Abnormal Uterine Bleeding: Symptoms, Causes, Diagnosis, Treatment

What Is Abnormal Uterine Bleeding?

Abnormal uterine bleeding is when you bleed outside of your normal monthly period. You might hear it called anovulatory bleeding. Your flow could also be heavier or last longer than what’s typical.

When it comes to menstrual cycles, there’s a wide range of “normal.” But your period shouldn’t be a problem for you month after month. If it’s so heavy or unpredictable that it keeps you from doing some activities or makes you miss work or school, you may have a medical condition that should be treated.

Abnormal Uterine Bleeding Symptoms

The signs of abnormal uterine bleeding include:

• Heavy period (menorrhagia)
• Bleeding between your periods, after sex, or during menopause
• Long periods (more than 7 days)
• Irregular periods

Doctors check these things when diagnosing abnormal uterine bleeding:

• How often you get your period. It should be fairly regular. The length of each cycle shouldn’t change by more than a week. If it’s shorter than 3 weeks or longer than 5, that could be a sign of a problem.
• How long it lasts. A typical period lasts 4 or 5 days. If yours is often less than 2 days or longer than a week, that could mean something’s wrong.
• How heavy it is. Most women only lose about 2 tablespoons of blood each period. More than 5 tablespoons is thought to be unusually heavy, but that’s hard to judge. Let your doctor know if you need more than one tampon or pad in an hour. Abnormally heavy menstrual bleeding is called menorrhagia.
• Whether you have spotting between periods.
• Whether you have bleeding after sex.

If you could be pregnant or you’re past menopause and have any kind of bleeding, call your doctor.

Some spotting is common early in pregnancy, but bleeding can be a sign of a serious condition called an ectopic pregnancy. That’s when a fertilized egg implants somewhere outside your uterus, most commonly in a fallopian tube. It could also mean you’re having a miscarriage.

After menopause, women who take hormone replacement therapy may still have periods. But any bleeding should be checked out.

Abnormal Uterine Bleeding Causes

There are a few possible causes behind abnormal uterine bleeding:

Hormone changes. Problems with your hormones are the most common reason for abnormal uterine bleeding. When one of your ovaries releases an egg (called ovulation), certain hormones tell your body to build up and then shed the lining of your uterus (called the endometrium). With teenagers and women getting close to menopause, the endometrium can build up too much. That can lead to an irregular or heavy period or spotting between periods.

These things can throw off your hormones, too:

Problems with your uterus. Another possible reason for abnormal bleeding is a physical problem with your uterus. Millions of women have fibroids — noncancerous tumors that grow in the muscles of the wall of the uterus. A polyp is another kind of growth that can form in the lining of your uterus. A condition called adenomyosis is where the cells similar to the ones that grow in the lining of the uterus start to grow in the muscle part of the uterus. Endometriosis can also cause abnormal bleeding. This is when tissue like the kind that lines the inside of your uterus grows outside of your uterus.

Other health conditions. These are much less common, but abnormal uterine bleeding also can result from:

• Bleeding or clotting disorders or blood-thinning medicines
• Cancer of the cervix, endometrium, or uterus
• Illnesses that affect your kidneys, liver, thyroid, or adrenal glands
• Infection of your cervix or endometrium
• Sexually transmitted diseases

Abnormal Uterine Bleeding Diagnosis

It can help to take detailed notes over a few cycles so you can give the doctor specific information about your symptoms. They’ll also ask about your overall health and give you a physical exam. You’ll probably get a pregnancy test, and you may also have:

• Blood work. Heavy bleeding can leave your body short of iron. A blood test can see if that’s a problem for you. It can also show if your hormones are out of balance or if you have a blood disorder or chronic disease.
• Ultrasound. This uses sound waves to make images of the inside of your uterus so your doctor can look for fibroids or polyps.
• Hysteroscopy. The doctor will look inside your uterus with a tiny lighted scope that they put in through your cervix.
• Biopsy. The doctor may take out a small piece of tissue and check it under a microscope for abnormal cells.
• Magnetic resonance imaging. This test uses radio waves and powerful magnets to make detailed pictures of your uterus. It isn’t used that often, but it can help spot adenomyosis.

Abnormal Uterine Bleeding Treatment

Your treatment will depend on the cause of the abnormal uterine bleeding — if a chronic illness or a blood disorder is at the root of your symptoms, treating that can help.

Treatment also can depend on whether you plan to have children. It might not be safe to get pregnant after some treatments, while others can make it impossible. If you’re close to menopause, the doctor may want to take a wait-and-see approach because your symptoms may get better on their own.

Drugs are usually the first thing your doctor will try. They include:

• Hormones.Birth control pills and other hormone treatments may be able to give you regular menstrual cycles and lighter periods.
• Gonadotropin-releasing hormone agonists (GnRHa). These stop your body from making certain hormones. They can shrink fibroids for a while, but they’re usually used along with other treatments.
• NSAIDS. If you take anti-inflammatories like ibuprofen or naproxen a few days before your period starts, they may help lighten the bleeding.
• Tranexamic acid. This is a pill that helps your blood clot and can control heavy uterine bleeding.
• IUD. For some women, an IUD that releases a hormone called progestin can stop heavy bleeding. Many women who use one don’t get a period at all.

