ovulation, but. this means that the corpus luteum is not formed either. As a result, estrogens (hyperestrogenia) affect the uterus, since the production of progesterone stops, its cycle is disrupted. Hyperplasia occurs (when the endometrium grows too much), and further rejection of the endometrium, which is accompanied by uterine bleeding, which is profuse and prolonged.

It is important to note that hyperestrogenism in dysfunctional uterine bleeding greatly increases the risk of developing adenocarcinoma, fibrocystic mastopathy, diseases of the uterus and appendages, breast cancer.

Dysfunctional uterine bleeding is divided into ovulatory, that is, associated with menstruation (deviations in the volume and duration of blood loss during menstruation), and anovulatory - observed between menstruation and occurring after a delay or less than 21 days after the last menstruation. Ovarian dysfunction often provokes the development of infertility, miscarriage. Turning to the doctor in time, namely immediately after the appearance menstrual disorders, you will avoid dangerous consequences in future.

The causes of uterine bleeding can also be diseases of the uterus and appendages, in particular fibroids, endometriosis, adenomyosis, various tumors of a benign and malignant nature. In very rare cases, diseases that are not related to the work of the genital organs, in particular liver diseases, blood disorders, can contribute to the development of uterine bleeding. In this case, in addition to uterine bleeding, patients also note other types of bleeding (nose, bleeding gums, severe blood loss with minor cuts, etc.). Such bleeding is classified as organic, that is, associated with the political science of the genital organs or systemic diseases.

Uterine bleeding (profuse) can also occur with hypothyroidism (hyperthyroidism) or a malfunction of the thyroid gland.

Uterine bleeding is also noted as a complication of pregnancy and childbirth. Prolonged bleeding from the uterus can be observed with anemia.

You should also highlight iatrogenic bleeding observed due to the use of intrauterine contraceptives, the use of non-hormonal and hormonal contraceptives, drugs that help thin the blood.

Symptoms of uterine bleeding.
The main manifestation of this pathological condition is the discharge of blood from the vulva. Uterine bleeding differs from normal menstruation:

Increased blood loss (normal up to 40-80 ml, pathology - over 80 ml). A woman may notice a pathology due to the need for a more frequent change of hygiene products (every half hour to one and a half).
Increased bleeding time (over seven days).
Menstrual disorders associated with a decrease or increase in its interval.
The occurrence of bleeding after sexual contact.
Observed uterine bleeding in the postmenopausal period, after the cessation of menstruation.

From here, the following symptoms of uterine bleeding can be noted:

Menorrhagia (hypermenorrhea) - excessive and prolonged menstruation, while maintaining their regularity (21-35 days).
Metrorrhagia - low-intensity spotting in the middle of the cycle.
Menometrorrhagia - prolonged bleeding of an irregular nature.
Polymenorrhea is a violation of the cycle, expressed in too frequent bleeding (less than 21 days). As a rule, prolonged and intense blood loss in this pathology provokes the development of iron deficiency anemia (low hemoglobin in the blood), in which dizziness, weakness, pale skin, and shortness of breath are common symptoms.

Types of uterine bleeding.

Uterine bleeding in the neonatal period.
Occur, as a rule, in the first week of life and are of a meager bloody nature. Their appearance is due to a sharp change in hormonal levels. They pass quickly and on their own, usually no treatment is needed.

Uterine bleeding of the first decade (before puberty).
They are observed very rarely and are explained by the presence of ovarian tumors, which can produce elevated level sex hormones (so-called hormonally active tumors). As a result, false puberty is observed.

Juvenile uterine bleeding.
As a rule, they occur in the period of puberty of girls (from 12 to 18 years). The main cause that causes bleeding in this period is ovarian dysfunction. The causes of such failures may be psychological trauma, infections in chronic form, excessive physical activity, frequent cases of acute respiratory viral infections, malnutrition. In addition, such a factor as seasonality plays an important role here. Winter and spring are the periods in which bleeding is most common, while, as a rule, they are anovulatory, that is, when ovulation does not occur. Very rarely, but such cases occur when tuberculous lesions of the genital organs, blood clotting disorders, tumors of the ovaries, cervix and body of the uterus can provoke bleeding. Prolonged and severe uterine bleeding during this period provokes the development of anemia. Treatment of girls during this period is carried out only in stationary conditions.

