Why am I bleeding for a month. What are the causes of long-term spotting and abnormal uterine bleeding. When should I see a doctor about persistent bleeding.

Spotting: What Is It and What Causes It?

Spotting is a very light form of bleeding that occurs outside of your regular menstrual cycle. It can happen mid-cycle, before or after your period, or during menopause. Spotting may even occur during pregnancy for some women. You may notice spotting as a few drops of red or brown on your underwear or toilet paper after using the bathroom. Spotting can occur sporadically throughout the month or as daily spotting, but it does not produce enough blood to fill up a sanitary pad.

There are many potential causes of spotting and other types of abnormal uterine bleeding. These causes can range in severity and may result in a variety of treatment outcomes. You should discuss any regular or prolonged spotting with your doctor.

8+ Causes of Bleeding for a Month

1. Hormonal Changes (Puberty or Perimenopause)

Hormonal changes can cause spotting. You may experience spotting if you’re just starting puberty and getting your first periods, or if you’re entering menopause and nearing the end of your menstrual cycles. During puberty and perimenopause, the hormones are constantly adjusting, which can lead to irregular menstrual cycles and spotting.

2. Hormonal Contraception

Spotting is common when starting or using certain types of hormonal birth control, such as birth control pills, injections, or implants. Nearly 30% of women experience abnormal bleeding in the first month of taking birth control pills, and up to 80% of women with birth control implants have abnormal bleeding in the first year. This type of spotting typically goes away as the body adjusts to the hormones.

3. Polycystic Ovary Syndrome (PCOS)

PCOS is a condition caused by hormonal imbalances that can lead to irregular periods and spotting. Symptoms of PCOS include ovarian cysts, excess hair growth, acne, and difficulty managing weight.

4. Endometriosis

Endometriosis occurs when uterine tissue grows outside the uterus, which can cause spotting, pelvic pain, and painful periods or sex. In addition to spotting, other endometriosis symptoms include pelvic pain, painful periods, and painful intercourse.

5. Fibroids and Polyps

Long-term spotting can be caused by non-cancerous growths called fibroids or polyps in the uterus or cervix. These benign growths can cause irregular bleeding and discomfort.

6. Sexually Transmitted Infections (STIs)

Certain STIs like chlamydia, gonorrhea, and human papillomavirus (HPV) can cause spotting or bleeding between periods, especially with frequent sexual activity.

7. Pelvic Inflammatory Disease (PID)

PID is an infection of the female reproductive organs that can also lead to spotting, in addition to symptoms like abdominal pain, unusual vaginal discharge, and pain with urination.

8. Cancer

In rare cases, long-term spotting could be a sign of a more serious condition like cancer. Risk factors include family history, age, obesity, and pregnancy history.

When to See a Doctor About Prolonged Bleeding

You should discuss any regular or extended spotting with your doctor, as it could be a sign of an underlying health issue. Seek medical attention if you experience:

• Spotting that lasts for more than a few days
• Spotting between your normal menstrual periods
• Unusually heavy or prolonged bleeding during your period
• Pain, fever, or other concerning symptoms along with the spotting

Early diagnosis and treatment of the underlying cause is important, so don’t hesitate to bring up any changes in your menstrual patterns with your healthcare provider.

Spotting During Pregnancy

Spotting during pregnancy is fairly common, affecting up to 50% of pregnant women. It’s most likely to occur during the first trimester, either due to implantation bleeding when the fertilized egg attaches to the uterine lining, or due to the increased blood flow to the uterus. However, spotting during pregnancy can also signal potential complications, so it’s important to report it to your doctor right away.

Preventing and Managing Prolonged Bleeding

The best way to prevent and manage prolonged or irregular bleeding is to identify and treat the underlying cause. This may involve adjusting hormonal birth control, treating an infection, or addressing a structural issue like fibroids or polyps. Your doctor can help determine the cause and develop an appropriate treatment plan.

In the meantime, you can try to manage spotting by:

• Using panty liners or light pads
• Avoiding tampons, which can irritate the vagina
• Staying hydrated and practicing good hygiene

Don’t hesitate to see your doctor if you have any concerns about persistent or heavy bleeding. Early diagnosis and treatment are important for resolving the issue and preventing potential complications.

8 Plus Causes and When to Seek Help

What is spotting?

Spotting is a very light form of bleeding that occurs outside of your regular menstrual cycle. It can occur mid-cycle, before or after your period, or during menopause. It may even occur during pregnancy for some women.

You may notice spotting by seeing a few drops of red or brown on your underwear or on toilet paper after using the bathroom. Spotting may occur sporadically throughout the month, or you may have daily spotting. Spotting doesn’t produce enough blood to fill up a sanitary pad.

There are many causes of spotting and other types of abnormal uterine bleeding. The causes can range in severity and may result in a variety of treatment outcomes.

You should discuss spotting that occurs regularly or lasts for an extended period of time with your doctor.

Read on to learn why you may have spotting for a month, and when to seek help from a doctor.

1.

Hormonal changes (puberty or perimenopause)

Hormonal changes can cause spotting. You may experience spotting if you’re starting puberty and just getting your period or if you’re entering menopause and nearing the end of your menstrual cycles. Puberty typically begins between the ages of 10 and 14. Perimenopause often starts between ages 45 and 55.