Sometimes surgery can be needed to stop the bleeding:

• Endometrial ablation. This uses heat, cold, electricity, or a laser to destroy the lining of your uterus. It may end your periods entirely. You probably won’t be able to get pregnant after having it done, but it can be dangerous if you do. You’ll need to use birth control until menopause.
• Myomectomy or uterine artery embolization. If you have fibroids, the doctor may take them out or cut off the vessels that supply them with blood.
• Hysterectomy. This is when the doctor removes your uterus. You may need a hysterectomy if your fibroids are very large or you have endometrial or uterine cance r. Otherwise, it’s a last resort when other treatments haven’t worked.

Abnormal Uterine Bleeding Complications

Complications that may happen with abnormal uterine bleeding include:

• Trouble getting pregnant
• Anemia or blood loss
• Higher risk of endometrial cancer

Abnormal bleeding: Why women should treat it, not tough it out | Women’s Health

Women of any age can experience abnormal bleeding – that is, bleeding that is heavy, lasts long periods of time, or occurs outside of regular menstrual cycles. When we say abnormal bleeding, the textbooks define it as blood loss from the uterus in excess of 2.8 ounces, or about a third of a cup over a few days. But who is actually measuring their blood loss? For practicality, abnormal bleeding is bleeding that interferes with regular activities.

Many women also deal with irregular periods that come so irregularly that they feel they are bleeding all the time or so infrequently that the bleed only once every 3-4 months. Though fewer periods may be desirable, it needs to be evaluated. Abnormal bleeding or spotting often happens:

• After menopause
• After sex
• Between periods

Abnormal bleeding can make everyday activities such as working, exercising, or socializing stressful and difficult. Some women even have to wear a pad as well as a tampon for protection, yet they think it’s normal and try to tough it out.

Abnormal bleeding is not “normal,” and you don’t have to live with it. Help is available, whether you’re a teen who’s just starting to deal with abnormal bleeding or a woman in perimenopause who’s struggled for years. Let’s discuss the primary causes of abnormal bleeding, some common treatment options, and which associated conditions can exist.

What causes abnormal bleeding?

To diagnose the cause, we first must determine the source of the bleeding. Is it coming from the uterus, the cervix, or the vagina? Sometimes, bleeding that is thought to be coming from the vagina may actually be from the bladder or the bowels.  Next, we discuss the patient’s symptoms. Then we perform a physical examination, which will generally include a pelvic exam to check the cervix and vagina as well as all potential sources of bleeding.

One of the most common causes of bleeding and discharge is cervicitis, an infection that often is triggered by sex. It causes inflammation and irritation of the cervix, which is located at the lower end of the uterus. Often, we will also evaluate the cervix for cancerous and pre-cancerous lesions of the cervix by performing a pap test.

However, abnormal bleeding can be the result of many conditions, many of the uterus (or the womb). To identify a condition, we follow the acronym PALM-COEIN (pronounced palm coin) for the primary conditions of the uterus that lead to abnormal bleeding:

• Polyps: growths, or small clumps of cells, that form when cells in the lining of the uterus overgrow
• Adenomyosis: the result of tissue that normally lines the uterus growing into the uterine wall
• Leiomyoma: benign tumors in the uterus, often called fibroids
• Malignancy and hyperplasia: when the lining of the uterus (endometrium) becomes too thick
• Coagulopathy: when the body’s ability to clot is worsened, usually due to reduced levels or absence of blood-clotting proteins
• Ovulatory dysfunction: a very common cause of abnormal bleeding and occurs when ovulation is abnormal, irregular, or absent
• Endometrial: abnormal functioning of endometrial tissue
• Iatrogenic: when bleeding could be the result of birth control, other hormonal drugs, or other medications
• Not otherwise classified: when doctors can’t discern one specific cause for bleeding issues

If the diagnosis still is not apparent after a physical exam, testing through ultrasound, endometrial biopsy, and other tests that may include examination for infections can help us diagnose the condition. Finally, we discuss treatment options.

Abnormal Uterine Bleeding | ACOG

Abnormal Uterine Bleeding: Bleeding from the uterus that differs in frequency, regularity, duration, or amount from normal uterine bleeding in the absence of pregnancy.

Cervix: The opening of the uterus at the top of the vagina.

Ectopic Pregnancy: A pregnancy in which the fertilized egg begins to grow in a place other than inside the uterus, usually in the fallopian tubes.

Endometrium: The lining of the uterus.

Fibroids: Benign (noncancerous) growths that form on the inside of the uterus, on its outer surface, or within the uterine wall itself.

Gonadotropin-releasing Hormone (GnRH) Agonists: Medical therapy used to block the effects of certain hormones.

Intrauterine device (IUD): A small device that is inserted and left inside the uterus to prevent pregnancy.

Menopause: The process in a woman’s life when ovaries stop functioning and menstruation stops.

Menstrual Cycle: The monthly process of changes that occur to prepare a woman’s body for possible pregnancy. A menstrual cycle is defined as the first day of menstrual bleeding of one cycle to the first day of menstrual bleeding of the next cycle.

Miscarriage: The spontaneous loss of a pregnancy before the fetus can survive outside the uterus.

Obstetrician–Gynecologist (Ob-Gyn): A physician with special skills, training, and education in women’s health.

Ovulation: The release of an egg from one of the ovaries.

Perimenopause: The period before menopause that usually extends from age 45 years to 55 years.

Polyps: Growths that develop from membrane tissue, such as that lining the inside of the uterus.

Sexually Transmitted Infections (STIs): Infections that are spread by sexual contact, including chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Tranexamic Acid: A medication prescribed to treat or prevent heavy bleeding.

Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.