If bleeding occurs, be sure to call an ambulance, and at this time the girl must be provided with complete rest and bed rest. She should take a hemostatic drug (it can be aminocaproic acid, Dicinon, Vikasol (one tablet), put a cold heating pad on the lower abdomen. In stationary conditions, the treatment is symptomatic. Mainly used hemostatic drugs, drugs whose action is aimed at reducing the uterus (Oxytocin) If this is not enough, prescribe hormonal preparations to stop bleeding.

Curettage with this kind of bleeding is not performed, with the exception of heavy and life-threatening bleeding, which even hormonal treatment could not stop. In order to prevent the development of rebleeding, vitamin therapy, iron preparations, as well as some physiotherapy procedures, acupuncture are prescribed.

After the bleeding has been stopped, specialists prescribe estrogen-progestogen drugs, the purpose of which is to restore the normal menstrual cycle. During the recovery period, a special role is played by physical exercises, balanced nutrition, treatment of existing chronic infections.

Bleeding in the reproductive period (age from 18 to 45 years).
During this period, there can be a lot of reasons for the development of uterine bleeding. Dysfunctional factors mainly affect the production of sex hormones due to abortions, endocrine diseases (obesity, diabetes etc.) and infectious nature, severe stress, various intoxications, as well as taking some medications. Bleeding of a dysfunctional nature can be observed at absolutely any age, from puberty to the menopausal period.

Often, dysfunctional uterine bleeding occurs during childbearing, in particular, in the early stages of pregnancy, this is most often due to the threat of miscarriage and ectopic pregnancy (pain in the lower abdomen, delayed menstruation and normal signs of pregnancy are observed), and on later dates this condition occurs due to placenta previa or hydatidiform mole. At the first sign of bleeding during pregnancy, no matter how long, you need to go to the doctor. In the early stages, with timely treatment and appropriate therapy, pregnancy can be saved, but in the later stages, there is often a need for curettage.

At the end of the second and beginning of the third trimesters of gestation, bleeding can be life-threatening for both the mother and the baby, so a quick call to a specialist plays a huge role here. Often, bleeding occurs against the background of placenta previa (when the entrance to the uterus is partially or completely blocked), placental abruption, and also in case of uterine rupture. In these situations, bleeding can be internal and external, and therefore requires an emergency operation. caesarean section. The fair sex, who are at risk of developing such conditions, should be regularly observed by specialists. In the process of labor, the occurrence of bleeding (mainly due to placental abruption, atony or hypotension of the uterus) is especially dangerous, since it is accompanied by large amounts of blood loss.

After delivery, the causes of bleeding are mainly:

poor uterine tone and its weak ability to contract;
not completely released parts of the membranes;
blood clotting disorder.

In the childbearing period, uterine diseases can also provoke uterine bleeding: fibroids, endometriosis, tumors of various nature, chronic inflammation (endometritis), hormone-dependent ovarian tumors.

Uterine bleeding in menopause.
AT menopausal periods such conditions develop as a result of a violation of the production of hormones or against the background of diseases of the genital organs. Since during this period in the body occur hormonal changes, then bleeding is a common occurrence, however, it is important to consult a doctor, as they can be harbingers of malignant or benign neoplasms. This is especially true for the postmenopausal period. Remember, a timely visit to a doctor (at the first symptoms and manifestations) is the key to the success of further treatment.

For accurate diagnosis, separate diagnostic curettage of the cervical canal and uterine body is carried out, after which histological examination scraping to determine the cause of the bleeding. With dysfunctional uterine bleeding, optimal therapy with hormonal drugs is prescribed.