During puberty, your hormones are constantly adjusting and your menstrual cycle can be irregular. During perimenopause, the lining of your uterus may thicken, resulting in spotting or irregular bleeding.

2. Hormonal contraception

There are several reasons you may experience lengthy spotting if you use hormonal contraception. Some types of hormonal contraception include:

• birth control pills
• injections
• implants

You may experience spotting when you begin using birth control pills or have a birth control injection or implant inserted by your doctor. Nearly 30 percent of women experience abnormal bleeding during the first month of taking birth control pills.

About 70 percent of women with an injectable and 80 percent of women with an implant experience abnormal bleeding in the first year. This type of should go away as your body adjusts to the hormones.

You may also experience spotting if you forget to take your birth control pills on a regular basis.

3. Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is caused by hormonal imbalances. It can lead to irregularities with your periods.

Some symptoms of PCOS include:

• cysts that grow on your ovaries
• hair growth on the body, including facial hair
• acne
• thinning hair on the scalp
• difficulty with weight management

4. Endometriosis

Endometriosis occurs when your body produces uterine tissue in other places in your reproductive system, such as your ovaries and fallopian tubes. Your body can’t remove this unwanted tissue, which can lead to complications.

Some symptoms of endometriosis aside from spotting or irregular bleeding include pain:

• in your pelvis
• during your period
• during sex
• when using the bathroom

5. Fibroids and polyps

Long-term spotting could be the result of fibroids or polyps. Fibroids occur on the uterus and are the result of overgrowing muscles. Polyps are overgrowths that occur in the uterus or cervix.

Both of these conditions are benign, but they can cause discomfort when you urinate as well as cause irregular bleeding.

6. Sexually transmitted infections (STIs)

STIs can cause long-term spotting. You’re susceptible to an STI if you’re sexually active. You’re also at higher risk for contracting an STI if you have unprotected sex.

Some STIs that can cause spotting or bleeding between your periods include chlamydia and gonorrhea.

Human papillomavirus (HPV) is another STI that can cause spotting or bleeding after sex. If you engage in frequent sexual activity, this could result in regular and extended spotting.

See a doctor if you suspect you may have an STI.

7. Pelvic inflammatory disease (PID)

STIs or other bacteria may spread to your reproductive system and cause pelvic inflammatory disease (PID). This could result in spotting.

Other symptoms of PID include:

• abdominal pain
• unusual or foul-smelling vaginal discharge
• pain when urinating

8. Cancer

There is a chance long-term spotting is a sign of a more serious condition, such as cancer. Some risk factors for cancers related to spotting include:

• family history
• age
• obesity
• history of past pregnancies

Causes in pregnancy

It’s not unusual to experience spotting during pregnancy. When it occurs, the amount of time it lasts and any other associated symptoms could signal complications.

The March of Dimes states that up to 50 percent of pregnant women experience bleeding or spotting.

It’s more common to experience spotting during the first trimester of pregnancy. Two reasons you may have spotting during the first trimester are:

• implantation bleeding, which is when a fertilized egg attaches to your uterine lining a few weeks after fertilization
• an increased number of blood vessels in your cervix, which may cause spotting after sex or during a pelvic examination; this may continue into later months of pregnancy as well

Spotting that occurs in the second and third trimesters could be caused by serious conditions such as:

• Rh disease
• cervix problems
• placenta previa or abruption
• labor or pre-term labor
• uterine rupture
• placenta accrete

Contact your doctor if you experience more than 24 hours of spotting during your first trimester or any spotting in your second and third trimesters.

Call your doctor right away if your spotting gets heavier or you have other concerning symptoms such as abdominal pain, cramping, or dizziness.

Bleeding in early pregnancy may be the sign of a miscarriage or ectopic pregnancy. Bleeding in later pregnancy may be the sign of a serious condition that needs medical attention.

When to seek help

Talk to your doctor if you have prolonged spotting. You may find out that this spotting isn’t serious, but if it’s caused by an underlying condition, it’s important to find out the cause and if there’s anything you can do to treat it.

Contact your doctor right away if you experience spotting after menopause, when you’re 8 years old or younger with no signs of puberty, or if you’re pregnant.

Diagnosis

Prolonged spotting could be caused by one of many conditions. Your doctor could perform a range of tests and procedures to diagnose your condition. These include:

• pelvic exam
• blood tests
• ultrasound
• hysteroscopy
• biopsy
• MRI or CT scan

Treatment

Spotting may be treated in a variety of ways, depending on the cause. Your doctor may recommend that you try birth control pills to regulate your hormones. They may prescribe antibiotics if you have an infection or a medication to treat fibroids, for example. In some cases, you may need surgery.

How to manage spotting

Your doctor will give you the best advice for managing long-term spotting. You may wish to wear low-flow sanitary pads, though there shouldn’t be enough blood to soak through a pad.

Your doctor may recommend that you change your diet or take supplements to make up for iron deficiencies caused by blood loss.

Outlook

Occasional spotting between periods shouldn’t be a cause for concern unless you’re prepubescent, pregnant, or postmenopausal.