7 reasons you’re spotting the week before your period

You’ve been logging your periods on that tracking app you downloaded to your smartphone and it says you’re supposed to get your period next week. Soooo what gives with the totally random spotting you see in your underwear today? Getting your period is annoying enough — no one wants to blow through their entire tampon stock before a period shows up for real.

Inconvenience aside, spotting before your period can put you a little on edge if you’re just not sure what’s going on with your body. But don’t freak out, as there are a bunch of reasons for why your period is getting ahead of itself that are usually no big deal.

Spotting before your period is most likely related to your body’s ovulation patterns.

The biggest factor at play typically is…hormones (surprise!). “[Spotting before your period] means you’re not ovulating perfectly and not making as much progesterone as you should,” says Dr Mary Jane Minkin, a clinical professor in the department of obstetrics, gynaecology, and reproductive sciences at the Yale University School of Medicine.

Progesterone is one of the hormones involved with making menstruation happen, and Dr Minkin says it plays an important role in stabilizing the lining of your uterus. If you don’t make enough of it during your cycle, some of your uterine lining may be discharged in the five to seven days before your period, which is that spotting you notice.

This is mostly just an annoyance; you don’t have to do anything to address progesterone production, and nothing bad will happen if you ignore it. (The exception here is if you’re planning a pregnancy, in which case you should talk to your ob-gyn about having your hormone levels tested. )

But if the spotting is really bugging you, you can take birth control pills with progesterone, which stop ovulation altogether and provide you with a consistent amount of hormones each month.

Now, what if imperfect ovulation isn’t the cause of your pre-period spotting? You’re probably still not dealing with anything super serious. Dr Minkin stresses that bigger health problems that can cause spotting (we’ll get into some of those in a sec) would also cause symptoms throughout your *whole* cycle, not just the week before your period.

Here are nine other reasons why you might be spotting prior to your period’s big arrival — and what you can do about ’em.

READ MORE: This Is Why You Get Clots In Your Period Blood

1. You’re on a new birth control.

You’re more likely to see spotting throughout your entire cycle if you started a new type of BC, Dr Minkin says, but this could also cause spotting right before your period specifically. This is called breakthrough bleeding, and the estrogen in your birth control is to blame.

Breakthrough bleeding should resolve on its own in a few months after you start your new BC. If it goes on longer than that, Dr Minkin suggests talking to your doc, who may recommend a birth-control method with a lower amount of estrogen.

2. You’re pregnant.

Surprise: You thought your period was arriving a week early, but it turns out it won’t be back for another nine months! Spotting ahead of your normal period week might actually be an early sign of pregnancy, says Dr Minkin. The spotting you’re noticing might actually be implantation bleeding (a.k.a. when the fertilized egg attaches to the uterine lining) or even just the early stages of pregnancy itself.

“About one-third of women will bleed in the first three months of pregnancy,” explains Dr Minkin, who notes that this (obviously) makes some people nervous but does not necessarily signal that anything is wrong with the pregnancy.

If you see spotting the week before your period typically comes but then don’t get a full-fledged period soon after, you should consider taking a pregnancy test.

3. You have a hormone imbalance.

Just like how progesterone can mess with your period, abnormal levels of estrogen may also be to blame for your spotting. Yes, this could mean estrogen changes related to a new BC, as mentioned above, or those associated with perimenopause or menopause.

A thyroid issue may also be at play here. According to Dr Minkin, if you have hypothyroidism (meaning your thyroid produces less thyroid hormone than it should) you might miss periods. And if you deal with hyperthyroidism (when you have an excess of thyroid hormone), you might have heavier periods. Both of these may cause spotting between periods.

If you’re dealing with thyroid dysfunction, you would likely have other symptoms in addition to period issues, such as weight loss/gain or fatigue. It’s likely that your doc would rule out other possible underlying reasons for your pre-period spotting but possibly test your thyroid hormone levels if she suspects a thyroid problem.

READ MORE: Why Is My Period Blood Brown All Of A Sudden?

4. You’re under the weather.

Dr Minkin says almost any kind of illness or infection, from influenza to pneumonia to pelvic inflammatory disease (PID), can throw your whole cycle out of whack and give you any kind of irregular bleeding, including spotting. So if you’re spotting before your period but also battling some kind of sickness, chalk it up to your immune system doing what it does best: prioritizing where it needs to direct more of its energy to get you healthy.

That said, if your spotting comes with pain, fever, or a foul vaginal odour, you should check in with your doc — it could point to the kind of infection that requires medical treatment (like an STD or the aforementioned PID).

5. You just had sex.

On another note, early spotting could be (coincidentally) linked to something else you just happened to do the week before your period — like getting busy with a sexual partner.

This doesn’t actually have anything to do with your period. Medically referred to as “post-coital bleeding,” spotting a bit of blood after recently having sex may happen as a result of friction during intercourse, like if the vaginal lining gets damaged or if you don’t have proper lubrication, according to the Mayo Clinic.

Bleeding in the days after having intercourse doesn’t necessitate a call to your provider unless it’s happening all the time, Dr Minkin says. “If it happens once and goes away, it’s unlikely to be anything bad…but if it’s repetitive, we get concerned about precancerous changes on the cervix and would want to do a Pap smear,” she explains.

READ MORE: 25 Reasons Why You’ve Got Period Symptoms But No Period

6. You’re dealing with fibroids.

Uterine fibroids are benign growths that appear in or close to the uterus, as Women’s Health reported previously. When women visit their gyno and end up discovering they have fibroids, it often has to do with the fact that they were experiencing abnormal bleeding (which could mean before their period, but more likely is happening periodically throughout the entire cycle) and heavy periods that last longer than a week.