Breakthrough uterine bleeding.
Such bleeding develops against the background of hormonal disorders. It is hormones that are responsible for the normal menstrual cycle, as they maintain a balance between estrogen and progesterone. If everything is good, then menstruation always begins at the right time and is not plentiful. If the hormonal balance is disturbed, a strong growth of the endometrium begins, against which its rejection occurs in parts, and the result is breakthrough bleeding. Hormonal failures are most often observed in girls in adolescence and in women in the menopausal period.

Breakthrough bleeding can occur when taking hormonal oral contraceptives, which is explained by adaptation to the drug used. In this situation, you should consult your doctor about changing the dose used. If the increase in dosage does not stop the bleeding or it becomes more profuse, it is necessary to be examined for the presence of diseases of the reproductive organs. In addition, such conditions can develop against the background of damage to the walls of the uterus by an intrauterine contraceptive (IUD). In this situation, the woman is shown the removal of the intrauterine device.

Diagnostics.
At the first suspicion of uterine bleeding, you should seek help. It is very good if a woman keeps a menstrual calendar, noting the intensity, duration and nature of bleeding in it. This calendar will help the doctor in the future in diagnosing and prescribing optimal therapy. For the purpose of diagnosis, tests of smears from the cervix for cancer, tests for the presence of uterine bleeding are carried out. An ultrasound examination is required, as well as a measurement of the inner layer of the endometrium (its thickness). also do general analysis blood, “hormones”. If a woman is overweight or when her age approaches the menopause period, a biopsy of the inner layer of the uterus is taken (a small fragment of the endometrium is plucked off and examined under a microscope). Accurate diagnosis is of paramount importance for the appointment of further optimal therapy.

Treatment of uterine bleeding.
Therapy of such conditions has four main goals: stopping bleeding, replenishing blood loss, eliminating the root cause and prevention. I note that uterine bleeding of any nature is treated in stationary conditions. The methods used for this take into account the age of the patient, the cause of bleeding, and the severity of the condition.

The main method of stopping bleeding is surgical diagnostic curettage, which also makes it possible to find out the cause of their appearance. Application hormone therapy is another way to stop bleeding. For these purposes, mainly estrogenic or combined oral contraceptives are used, among them Marvelon, Mercilon, etc. For symptomatic treatment, hemostatic drugs are used, for uterine contraction, iron preparations (for low hemoglobin levels) or blood components, vitamins and vascular strengthening drugs (Ascorutin, Folic acid, vitamins C, B6, B12). After the uterine bleeding has been stopped, preventive actions.
In case of dysfunction, hormonal therapy is prescribed with combined oral contraceptives or drugs based on gestagens, or a hormonal intrauterine device is installed. If intrauterine pathologies were detected during the diagnosis, appropriate treatment is prescribed.

Treatment folk remedies.
For the treatment of uterine bleeding, traditional medicine methods can be used, only first you should consult a doctor and identify their cause. To stop uterine bleeding, decoctions and extracts based on raspberry leaves, yarrow, nettle, burnet, shepherd's purse, etc. are effective. Here are some recipes:

Yarrow infusion: Purchase a box of yarrow herb from the pharmacy. Take two teaspoons of dry herbs in a glass of boiling water, cover the bowl with liquid and soak for an hour, then strain. Ready infusion to drink four times a day (before meals), the dosage is 50 ml or 1/4 cup.

Decoction of yarrow: pour the herb in the amount of one tablespoon with a faceted glass of boiling water, then simmer for ten minutes from the moment of boiling. Then cool the broth, strain and you can drink. Do this before meals three times a day for 1/3 cup. It shows its hemostatic efficacy, both in internal and external uterine bleeding.

Shepherd's purse herb infusion: a tablespoon of finished herbs (in dry form, purchased at a pharmacy), pour a glass of boiling water, wrap it carefully and wait an hour. Then, after insisting the mixture, strain it and you can take the infusion in a tablespoon. This should be done three times a day before meals.