However, long-term spotting that lasts a month or longer should be discussed with a doctor. Your doctor can determine the cause of your spotting and recommend a treatment plan to reduce spotting and other symptoms.

Types, symptoms, risk factors, and causes

Von Willebrand’s disease is a hereditary blood-clotting disorder. It is the most common bleeding condition that a person can inherit.

However, a person might also acquire it as a result of other medical conditions, such as lymphomas, leukemias, and autoimmune disorders such as lupus, as well as by taking certain medications.

People with von Willebrand’s disease either lack, or have ineffective supplies of, a substance in the blood called von Willebrand factor (vWF). This promotes clotting.

People with the condition will have difficulty forming blood clots. For example, if they cut themselves, it will take longer to stop bleeding.

It occurs in up to 1 percent of people in the United States. No cure is available, but treatment can help people with the condition lead otherwise healthy lives.

In this article, we look at the different types of von Willebrand’s disease, their symptoms, and ways to manage them.

Share on PinterestVon Willebrand’s disease can lead to frequent, intense nosebleeds.

There are four main types of von Willebrand’s disease.

Type 1

Type 1 is the most common. About 60–80 percent of people with von Willebrand’s disease have type 1.

Type 1 is characterized by low levels of vWF. Clotting factor VIII, another essential blood-clotting protein, may also be affected. The severity of type 1 can range from mild to severe, but it mostly presents as mild.

Type 2

Several subtypes might occur in type 2 von Willebrand’s disease, but a doctor will generally diagnose type 2 when the vWF does not work properly, rather than there being a lack of it.

Different gene mutations can cause type 2, and each will require different treatment. Knowing the type 2 subtype can help a doctor shape treatment in a way that works best for the individual.

Type 2 is present in around 15–30 percent of people who have von Willebrand’s disease.

Type 3

In type 3, the individual typically has little to no vWF at all. This is the rarest and most severe form of von Willebrand’s disease.

Around 5–10 percent of people with the condition have type 3.

Acquired

While the more common types of von Willebrand’s disease are inherited, it is also possible to develop the condition from an autoimmune disease such as lupus or cancer, or as a result of taking some medications.

This is called acquired von Willebrand’s disease.

Signs and symptoms may be mild and difficult to observe, or they may occur in a range of ways. It is difficult for doctors to diagnose milder forms of von Willebrand’s disease.

When symptoms do appear, they tend to include bruising and extended or excessive bleeding. Bleeding might occur around the mucous membranes, including the gastrointestinal tract.

Symptoms of bleeding include:

• nosebleeds, which may be prolonged, recurring, or both
• bleeding from the gums
• longer, heavier menstrual bleeding
• excessive bleeding from a cut
• excessive bleeding after a tooth extraction or other dental work
• bruising, sometimes with lumps forming under the skin

Sometimes, a doctor will only discover the condition after the person has undergone a surgical procedure, had dental work, or experienced serious trauma.

Women may notice the following signs when menstruating:

• blood clots that are at least 1 inch in diameter
• soaking through at least two tampons or pads in 2 hours
• a need for double sanitary protection to control bleeding
• menstruation that continues for over a week
• symptoms of anemia, including fatigue, pallor, and drowsiness

In rare and severe cases, the bleeding can damage internal organs. When internal organ damage occurs as a result of this condition, it can be fatal.

When injury occurs in a blood vessel, small fragments inside a type of blood cell called platelets normally clump together to plug the wound and stem the bleeding.

vWF, which carries clotting factor VIII, helps platelets stick together to form a clot. Clotting factor VIII is either missing or faulty in people with the most common form of hemophilia.

Family history is the most common risk factor for von Willebrand’s disease. That said, the genetic content needed for each type to develop will differ.

For example, in types 1 and 2, only one gene is necessary to cause the condition. Also, the biological parents will likely have von Willebrand’s disease themselves.

In type 3, both parents need to pass on genes, and they will most likely be carrying the disease without actually having it.

Acquired von Willebrand’s disease can happen later in life, so advanced age is a factor.

Share on PinterestBlood tests can give a clear picture of how the blood clots.

Early diagnosis and treatment significantly increase the chances of living a normal and active life with von Willebrand’s disease.

Some people with type 1 or type 2 may not experience major bleeding problems. Therefore, they may not receive a diagnosis until they have surgery or a serious injury.

The diagnosis of type 3 usually occurs at an early age, because major bleeding will probably occur at some time during infancy or childhood.

A doctor will look at the person’s medical history, carry out a physical exam, and run some diagnostic tests.

When assessing medical history, the doctor may ask whether the person has ever experienced the following symptoms:

• excessive bleeding after surgery or a dental procedure
• unexpected or easy bruising, or bruising with a lump underneath
• blood in the feces
• bleeding in the joints or muscles
• bleeding after taking medications, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners
• abnormal blood platelet counts
• unexplainable nosebleeds that last for longer than 10 minutes, even after placing pressure on the nose
• frequent nosebleeds
• heavy menstrual bleeding for longer than a week, with clots
• kidney, liver, blood, or bone marrow disease

The physical exam will check for bruising and signs of recent bleeding.