Fibroids tend to bring on other symptoms in addition to abnormal bleeding. Those may include pelvic pain or pressure, constipation, the need to pee frequently, and more, according to the Mayo Clinic. So if you have bleeding (especially if it’s heavy) when your period should not be happening, not to mention any of these other symptoms, see your Doc. You can get diagnosed via an ultrasound and lab tests.

7. You have endometrial or cervical cancer.

Gynaecological cancers can present with abnormal bleeding, so it’s important to take any vaginal bleeding that you’re concerned about seriously and get it checked out.

As Dr Minkin points out, a little bit of spotting right before your period in particular most likely isn’t cause for concern. With these cancers, symptoms would happen throughout your whole cycle. (In addition to abnormal bleeding, other symptoms of endometrial or cervical cancers include pelvic pain and bloating.)

But with any health symptom that you feel uneasy about, don’t hold back from getting an expert opinion sooner rather than later—even if it turns out to be nothing serious. You know your body best and are your number-one health advocate.

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Vaginal Bleeding – Abnormal | Aurora, CO

What It Means and What Causes It

• Bleeding after Plan B is normal — it could be spotting or a sign of an early period.
• You may also experience symptoms like breast tenderness, dizziness, nausea, and headache.
• But it could be implantation bleeding if it occurs 10-14 days after you’ve last ovulated.
• Visit Insider’s Health Reference library for more advice.

Plan B, also called the morning-after pill, stops you from getting pregnant by interfering with your menstrual cycle. This means you might notice irregular bleeding after taking the pill.

While some unexpected bleeding is normal, spotting can also be a sign of implantation, one of the early stages of pregnancy.

Here’s how to interpret your post-Plan B bleeding to determine if Plan B worked, or not.

Does Plan B make you bleed?

Bleeding can start any time after taking Plan B — some people start bleeding as early as eight hours after.

“It is common for there to be unexpected or atypical bleeding after taking Plan B,” says Felice Gersh, MD, the medical director of the Integrative Medical Group of Irvine. The reason plan B can cause some bleeding has to do with how it works.

Plan B works to prevent pregnancy by stopping or delaying ovulation. It does this by supplying a synthetic version of progesterone, a hormone your body naturally makes, says Abigail Cutler, MD, a professor of obstetrics and gynecology at the University of Wisconsin.

Having high levels of progesterone can trigger your body to shed the lining of your uterus. When this lining is expelled from your vagina, it shows up as spotting or bleeding.

“This change in hormone levels is also the reason that some people experience a change in the expected timing of their period following Plan B,” Cutler says.

Plan B can trigger your period to come early, so bleeding or spotting may be a sign that it’s working, Gersh says.

According to a 2006 study of people who took Plan B:

• 21% of people got their period two or more days early
• 24% of people got their period two or more days late
• About 15% of people had spotting before their period, which lasted an average of two and a half days

You can tell the difference between spotting and your period because spotting tends to be shorter and much lighter than your usual bleeding.

Most people should expect their period within three weeks of taking Plan B, Cutler says. “If you don’t get a period within 3 weeks, it’s a good idea to take a home pregnancy test to make sure the pill worked,” says Cutler.

Plan B bleeding vs. implantation bleeding

Implantation bleeding occurs when a fertilized egg attaches to the wall of your uterus — this is typically the first stage of pregnancy, meaning Plan B didn’t work. 

There are a few ways to tell the difference between spotting, implantation bleeding, and your period:

Alyssa Powell/Insider

Related

When do you ovulate? How to track your cycle and determine when you are most fertile

Your period may also come early if you take Plan B. The menstrual blood should be similar to your usual period, but it may be darker and stickier than usual. 

If you think you may have implantation bleeding, you should wait at least three days from the start of bleeding to take a pregnancy test. This will give your body time to build up pregnancy hormones and give you an accurate result.

Other side effects of Plan B

In addition to bleeding, Plan B can cause other side effects, including:

• Nausea, vomiting, or diarrhea
• Lower belly pain or cramps
• Feeling dizzy
• Fatigue
• Headache
• Tenderness in your breasts

The most common side effects of Plan B are nausea and cramping, while vomiting and diarrhea are rarer.

When to see a doctor

In rare cases, bleeding after taking Plan B can be a sign of something more serious, especially if it comes with other symptoms like severe abdominal pain.

Generally, bleeding after Plan B shouldn’t last much longer than a week, so prolonged bleeding can be a sign of a problem like an ectopic pregnancy or may lead to a dangerous amount of blood loss.

It’s also concerning if your bleeding is too heavy, meaning you have to change your pad or tampon at least every two hours for longer than a day, Gersh says. 

If you’re having any of these symptoms after taking Plan B, it’s best to see your gynecologist to make sure there isn’t a more serious issue.

Other symptoms that should raise an alarm include:

• Sudden or severe belly pain
• Itching and a rash
• Vomiting within two hours of taking the pill 

Also, if any of the normal side effects like nausea or cramping last more than a day or feel severe to you, it’s best to get medical attention, Gersh says.

Insider’s takeaway

It’s normal to experience bleeding after taking Plan B, especially if you get your period early or just have light spotting. It’s also normal to have mild side effects, such as nausea or cramps. 

But if your symptoms feel severe or your bleeding doesn’t stop after a week, it’s best to reach out to your doctor to check if there is a more serious issue.