Infusion of nettle dioecious: pour a tablespoon of raw materials with a glass of boiling water, hold on low heat for ten minutes, then cool and strain. Take also a tablespoon four times a day before meals. As a preventive measure for the development of uterine bleeding, you can take an extract of this plant, it is easy to find in a pharmacy. The dosage is as follows: 30-40 drops half an hour before meals, dilute the drops with water (1/4 cup).

Pour the peel of six large oranges with one and a half liters of water, cook over low heat until the liquid is reduced to 500 ml. After that, drain the broth, take four teaspoons three times during the day.

Prevention of uterine bleeding.
The best prevention is considered to be a systematic visit to a gynecologist (at least once a year), a full course of treatment of existing ailments in terms of the genital area, personal hygiene and daily routine, regular sex life, and with one partner (permanent), healthy lifestyle life and boost the immune system.

Acute pathological uterine bleeding is a common problem faced by practicing gynecologists. Even single such cases sometimes require immediate medical attention. The causes of this pathology are numerous. To solve the problem and understand how to stop uterine bleeding, it is necessary to take into account the woman's age, her menstrual function and medical history, risk factors for endometrial pathology and blood coagulation.

Etiology of acute abnormal uterine bleeding

The etiology of uterine bleeding can be multifactorial. This pathology is classified as associated with structural abnormalities of the uterus and disorders in the blood coagulation system. This happens for reasons:

polyp;
hyperplasia;
adenomyosis;
leiomyomas;
cancerous processes of the body and cervix;
coagulopathy;
ovulatory dysfunction;
endometriosis;
pregnancy;
iatrogenic factors.

Determination of the most probable etiology has importance in choosing the most appropriate and effective way bleeding control for a particular patient and is achieved by taking an anamnesis, physical and gynecological examination and blood tests.

Clinical examination of hemostasis disorders in a woman with excessive menstrual bleeding

Initial screening for an underlying disorder of hemostasis in such women should be based on their medical history. Positive result research includes the following:

heavy menstrual bleeding, starting with menarche;
postpartum hemorrhage;
operations accompanied by blood loss;
violations of the coagulation system in the treatment of teeth.

In this case, the following conditions must be taken into account:

hematomas once or twice a month;
frequent nosebleeds;
persistent bleeding from the gums;
symptoms of coagulopathy in close relatives.

History or anamnesis

Obtaining a thorough anamnesis is necessary to focus on the circumstances of the bleeding. This takes into account concomitant symptoms and past causes of menstrual irregularities, details of gynecological and medical history and data from relevant laboratory and radiological tests.

Up to 13% of women with severe menstrual bleeding have a variant of von Willebrand disease and up to 20% of patients may have bleeding disorders. Other causes of coagulopathy, such as decreased clotting factors, hemophilia, and platelet dysfunction, can occur in any age group. In addition, with systemic diseases such as leukemia and liver failure, as well as with medications such as anticoagulants or chemotherapy drugs, clotting may decrease and this may cause bleeding. All this is taken into account in the development of tactics for solving the upcoming question: how to stop uterine bleeding.

Physical examination

Physical examination of a patient with uterine bleeding should begin with an assessment of acute blood loss and the main symptoms, which are hypovolemia, anemia, and findings that suggest an etiology of the disease. The woman's condition should be assessed so that the doctor can determine that she has uterine bleeding and not bleeding from other areas of the genital tract. Thus, a gynecological examination, including examination of the cervix in the mirrors and bimanual palpation, should be performed by a gynecologist in order to identify any injuries to the genitals, vagina, or cervix. All this allows us to draw conclusions, which was the cause that caused vaginal bleeding. A gynecological examination will also determine the volume, intensity of bleeding, the condition of the uterus, internal genital organs, or structural lesions of the reproductive organ (leiomyoma).

Laboratory research

Laboratory evaluation of patients with this disease is necessary. All adolescents and women are carefully examined for hemostasis disorders. Taking into account the clinical picture, it is required to take into account the pathology of the thyroid gland, liver dysfunction, sepsis, leukemia, etc. Endometrial tissue sampling should be performed in all women. This is especially true for patients over 45 years of age. Endometrial biopsy should also be performed in women younger than 45 years of age with a history of exposure to unconjugated estrogens (eg, observed in patients with obesity or polycystic ovary syndrome), a primary bleeding event, or with persistent such manifestations. The decision as to whether to perform a pelvic ultrasound should be based on a clinical assessment of the data.