Blood tests can assess:

• vWF levels
• the structure of vWF and its multimers, or protein complexes, as well as how its molecules break down, to determine the type of von Willebrand’s disease
• ristocetin cofactor activity, to reveal how well vWF works and whether it is adequately clotting the blood
• factor VIII clotting activity, to establish levels of factor VIII
• platelet function
• bleeding time, to see how long it takes for a small wound to stop bleeding

It may take 2–3 weeks for the test results to come back, and some tests may need repeating to confirm a diagnosis. The doctor may refer the individual to a hematologist, a doctor who specializes in diseases of the blood.

No cure is currently available for von Willebrand’s disease, but some options can prevent or stop bleeding episodes. Treatment tends to take the form of medication.

Symptoms are normally mild, and treatment for people with milder symptoms is only necessary during surgery, dental work, or after an accident or injury.

Management methods depend on the type and severity of the condition, as well as the person’s response to therapy.

Medications can:

• release more vWF and factor VIII into the bloodstream
• control heavy menstruation
• prevent the breakdown of blood clots
• replace missing vWF

Desmopressin (DDAVP) is a synthetic hormone that a person can take by injection or through a nasal spray (Stimate). It is similar to vasopressin, which is a natural hormone that controls bleeding by making the body release more of the vWF already present in the linings of blood vessels. This raises factor VIII levels.

A doctor will usually prescribe this for those with types 1 and 2. They may use the nasal spray at the beginning of a menstrual period or before minor surgery.

If DDAVP is not sufficient, the doctor might prescribe doses of concentrated blood-clotting factors containing vWF and factor VIII for all three types of von Willebrand’s disease.

Oral contraceptives, specifically birth control pills containing estrogen, can help women with heavy periods.

Clot-stabilizing medications delay the breakdown of clotting factors. A doctor may call these antifibrinolytic drugs. They help keep a clot in place once it forms, especially during surgery or dental work.

A doctor may also apply fibrin sealant to a wound to stop the bleeding. This is a glue-like substance.

vWF and factor VIII levels tend to rise during pregnancy, but bleeding complications might occur during delivery. Bleeding may be heavier and last longer after giving birth.

Women who have a type of von Willebrand’s disease should consult a hematologist and specialized obstetrician when they become pregnant.

They will likely carry out blood tests during the final trimester of pregnancy.

Share on PinterestSome medicines affect blood clotting. Speak to a doctor before taking some OTC medications.

To prevent bleeding episodes, people who have any type of von Willebrand’s disease should check with a physician before taking medications.

They should also avoid over-the-counter (OTC) medications that may affect blood clotting, such as aspirin, ibuprofen, and other NSAIDs.

It may also be worth a person informing healthcare professionals such as dentists about their condition, as well as sports coaches or people who oversee physical activity.

People with severe symptoms should also wear a medical ID necklace or bracelet.

To minimize common health risks, people with the condition should eat a healthful, balanced diet and exercise regularly. Normally, von Willebrand’s disease does not interfere with daily activities, but doctors may recommend that children with the condition avoid contact sports, such as football and hockey.

Von Willebrand’s disease is the most common type of heritable bleeding disorder. Type 1 is the most prevalent, affecting around 60–80 percent of all people with the condition.

Symptoms may be mild or severe, and they may include nosebleeds, excessive bleeding from a cut, and bruising more easily.

Though no cure is currently available for von Willebrand’s disease, treatments tend to include taking medications that prevent the breakdown of blood clots and applying a glue-like substance called fibrin sealant to bleeding wounds.

Q:

What is the difference between von Willebrand’s disease and hemophilia?

A:

While von Willebrand’s disease and hemophilia are both genetic and cause problems with blood clotting, they are distinctly different conditions.

Von Willebrand’s disease is usually milder than hemophilia and is more common. It affects males and females equally, while hemophilia almost always affects males.

Hemophilia causes low levels of clotting factors that are different than the vWF involved in von Willebrand’s disease.

Karen Gill, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Uterine bleeding – description, causes, symptoms, diagnosis and treatment

For any woman, sexual health is the key to good health and mood, as well as the ability to give birth to a healthy child. It is necessary to constantly monitor changes in the body.

In violation of the integrity of the vessels of the uterus, bleeding occurs. Uterine bleeding is characterized by more abundant and prolonged discharge, compared with the menstrual cycle. It can develop at any age and requires immediate treatment to a gynecologist.

Basic information

Uterine bleeding can be a symptom of gynecological or oncological diseases, as well as complications during pregnancy and childbirth. Regardless of age, girls can have this problem. Even newborn girls can experience spotting from the genitals.

A regular menstrual cycle averaging 5 days a month is normal. Allocations at the initial stage are insignificant, towards the middle there is an increase, and then a gradual decline. If a woman is absolutely healthy, then no pain during menstruation is observed.

All other manifestations and changes are due to a deviation or congenital pathology of the uterus, as well as gynecological diseases or hormonal failure. If dizziness and weakness are observed during painful menstruation, it is necessary to consult a specialist.

Serious pathological abnormalities are early menstruation in girls under the age of 11 years, as well as the appearance of bleeding in women after menopause (over 55 years), requiring observation by a gynecologist. During pregnancy, menstruation stops.