How to Stop Breakthrough Bleeding (Spotting) on Birth Control Pill

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated on December 18, 2020

So you’ve decided to start your #PeriodsOptional journey, and you are using birth control to skip your period. You’re excited to live your new period-free life. But a few months later, breakthrough bleeding has messed up your plans.

What causes breakthrough bleeding or spotting while you’re on birth control — and how do you prevent it? There are many reasons a faint version of Aunt Flo will knock on your uterus door and the good news is that it’s simple to get rid of her!

If you didn’t know that making your #PeriodsOptional was possible, now you know! Want to learn how to skip your period safely and effectively? Check out our webpage and our CEO/Co-Founder, Dr. Sophia Yen’s, TEDxBerkeley talk on periods optional! You can skip your periods using the birth control pill, ring or patch. Sign up today to get FREE delivery.

What is Breakthrough Bleeding?

Breakthrough bleeding is spotting or bleeding which occurs between periods. It’s usually a lighter bleed than your usual flow levels, but in some cases, it can be the same.

Breakthrough bleeding commonly occurs if you switch to a new type of hormonal birth control, take an over-the-counter cold medication that revs up your liver and eats some of the birth control hormones, or if a new person with a uterus “infects” you with their period. Your internal hormones are fighting back the birth control hormones and they won’t back down until you have a period.

Forms of birth control with low ratios of estrogen to progesterone are often to blame for this issue. It could also be the type of progesterone in the birth control pill, patch, or ring that is the problem. Estrogen is needed to grow the lining of the uterus (the endometrium) while progesterone helps to maintain and nourish it. Thankfully, the hormone balance should sort itself out eventually.

What causes breakthrough bleeding?

Breakthrough bleeding can have a variety of causes. If you have been using birth control for an extended period of time, your body may need to adjust to having the hormones that it contains consistently.

How long does breakthrough bleeding last?

The length of breakthrough bleeding varies from person to person, but it should not last for longer than a week.

Periods are Optional!

One explanation for why you get breakthrough bleeding is because your body wants you to — while Pandia encourages you to take control of your body, sometimes it reacts without us knowing why. However, a clearer reason is due to human error — maybe you forgot to take your daily pill! According to a 2017 survey, 16% of women aged 15 to 44 years reported missing two or more pills — so you’re not alone, my friend!

How to stop breakthrough bleeding

Try not to panic or get frustrated at the red spots in your underwear. While it may be surprising, the good news is that there is a solution, it just may require some patience. If you’ve taken at least three weeks of active pills, to stop breakthrough bleeding, all you have to do is come off of the medication for five days; on day six, whether or not you are still bleeding, just begin taking the active pills again. The breakthrough bleeding will stop.

To treat breakthrough bleeding or spotting while on the pill, patch, or ring Dr. Yen suggests you try 600mg ibuprofen WITH Food for up to 3 times a day for up to 5 days MAXIMUM. Make sure you don’t have any kidney problems and that you drink eight glasses of water per day.

To Skip the Bleed

If you’re spotting and haven’t taken at least three weeks of active pills, continue taking them until you reach the end of the third week — it may sound like a longer process but it’s better to be on the pill than pregnant! Once you hit the end of that third week, simply go off the medication and let your uterus bleed.

If you try to fight it by not consistently taking the pill, it’ll just make it worse. By getting to week three and skipping the other pills for five days, your uterus will reset. Between 30 to 50% of people using combination birth control pills experience breakthrough bleeding and spotting in the first three to six months of use; this drops to 10 to 30% by the third month. The more consistent you are with taking your pill at the same time every day the more likely it is for breakthrough bleeding to stop. If you are still experiencing breakthrough bleeding speak with your doctor about other ways to stop the unscheduled bleeding.

First time Skipping your Period

The first time you skip your period with the pill or the ring, you may experience breakthrough bleeding or spotting after two to three months. As you continue the cycle of taking the medication for three weeks and coming off of it for five days, that stretch of time between bleeding and not will lengthen. You may have to repeat the process in 6-8 months if you begin spotting again. That means eventually, you will not have a period at all!

When to worry about breakthrough bleeding?

However, there are a few causes of breakthrough bleeding that are more serious. For example, if you are experiencing diarrhea and vomiting it may be because the pill hasn’t been absorbed properly or you may have taken certain medications that have interacted with the pill; smoking can also make spotting and breakthrough bleeding more likely. These instances are typically nothing to worry about but if you feel uncomfortable, consult with a doctor.

Pandia Health is the most trusted provider for birth control delivery, boasting an exceptional team of doctors who can prescribe your birth control online through a telemedicine consultation. The next step is getting your contraceptive method of choice delivered for free — even if you are uninsured! 

Check out this video for more information on spotting and breakthrough bleeding! And be sure to subscribe to the Pandia Health YouTube channel for more content like this!

Frequently Asked Questions about Breakthrough Bleeding

What does breakthrough bleeding look like?

Breakthrough bleeding typically appears as traces of blood on your underwear. It probably will look similar to your normal period blood, although in most cases it will be lighter.

How many days does breakthrough bleeding last?

The length of breakthrough bleeding depends on the person. However, it should not last longer than seven days. If you are experiencing breakthrough bleeding while taking birth control continuously, it is best to go off of birth control for a week to let your uterus reset.

Can stress cause breakthrough bleeding?

In some cases, stress can trigger breakthrough bleeding, as it can affect our hormones. The stress can be emotional or physical.

What color is breakthrough bleeding?

Breakthrough bleeding will typically be the same color as your normal period blood (red or dark brown).

How to stop breakthrough bleeding on the pill immediately?