Initial laboratory testing requires:

determination of the group and Rh factor;
pregnancy test;
registration of activated partial thromboplastin time;
prothrombin time;
determining the amount of fibrinogen;
initial testing for von Willebrand disease;
determining the level of thyroid-stimulating hormone;
identifying serum iron, total iron-binding capacity and ferritin;
liver function tests;
detection of chlamydia trachomatis.

Control of acute abnormal uterine bleeding in non-pregnant women of reproductive age

The initial assessment of a patient with acute abnormal uterine bleeding should be to test her for signs of hypovolemia and potential hemodynamic instability. Measures to stop bleeding are intravenous administration conjugated estrogens, combined oral contraceptives, oral progestins and tranexamic acid. Decisions should be based on the patient's medical history and contraindications to therapy. Surgery should be considered for those women who are not clinically stable. The choice of surgical intervention should be based on the patient's underlying comorbidities underlying the pathology and the woman's desire to have children in the future. Once an acute episode of bleeding has been resolved, transition to long-term maintenance therapy is recommended.

Uterine bleeding is defined as bleeding from the body of the uterus if it is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy. This pathology can be acute or chronic. Acute bleeding is a situation that requires immediate intervention to prevent further blood loss. An acute process can occur spontaneously or in conditions of chronic spotting or bleeding. The overall assessment of a patient who has this pathology should go through three stages:

determination of the amount of blood loss;
clarification of the most probable etiology;
choosing the right treatment.

Treatment

Limited evidence, expert opinion and recommendations decide how to quickly stop uterine bleeding. The choice of the method of therapy in this case depends on the clinic and etiology, taking into account the main medical problems. The two main goals of management are to stop bleeding and control to reduce menstrual blood loss in subsequent cycles. Medical therapy is considered the preferred primary treatment option. However, certain situations may necessitate surgical intervention.

Basic drugs

How to stop uterine bleeding? The drugs used for this purpose are hormonal agents. They are considered the first line drug therapy for patients with acute bleeding. Treatment options include combined oral contraceptives and oral progestins.

Antifibrinolytic drugs such as tranexamic acid are used to prevent fibrin degradation and are effective in treating patients with any form of bleeding. Tranexamic acid effectively reduces the rate of intraoperative blood loss and removes indications for blood transfusion in surgical patients.

Patients with coagulation disorders or those who are suspected of bleeding may develop unpredictable reactions to hormonal and non-hormonal treatments. For such patients, consultation with a hematologist is recommended, especially if the bleeding is difficult to control or the gynecologist cannot cope with this pathology on his own. Desmopressin may help treat patients with von Willebrand's disease if the woman is known to respond to this drug. It can be administered as an intranasal inhalation, intravenously or subcutaneously. This remedy should be used with caution due to the risk of fluid retention and hyponatremia. It should not be given to patients with massive bleeding receiving intravenous resuscitation. Recombinant factor VIII and von Willebrand factor are also available and may be necessary to control major bleeding. Other disadvantage factors may require factor-specific substitutions.

Patients with bleeding disorders or platelet dysfunction should avoid non-steroidal anti-inflammatory drugs because of their effect on platelet aggregation and their interaction with substances that can affect liver function and the production of blood clotting factors.

Surgery

How to stop uterine bleeding with endometrial hyperplasia or with myoma? Need surgical treatment based on the clinical stability of the patient, the severity of bleeding, the presence of contraindications for therapeutic treatment, no response to medical preparations and associated pathology. Surgical options include endometrial dilatation and curettage, endometrial ablation, uterine artery embolization, and hysterectomy. The choice of the method of surgical intervention is made on the basis of the above factors plus the desire of the patient to maintain fertility in the future.