Bloody discharge may appear in the intermenstrual period. This may be due to hormonal imbalance during the period of ovulation (duration 1-2 days). Colds or inflammation in the body can cause bleeding.

The main symptom of uterine bleeding is profuse discharge of blood from the vagina. There is a sharp increase in blood loss, the cycle lasts more than a week, the interval changes. Blood discharge is observed after sexual intercourse, as well as after menopause.

Causes and types of bleeding

The main cause of uterine bleeding is ovarian dysfunction. The pathology is based on a violation of the hypothalamic-pituitary system, leading to anovulation during the menstrual cycle. The absence of ovulation and the corpus luteum phase provoke menstrual disorders associated with insufficient levels of progesterone and excess estrogen.

Prolonged and heavy bleeding can lead to the development of diseases of the uterus and adnexal system.

Many factors can cause bleeding:

• oncological diseases;
• hard physical labor and stress;
• hormonal disorders;
• injuries received during gynecological procedures;
• anemia;
• tumors of the ovaries or uterus;
• sexual abuse;
• abortions.

In case of any uterine bleeding, it is necessary to urgently consult a doctor to determine the cause and reduce the risk of complications in the future. Lack of medical attention as soon as possible can aggravate the situation, as the bleeding will become more severe. A woman can simply die from blood loss.

During pregnancy

Uterine bleeding may occur during pregnancy. This may indicate the onset of a miscarriage, an ectopic or missed pregnancy, or premature birth. These causes are accompanied by pain in the lower abdomen, nausea, vomiting, weakness, bloody discharge with clots.

Bleeding can be caused by:

• uterine scar;
• pathology of the development of the fetal egg;
• placental abruption;
• injuries of the birth canal;
• uterine fibroids;
• uterine rupture;
• delayed release of placenta after childbirth.

Uterine bleeding is dangerous for pregnant women, as it can harm not only the child, but also the mother. In this situation, you must immediately call an ambulance.

During menopause

During menopause, women often experience bleeding, which is characterized by profuseness, intensity, and painful sensation. There are many reasons for bleeding. Some are not dangerous, while others may indicate serious illness.

The main causes of uterine bleeding in menopause:

• hormonal disorders;
• cancer of the uterus and ovaries;
• taking hormonal medications;
• inflammation of the vaginal mucosa;
• genital tumors.

Dangerous symptoms of bleeding are high fever, dizziness, pale skin, cold sweat, prolonged discharge, pain in the lower abdomen. To avoid deterioration of health, it is urgent to visit a gynecologist.

In case of hormonal failure

In case of hormonal imbalance in women, there is a risk of uterine bleeding. With functional disorders of the brain, the level and production of the hormone is not controlled. Pathology of the pituitary gland is an example of such a disease.

Chronic fatigue and weakness, exhaustion of the body against the background of constant malnutrition can lead to such a problem. These violations can occur in the girl’s body during the first menstruation, as well as after abortion, during childbearing and after childbirth. Prolonged bleeding can occur after medical abortion, taking hormonal drugs.

In case of any bleeding, you should contact a specialist who will help you find out the cause of the occurrence and choose the right treatment.

After caesarean section

The main cause of bleeding is hemostasis, which requires medical intervention (the walls of the uterus are being cleansed). As a result of surgery, a scar is formed on the uterus, preventing its contraction. The healing process takes a long time and can cause bleeding. At the first sign of appearance, you should immediately contact a gynecologist.

Hypotonic bleeding is difficult to control because it occurs with uterine contractions and hypotonic shock can occur. If it is not possible to stop the bleeding, then doctors can go to extreme measures and remove the uterus to save the patient.

In oncological processes

One of the symptoms of uterine cancer is also bleeding. Together with him, the woman has frequent pain and purulent discharge. Particular attention should be paid to such a combination of symptoms if the woman has already passed the border of reproductive age.

Uterine cancer is a dangerous disease with a rapid rate of development. According to statistics, about 60 thousand patients with this diagnosis are noted every year. The biggest problem with this disease is the difficulty of identifying it in the early stages, since often the symptoms are similar to many other gynecological diseases. The later a woman starts treatment, the worse the prognosis becomes.

Classification of uterine bleeding according to signs

Gynecologists classify uterine bleeding according to several signs:

1. Hypotonic. With hypotension, the fetal egg lingers in the myometrium of the uterus. After childbirth, contractions of the muscle tissue of the uterus occur spontaneously, and in their absence, a critical condition occurs. It is urgent to stop the bleeding, and it is imperative to replenish the volume of circulating blood. Blood pressure and pulse are monitored. After childbirth, the placenta is removed. To do this, use: massage (if necessary), apply ice or a swab dipped in ether. If hypotension continues, then atony therapy is performed. Treatment is aimed at restoring the motor function of the uterus.
2. Atonic. These bleedings appear in the absence of uterine contractions. The gynecological name is Kuveler’s uterus. Zero uterine tone is not able to stop bleeding with drug therapy. This bleeding is very dangerous, because in a short period of time a woman loses over 1.2 liters of blood. In this situation, electrical stimulation is performed to restore contractile function. If there is a threat to life, then doctors decide on a hysterectomy.
3. Juvenile. characteristic of puberty. Therapy is carried out only in a hospital. The main reason is ovarian dysfunction. In addition, psychological trauma, excessive physical activity, colds, and various infections can provoke bleeding. In severe cases, anemia may develop. If bleeding occurs, then you must immediately take a horizontal position, apply ice to the lower abdomen, and take hemostatic drugs.
4. Dysfunctional. Violations of the hormonal regulation of ovarian function lead to the appearance of bleeding. Irregular menstrual cycles with heavy bleeding after a missed period are characteristic of this type.
5. Anovulatory. These bleedings are shown at pubertal or preclimacteric age. The reason is single-phase cycles that occur when the pituitary gland is disturbed and the quantitative decrease in follicle-stimulating or luteinizing hormone and with hormonal imbalance. This type of bleeding can provoke the development of malignant tumors.
6. Profuse. Bleeding occurs against the background of stress, physical exertion, after abortion, endocrine disorders, taking hormonal drugs. Bleeding proceeds without pain, the amount of blood loss is variable.