The best way to resolve breakthrough bleeding is to go off of the pill for a week. This will reset your uterus. Then, resume taking birth control, and the bleeding should go away.

How to stop breakthrough bleeding from missed birth control pills?

Make sure to take your birth control pills consistently to avoid breakthrough bleeding. It might help to set an alarm or to always take it at exactly the same time every day so you do not forget.

The above information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.

90,000 In Buryatia, neurosurgeons from all over Siberia held a conference

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60 years of the Neurosurgical Department of the Semashko Republican Hospital. In honor of this event, a conference of the Association of Neurosurgeons “Sibneiro” was held.Doctors from other cities of Siberia came to the capital of the republic. About how the doctors were congratulated and what was discussed at the meeting further.

– At that time we had neither CT, nor MRI, nor angiographic equipment. We ourselves did everything in a routine way – we put on an apron, injected contrast into the vessels.

This was the case in 1961. In the Republican hospital, only 10 patients with vascular diseases could be admitted. Today it is a whole department. Over the past year, doctors have operated on more than 500 people.

Evgenia Ludupova, Minister of Health of the Republic of Buryatia: The health of our citizens depends on your skills, on your skills, on your kind attitude, caring attitude. The republic makes as many efforts as possible to equip the neurosurgical service with the necessary equipment.

Vasily Khundanov, head of the neurosurgical department, R. NA Semashko: We have mastered quite a few methods of surgical interventions with the implantation of metal structures on the spine in different departments.We work very closely with the federal center of the city of Novosibirsk. We have two doctors trained for two years at the neurosurgery center, brought their accumulated experience.

We exchanged knowledge today. For the third time, Ulan-Ude doctors received colleagues from Irkutsk and Novosibirsk. We discussed the most relevant topics in their field. For example, the treatment of hematomas and malignant brain tumors. On the way and practice. They will operate on a patient with a rare mutation – a cerebral aneurysm.

The patient is clearly conscious. You can help him by attaching clips to the aneurysm – a titanium clothespin. It is fixed on the affected area and bleeding is stopped.

Andrey Dubovoy, neurosurgeon, neurosurgeon, neurosurgical department, Federal Center for Surgery, Novosibirsk: Difficulties are presented by either very large, gigantic, or very small aneurysms. On a small aneurysm, the clips with which we clip this aneurysm may slip off and bleeding may recur.

Igor Shpak, chief physician of the N.N. ON. Semashko: If recently the same young people who had aneurysms, they simply died, because a vessel in the brain burst. At the moment, it is possible to prevent the progression of this disease in the early stages. They can do something, we can do something. There may be one technology, but some feature of the operation is learned through live communication, and this is very important today.

11 neurosurgeons are currently working at the Republican Clinical Hospital.Over the past year, they have cured about 800 patients.

Full or partial copying is permitted only with the written consent of the editor-in-chief Arig Us online

benefits and harms, how to eat, recipes

The material is published for informational purposes only and under no circumstances can it be considered a substitute for medical advice with a specialist in a medical institution.

Remember: self-medication is dangerous!

Benefits of feijoa for men and women

The beneficial effect of berries is fully revealed when they are regularly consumed throughout the month.Then you can count on the effects presented below:

Strengthening the immune system.

Myocardial support. Minimization of cholesterol, prevention of heart and vascular diseases. Arteries and veins become elastic, flexible, which allows you to control pressure.
Regulation of blood glucose levels due to a low glycemic index, while reducing cravings for sweets, which is important for diabetics.
Source of available iodine. Macronutrient deficiency leads to gallstone disease, obesity, chronic fatigue, dry skin, blurred vision, brittle hair, and split nails. Two or three berries a day will relieve euthyroidism, toxic goiter, hypothyroidism. It is recommended that you obtain endocrinologist approval before use .
Normalization of brain activity , neural activity, improvement of cognitive functions, namely the ability to concentrate and remember, reducing the risk of developing Alzheimer’s disease.Feijoa rivals dark chocolate in its ability to lift mood and resist depression.
Improvement of intestinal motility without excessive gas formation and bloating. Berries help in the treatment of mononucleosis, pancreatitis (non-acute stage), liver cirrhosis, gastritis, cholecystitis, colitis.
Therapy of cystitis , pyelonephritis, renal failure, urolithiasis due to the disinfecting and diuretic properties of the fruit.

Cleansing the blood and improving the condition of the skin with scaly lichen.
Normalization of the thyroid gland , regulation of metabolic processes due to iodine.
Treatment of anemia , increased hemoglobin levels due to high iron content.

Improving the condition of the musculoskeletal system with arthrosis, osteochondrosis, gout.

Berries are included in the diet of patients with hepatitis , as well as those undergoing a period of rehabilitation. To cleanse the liver, pour the ground peel with water (1: 4) and cook for 5-7 minutes.Drink 2-3 times a day for 1 tbsp. l.

Useful properties for men is that the habit of eating these berries prevents prostatitis, pathology of the reproductive organs, inflammation of the genitourinary system. Feijoa normalizes hormonal levels, reduces the likelihood of developing hypertension, heart ischemia, ulcers, pancreatitis.

Berries improve mineral metabolism, eliminate problems with female infertility. Phytoflavonoids are designed to support the beauty and health of the fair sex.They relieve discomfort during menopause, reduce pain in the premenstrual period.

The benefits of feijoa for the body are enormous, it is difficult to overestimate all its positive effects, but not everything is so simple, any healthy vegetables, berries and fruits can cause big problems if they are used incorrectly or in the wrong situation. Be sure to read the contraindications below if you do not want to cause irreparable harm to your health.