Specific procedures such as hysteroscopy, polypectomy, myomectomy may be required if structural abnormalities are suspected as the cause of the identified pathology. And so the question of how to stop uterine bleeding with myoma or polyposis is decided in favor of surgical methods. Dilation and curettage alone (without hysteroscopy) is an inadequate tool for evaluating uterine disorder and may provide only temporary relief from bleeding. If they are carried out with concomitant hysteroscopy, then this may be of importance for those patients in whom intrauterine pathology is suspected, or it is desirable to obtain a tissue sample to identify certain processes. Case reports of uterine artery embolization and endometrial ablation have shown these procedures to be successful in managing bleeding. Endometrial ablation, although readily available at most centers, should only be considered if other treatments have failed or are contraindicated. This procedure should only be performed when the woman has no plans for future childbearing and uterine cancer has been reliably excluded as the cause. Hysterectomy is used as a definitive treatment for excessive bleeding, which may be necessary for patients who do not respond to medical therapy.

Thus, it was listed in what ways and how to stop uterine bleeding in the hospital.

Special cases

In most cases, a woman does not know why she has bleeding, and does not suspect that she has certain predisposing factors for the development of this uterine pathology. But sometimes there are diseases that the patient knows about, and it is her information, as well as additional methods Examinations help in clarifying the diagnosis and choosing a specific treatment strategy.

Bleeding during pregnancy

During perimenopause, the most common cause of abnormal bleeding is hormonal changes that prevent ovulation. Regular but much more severe periods are very common in the years leading up to menopause. For women in their 40s, low-dose birth control pills can also help control heavy uterine bleeding. How to stop it and deal with other perimenopausal symptoms, including hot flashes, night sweats, premenstrual syndrome, and headaches? This will help the use of tableted contraceptives when used on an ongoing basis. After the age of 50, with hormone replacement therapy (which consists of lower doses of estrogen and progesterone than pills), it is possible to eventually wean the patient off hormones altogether if the menopausal symptoms gradually decrease.

In perimenopause, some choose not to take birth control pills therefore, other conservative methods of stopping bleeding can be used in this case. The progesterone-IUD is one such option, and it provides a great opportunity for birth control that can last five years. The device secretes progesterone, a hormone that works in the lining of the uterus, resulting in menstruation without complications. An IUD is the preferred option for women who need reversible methods of contraception.

How to stop uterine bleeding surgically? Removal of the endometrium is a minimally invasive procedure that has proven effective in treating severe perimenopausal bleeding and may even help some patients avoid hysterectomy. Ablation procedures have been used quite successfully to reduce the amount of bleeding, in some cases leading to a complete cessation of the menstrual cycle. This procedure is not a method of birth control and is used only for women who have completed childbearing.

For patients who have not responded to drugs and less invasive options, this perimenopausal surgery may be the best option to address the issue of how to stop uterine bleeding. For endometriosis, fibroids, hyperplasia, polyps, hysterectomy is the most preferred method for women with such changes. In this case, the amputation of the uterus is possible using various options. The doctor should know the concomitant diseases of such a woman.

How to stop uterine bleeding at home

Bleeding in any case requires a visit to a doctor to determine the cause and prescribe adequate treatment. Before the arrival of the ambulance, it is necessary to take a horizontal position and raise the legs at the same time. You can put a heating pad with ice on the lower abdomen. Compresses and warming procedures are strictly contraindicated. How to stop uterine bleeding at home, what decoctions and preparations can be used? This is well known to older women. "Vikasol", "Ditsinon", "Oxytocin", "Tranexamic acid" - these are the drugs that should be in every woman's first aid kit. These medicines help in deciding how to stop uterine bleeding at home.

Folk remedies

Traditional medicine recipes are used in the treatment of many diseases. How to stop uterine bleeding folk remedies? This question interests both young girls and older women. Most often, in this case, a decoction of nettle leaves, yarrow, shepherd's purse, tincture of water pepper is used. Decoctions are also prepared from cucumber lashes, yasnotki, pepper mountaineer. However, such treatment can only be used as an auxiliary method and only after consulting a doctor.