Clots in uterine bleeding

Blood clots are sometimes observed during menstruation. Usually they appear due to an anomaly that has developed in the uterus during the uterine development of the fetus. The blood filling the uterus is excreted in clots. Such menstruation is very painful, especially with hormonal failure. They may also be acquired. Among the main factors of occurrence are lifestyle, profession and addiction to bad habits.

To exclude the appearance of clots due to the hormonal background, it is necessary to conduct tests. There may be endometriosis, if this diagnosis is confirmed, urgent treatment is required.

Stop bleeding

Treatment is carried out in a hospital. For a woman who has not given birth and does not have tumors, therapy includes a course of hormonal drugs. Treatment involves taking medications at a high dosage, which is gradually reduced. To stop bleeding, Vikasol, Ascorutin and other drugs are used.

For girls who are in the process of development, a course of vitamins and restorative drugs is prescribed. In addition, a course of herbal medicine and hormonal preparations can be prescribed, the action of which is aimed at stabilizing the menstrual cycle.

Women past reproductive age undergo surgery for endometriosis and fibroma. The presence of oncological problems and pathologies of the uterus and ovaries requires the removal of the appendages and uterus.

First aid for uterine bleeding

After calling the ambulance, first aid must be given to the woman before the doctors arrive.

The algorithm is as follows:

1. Put the woman in bed, while the legs should be higher than the head. This will help reduce the rate of bleeding and prevent her from passing out.
2. Use ice. You need to apply cold to the stomach with 5-minute breaks. You must understand that this is a temporary measure that will allow you to reduce bleeding for 15 minutes.
3. Give us plenty of water. Fluid in the body will help maintain the condition.
4. If a woman is pregnant, then only drugs that have a minimum of contraindications should be used. After the arrival of the doctors, name the medicines used and their dosage.

At the first manifestations, you should consult a gynecologist. An ultrasound diagnostic method is usually used, blood tests and a biopsy are performed.

Proper diagnosis is the key to successful treatment.

Author

Radlevich Natalya Vadimovna

obstetrician-gynecologist, ultrasound diagnostics

Doctor of the highest category, candidate of medical sciences

Experience 26 years

+7 (495) 032-15-21

Uterine bleeding – causes, symptoms, diagnosis, treatment and prevention

Uterine bleeding refers to a pathological condition common in gynecology, which is accompanied by the release of blood from the genital tract outside the menstrual cycle. In this condition, the woman needs urgent medical attention. Otherwise, bleeding can lead to anemia, shock and other dangerous complications.

ON CLINIC employs experienced gynecologists who have at their disposal innovative methods of diagnosis and treatment. Uterine bleeding requires a comprehensive examination of the woman, determining the true causes of the disorder and prescribing appropriate therapy. You can make an appointment with a specialist and get all the help you need in our clinic.

Disease classification

Uterine bleeding can be juvenile (adolescent), menopausal and reproductive. Most often, such violations are associated with dysfunction of other genital organs. Separately allocate anovulatory uterine bleeding. It appears after a missed period. The form of bleeding is determined by the gynecologist based on the examination data.

Predisposing factors

Uterine bleeding in most cases is associated with certain gynecological diseases, congenital malformations. They are easy to detect with a standard ultrasound examination. Bleeding during puberty (juvenile) may not have an organic nature. They occur mainly after a long delay in menstruation. In this case, spotting exceeds the usual volume of blood loss characteristic of the menstrual cycle of a particular patient.

Bleeding from the genital tract is dangerous for the health of the girl, as it is often combined with inflammatory processes that affect the organs of the reproductive system. If you do not pay attention to juvenile uterine bleeding, there is a risk of infertility in the future.

Dysfunctional uterine bleeding of the reproductive period may appear against the background of a change in the climatic zone, the effects of stress, past infections, and surgical operations on the pelvic organs. Chronic inflammatory processes cause thickening of the ovary membrane, reducing its sensitivity to certain hormonal substances produced in the body during different phases of the menstrual cycle. As a result of such changes, periodic uterine bleeding may occur.