Contraindications:

The main contraindication of feijoa is an individual intolerance that causes an allergic reaction.If you are trying the fruit for the first time, then limit yourself to one berry and see how it works for you.
Berries contain sugar, so it is not recommended to use them in significant quantities for diabetes. The permissible dose should be discussed with your doctor. In severe stages, you will have to abandon feijoa altogether.
Obesity is another category of people who should not abuse feijoa berries. You can eat, but just a little.
It is not recommended to eat feijoa during pregnancy and during breastfeeding without first consulting a doctor.
It is also not recommended to give feijoa to very young children without first consulting a doctor. For older children, there are no special restrictions, unless they have an individual intolerance.
Feijoa is contraindicated in thyrotoxicosis – a disease in which the function of the thyroid gland increases (hyperfunction).
The rest of the restrictions are inherent in almost all fruits – do not eat spoiled, do not overeat.

How to eat feijoa

A clean berry can be cut into 2 parts to make impromptu cups, from which the pulp is taken out with a small spoon.The rind is good for stool disorders and can be chewed on.

Feijoa – recipes

Uncooked feijoa jam (pureed with sugar)

Making jam without heat treatment allows you to preserve the maximum of vitamins contained in feijoa fruits, but imposes storage restrictions – it should only be kept in the refrigerator, where tightly closed jars will stand all winter.

Sugar Feijoa Recipe:

1 kg of berries;
1 kg of sugar;

Wash the berries.If there are large dark spots on the skin, it is best to remove them. Sometimes, it is recommended to pour over boiling water – this is not necessary, but it will not make it worse. Dry.

Cut the finished fruit in half – this will reveal the spoiled specimens. Cut off the tip with the rest of the inflorescence.

Next, grind the feijoa using a meat grinder or blender, you can use a grater.

Mix the mashed feijoa with granulated sugar until the latter is completely dissolved. We prepare dry clean jars and put the resulting jam in them and close with tight lids.It is advisable to use small cans.

Over time, the surface of the jam may darken, there is nothing to worry about – this is the result of oxidation of iron and iodine, which are abundant in feijoa.

You can eat right away, and put it in the refrigerator for storage.

Feijoa compote for the winter

To prepare 3 liters you need:

600 grams of feijoa berries;
2.2 liters of water
200 grams of sugar;
0.5 teaspoon citric acid.

Wash the berries and cut off the tips with inflorescences. We put them in a 3 liter jar. Boil water and pour boiling water to the top.

We let it brew for about an hour, during this time the water cools down.

Pour the resulting first infusion into a saucepan and add sugar – cook this syrup for about half an hour, pour citric acid at the end.

Pour into jars with berries again and roll them up with tin lids. We turn the banks over and cover with a blanket. In such “insulation” the compote should stand for 24 hours.

The resulting feijoa compote will reach its maximum saturation in 1.5-2 months.

Recipe for feijoa with honey to improve immunity

By the way of preparing feijoa with honey, it strongly resembles a recipe with sugar, only the beneficial properties of this product become an order of magnitude greater. You can use such a mixture not as jam, as a therapeutic and prophylactic agent – 2-3 teaspoons per day.

For cooking you need:

1 kg feijoa;
1 kg of honey;

We wash the berries, cut off the tail of the inflorescence.

It is worth cutting each fruit in half before proceeding with further chopping in order to reveal the spoiled berries.

Grind feijoa in a meat grinder or blender to a state of gruel.

Mix the grated berries with honey in equal proportions until a homogeneous mass is obtained. Store this product in the refrigerator and eat in small portions – this is an excellent prevention of colds and many other diseases.

If desired, the feijoa recipe with honey can be easily supplemented with other ingredients, for example, walnuts go well.They are ground together with the berries, making the taste more interesting as a result.

Feijoa for weight loss

Unfortunately, this berry does not give an opportunity to lose weight. It does not remove accumulated fat, but it helps not to store it in the future. This is due to the feijoa phytosterols, which reduce the absorption of fats from the intestines. It is useful to consume 2 fruits before dinner, then digestion will improve, and the intestines will work like a clock. To control weight, it is worth replacing your usual dinner with a light exotic salad 2-3 times a week.For cooking you will need:

beets – 2 pcs.;
feijoa – 4 pcs.;
walnuts – 3 pcs.;
olive oil.

The material is published for informational purposes only and under no circumstances can it be considered a substitute for medical advice with a specialist in a medical institution.

Remember: self-medication is dangerous!

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Sex after 40: what is normal and what is not?

TV series “Sex and the City”

Intimate relationships are important in the life of every person.But when we are 20-25 years old, it seems that after forty, life ends. We think that sex ceases to be as bright: now the knee aches, then the lower back pulls. However, in adulthood, sexual activity can reach such heights that were not even suspected at a young age.

On delicate questions about intimate life after 40 years and physiological changes, answered Eliso Jobava, MD, professor, obstetrician-gynecologist and expert of the Lignarius brand.

How the female body changes after 40 years

After 35–40 years, a chain of successive changes begins in the woman’s body, which coincides with the onset of menopause – the natural extinction of reproductive function.During this stepwise process, the production of female sex hormones decreases, which explains the characteristic symptoms. And this is reflected in the sex life of the couple, however, not always in a negative way.