With menopause, spotting from the genital tract differs in duration and frequency. They appear due to a violation in the hypothalamic-pituitary-ovarian system of regulation. Due to a failure in the production of hormonal substances, disturbances occur in the process of maturation of the follicles. There are certain changes in the duration of the phases of the menstrual cycle. Against the background of an age-related decrease in the functionality of the ovaries, the inner layer of the uterus begins to grow, as a result, polyps appear, which are often manifested by profuse uterine bleeding and the need for urgent surgical treatment of a woman.

In addition to impaired ovarian function in menopause, atrophic processes, adenomyosis, and malignant changes in the cervix often progress. Against the background of such diseases, uterine bleeding also appears. They can be provoked by contraceptives, hormonal drugs that are prescribed to a woman as part of substitution therapy.

Also, bleeding can be a manifestation of a miscarriage or an ectopic pregnancy. To assess the severity of the patient’s condition and determine the exact causes of the disease, it is necessary to conduct a comprehensive examination in a short time.

Bleeding after coil insertion

The intrauterine device (IUD) is a T-shaped device, which is made of a special hypoallergenic material containing alloys of copper and silver. Such a contraceptive is used not only to protect against unwanted pregnancy, but can also be used as a treatment for hormonal disorders. But in some women, after the installation of the spiral, heavy menstruation and bleeding appear.

Modern IUDs suppress pathological growths of the endometrium, reduce the size of existing myoma nodes, restore the menstrual cycle, and relieve chronic pelvic pain. But if in the first 3-6 months after the installation of the spiral, heavy menstruation does not stop or bleeding appears, then the contraceptive must be urgently removed.

Sometimes the cause of copious discharge from the genital tract after the use of the IUD is the patient’s failure to comply with certain restrictions. Two weeks after the procedure, intimate contacts, visits to the bathhouse, public pool are prohibited. You can not lift heavy objects and take a hot bath. Otherwise, at the stage of adaptation to the intrauterine device, the patient may begin uterine bleeding.

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Totochia Nato Enverovna, obstetrician-gynecologist, candidate of medical sciences.

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Diagnosis of uterine bleeding

A woman with uterine bleeding should contact a medical facility as soon as possible and be diagnosed. The purpose of the survey is to determine the true causes of blood loss. Specialists must confirm or rule out an organic pathology of the pelvic organs: the presence of endometriosis, neoplasms, ectopic pregnancy, polycystosis and other common diseases.

Additionally, gynecologists conduct ultrasound diagnostics, laboratory blood tests. With the help of hormonal studies, it is possible to detect existing diseases of the ovaries, endocrine glands and other organs. A woman may need additional consultations of specialized specialists, including an endocrinologist. Diseases of the endocrine glands are often combined with gynecological pathologies and can provoke volumetric uterine bleeding. To exclude the growth of brain tumors, radiography of the Turkish saddle is prescribed. Neoplasms in this area can disrupt the ratio between sex hormones and provoke secondary uterine bleeding.

The gynecologist will carefully study the features of the patient’s menstrual cycle. This will allow you to choose an individual scheme for the diagnosis and treatment of uterine bleeding. They are differentiated with ectopic pregnancy and heavy menstruation.

Symptoms of uterine bleeding

Clinical manifestations of uterine bleeding depend on the underlying disease causing them. A woman can take discharge from the genital tract for menstruation. This is a common reason for delayed initiation of treatment.

Juvenile bleeding may be minor, lasting up to several weeks. But even an insignificant discharge of blood for a long period of time is an indication for contacting a gynecologist and conducting a clarifying diagnosis.

Against the background of diseases of the genital organs in women of the reproductive period, breakthrough uterine bleeding usually occurs. They are characterized by abundance, require hospitalization and urgent medical care.

Against the background of uterine bleeding, additional symptoms appear:

• pale skin;
• physical weakness;
• dizziness;
• lowering blood pressure;
• pain in the abdomen;
• increased heart rate;
• loss of consciousness.

With frequent uterine bleeding, posthemorrhagic anemia appears. In addition to pallor and dry skin, a woman may experience disorders in the functioning of the cardiovascular system, which are manifested by fluctuations in blood pressure, increased heart rate, increased anxiety, and physical weakness.

Uterine bleeding during menopause is accompanied by cycle disorders. Menstruation becomes irregular, may be absent for several months. Many premenopausal women have profuse discharge with blood clots. Such manifestations may indicate the presence of polyps, uterine fibroids and other dangerous neoplasms. They require periodic diagnosis and timely surgical treatment.

Uterine bleeding during pregnancy

Uterine bleeding during pregnancy indicates the risk of its spontaneous interruption. The causes of this condition can be associated with both chronic diseases and external factors. Bleeding from the genital tract also appears in ectopic pregnancy due to the rapid decrease in progesterone levels.

Special care should be taken by women who have a history of several miscarriages. Spontaneous abortion usually begins with minor pain in the lower abdomen, spotting spotting. If you seek medical help at this stage, specialists in most cases manage to save the pregnancy.

With uterine bleeding during gestation, a woman may develop preeclampsia or eclampsia. These severe conditions are characterized by dysfunction of the cardiovascular, respiratory, excretory systems. Perhaps an increase or a sharp decrease in blood pressure, increased heart rate. Even a slight discharge of blood from the genital tract during pregnancy indicates a threat of miscarriage and is an indication for an urgent appeal to a gynecologist.

Uterine bleeding after childbirth

Postpartum hemorrhage can occur immediately after the birth of the baby, or within a few weeks after that. The severity of a woman’s condition is determined by a specialist depending on the amount of blood loss. Postpartum hemorrhage can occur up to 5-6 weeks after the baby is born. Sometimes a woman takes her condition for the restoration of the menstrual cycle, especially if there is no breastfeeding.

Uterine bleeding after childbirth is dangerous for a woman’s life. Due to the intensive blood flow of the uterus, it can quickly cause irreversible consequences for the health of the woman in labor, including the development of DIC, a violation of hemostasis that can result in dysfunction of internal organs, including the lungs, liver and kidneys.

Most often, postpartum hemorrhage occurs due to a delay in the uterine cavity of the remnants of the placenta. Also, predisposing factors include the presence of a woman in labor with fibroids, fibroids, cicatricial changes in the tissues of the uterus, and a caesarean section.

Abundant bleeding leads to the development of hemorrhagic shock. A safe loss is considered to be 0.5% of a woman’s weight. When bleeding appear intense pain in the abdomen. Often, a few days before the onset of a pathological condition, blood clots begin to stand out from the genital tract. This sign should alert a woman and force her to consult a gynecologist.

Treatment features

Medical tactics for uterine bleeding depends on the results of the examination and a comprehensive examination. Treatment may require hospitalization, especially if prolonged fluid therapy is required. Hemostatic drugs are used to stop bleeding. Additionally, experts prescribe vitamin complexes containing iron. Conservative therapy eliminates signs of anemia, improves the general well-being of the patient, and prevents dangerous complications.

Oral contraceptives for uterine bleeding

Contraceptives are actively used in the treatment of gynecological diseases, including uterine bleeding and comorbidities (endometriosis, uterine polyps, polycystic). Such drugs reduce the thickness of the endometrium, favorably affect tissue regeneration, and several times reduce the likelihood of breakthrough bleeding. Also, combined oral contraceptives reduce the likelihood of malignant degeneration of genital tissues. Hormonal treatment enables specialists to take control of the course of chronic pathologies.

Contraceptives for uterine bleeding are prescribed for a long time. Throughout the entire period of treatment, a woman should visit a gynecologist, take blood and urine tests, periodically conduct ultrasound examinations of the pelvic organs. According to indications, specialists carry out diagnostic curettage of the uterine cavity. Most often, the method is used in the presence of polyps and other neoplasms, including glandular-cystic deformities of the endometrium.

Hysteroscopy for uterine bleeding

Hysteroscopy of the uterus is an endoscopic diagnostic and surgical medical procedure that is performed to assess the condition of the endometrium and cervical canal using an optical system. The doctor inserts the necessary instruments through the woman’s vagina. The technique is actively used in minimally invasive operative gynecology for uterine bleeding.

Before the procedure, a woman undergoes a standard examination for minimally invasive gynecological interventions. It includes laboratory diagnostics, colposcopy, ultrasound, examination of smears. Shortly before the hysteroscopy, the woman is given general anesthesia. After antiseptic treatment of the genital organs, the uterine cavity is probed to determine its depth. To expand the cervical canal, Gegar dilators are used.

The hysteroscope is connected to a light source, as well as a system that provides fluid supply. The doctor works under visual control. The image of the walls of the uterus is fed to the monitor. According to certain indications, the specialist removes polyps, myomatous nodes, takes tissue for further histological examination. As part of hysteroresectoscopy, with the help of special equipment, pathological formations that can provoke uterine bleeding are removed. The results of the procedure can be reflected both in a medical document and on various information media.

The procedure is transferred quite easily. Full recovery takes 7-14 days. During this period, sexual intercourse, visiting the bath, sauna, public pool is prohibited. Also during this period, you can not play sports and lift heavy objects.

Curettage of the uterine cavity

Uterine bleeding during childbearing is stopped with the help of drug therapy. For the entire period of treatment, a woman must observe maximum physical rest. To maintain pregnancy, special hormonal preparations are prescribed.

With uterine bleeding, a separate diagnostic curettage is performed. Its purpose is to remove the endometrium. Also, as part of the procedure, the doctor performs resection of existing polyps and other small neoplasms.

Before diagnostic curettage, the patient is examined by a gynecologist. The doctor prescribes standard studies that allow you to assess the complexity of the clinical case and develop a treatment regimen. The endometrium obtained during the procedure is used for histological diagnosis. Separate diagnostic curettage is performed under general anesthesia. After the procedure is over, the woman is transferred to the ward, where she is monitored by qualified specialists. According to indications, infusion therapy, antibacterial agents, as well as drugs that accelerate uterine contraction are prescribed. After scraping, slight spotting persists for several days. In most cases, uterine bleeding can be completely stopped.

Treatment of uterine bleeding after childbirth

Treatment of postpartum hemorrhage does not require delay. Specialists use medications that stop acute blood loss, compensate for the volume of lost circulating blood, normalize blood pressure, and the functioning of internal organs. If ruptures of the vagina, cervix, perineal tissues are detected, suturing is performed under local anesthesia. Sometimes manual separation of placental remains is required. If uterine bleeding is accompanied by uterine rupture, it is removed surgically.