It is enough just to consider in more detail the positive “consequences” of these changes:

• Decrease, and then the absence of the likelihood of pregnancy. You no longer need to think about contraception with a regular partner and fear an unwanted pregnancy.
• Changes in the menstrual cycle: regularity, duration and abundance of discharge.Consequently, the couple has more opportunities to devote time to themselves.

But there are also negative aspects. Due to a decrease in the production of estrogen, dryness of the mucous membranes is formed, the walls of the vagina can become thinner, which affects sensations. However, even this can be dealt with, for example, with the help of lubricants.

Some women report a decrease in sexual desire, which is associated with many aspects. First, physiological changes in the body, weight gain, vaginal dryness and much more.Secondly, with the stereotypes associated with menopause.

There is evidence that the intake of certain phytoestrogens improves sexual activity, increases libido, relieves menopausal symptoms and even reduces the risk of developing cancer. Phytoestrogens are an alternative to hormone replacement therapy when the latter is not suitable for a woman.

According to research, the sex life of US residents lasts up to 70 years. In Russia, this indicator is difficult to track, because in our country these topics are taboo, especially among the elderly.However, according to a large-scale study, a third of people aged 65–67 continue to have an intimate life, while at 79, only 6% of Russians are sexually active. Only by the age of 80 does the sex life come to naught. Data provided by Dmitry Rogozin, Director of the Center for Methodology for Social Research, RANEPA.

In another study, conducted in 2004, more than 27.5 thousand men and women of 40–80 years old took part. They were asked to fill out a questionnaire. Analysis of the data showed that more than 80% of men and 65% of women were sexually active over the past year.However, one cannot fail to mention the presence of some dysfunctions:

• early ejaculation – 14%;
• erection problems in men – 10%;
• inability to achieve orgasm – 16% (among women).

12 awkward questions for a sexologist:

All data indicate that active sex life persists after 40 years and, if desired, you can enjoy each other until the very old years. And all the difficulties are easily surmountable.However, due to the lack of education in these matters, myths still exist. Let’s consider the most common ones.

Myth 1. Sexuality goes away during the onset of menopause

Such thoughts and all the ensuing consequences are exclusively a psychological problem that is associated with the changes that occur during menopause. Psychologists advise to talk frankly with your partner and make sure that the woman is still attractive and desirable.Of course, serious changes have taken place in life, but you need to take maximum benefit from them.

Myth 2. No need to use contraceptives

This is possible only with a regular partner. Under other circumstances, this is a dangerous delusion, and it is associated with several factors. First, age does not protect against sexually transmitted infections. Secondly, only with the onset of menopause, when menstruation is absent for 12 months in a row, pregnancy is completely excluded.

Myth 3. Orgasm cannot be reached

Studies show that women under 36 do not have problems with orgasm. However, at 67 years old, they have an orgasm more often than at 24 years old. There are no physiological reasons for this, everything is based on experience, psychology and sexuality.

Meanwhile, older men are better at accepting criticism, listening to their partner’s wishes and becoming less selfish in bed. So older women have every chance not only to preserve their sex life, but also to improve it.

How sex after 40 is different for women and men

Some problems are pointless to deny. For example, men 40-50 years old may have problems with an erection, and active actions are required to restore it: the introduction of strength exercises into a sports load, the use of seafood and red meat, as well as regular sex.

But even in this case, the result may be less stable, any distraction is the reason for its violation.However, it is noted that orgasm in men is possible even with an average erection, and its quality does not change.

Women after 35–40 years of age feel more relaxed, experienced, aware of their preferences. Sexual satisfaction increases with age.

According to studies, women after 45 years of age continue to experience sexual arousal, bright orgasm, and this despite changes and even a decrease in libido.

During this period, a career has already been built, motherhood has been realized, it remains only to maintain femininity and sexuality in oneself.Just after 40 years, the desires and mentality of women and men converge: a great sexual experience, the desire not only to satisfy needs, but to establish relationships and take care of oneself and each other has the best effect on intimate life.

Pros and cons of sex at 40

A state in which a person experiences arousal, but there is no discharge, is called sexual frustration. Frequent episodes are the cause of neurological disorders, decreased motivation.

In men, this is one of the causes of unpleasant and even painful sensations in the lower abdomen and scrotum. And in women – the development of congestion in the pelvic organs, which are aggravated by a sedentary lifestyle. And this is a direct path to serious consequences.

20 Scientific Facts About Sex:

Lack of regular sex is a factor that affects libido. When a woman does not have regular sex, for example, after a divorce, the desire persists for the first few months, but if these needs are not met, libido decreases.There is no interest in intimate relationships. It is difficult to restore them.

Sex also helps regulate mood swings. It’s all about the production of hormones, especially the “hormone of happiness.”

It is difficult to name the cons of sex for a woman’s health. Perhaps the only negative is sexually transmitted infections.

But with the use of barrier contraception and regular medical examination of both partners, the risks come to naught.

How to make sex after 40 brighter

Lack of regular intimate life negatively affects the body and psychological state of a woman at any age.It is important and necessary to support yourself, and sex will bring more benefits if you follow these simple rules:

1. Positive attitude. Any age-related changes are not limitations, but new opportunities. After all, even the extinction of reproductive function is an opportunity to relieve anxiety about an unwanted pregnancy.
2. Experiments. It’s time to try something new: the children have grown up, are busy with their lives and there is already an opportunity to fulfill their innermost fantasies, to indulge in love at any time of the day or night, to be as loud as they want.
3. Sports activities. It is known that regular exercise (1-2 per week) maintains tone, libido and even sexual desire precisely because of the production of a number of hormones: adrenaline, oxytocin and serotonin.