What causes bleeding between periods. How to identify abnormal vaginal bleeding. When to seek medical advice for intermenstrual bleeding. What tests may be performed to diagnose the cause of bleeding between periods. How to prevent and treat intermenstrual bleeding.

Understanding Intermenstrual Bleeding: Causes and Concerns

Intermenstrual bleeding, also known as bleeding between periods, spotting, or metrorrhagia, is a common gynecological issue that affects many women. While occasional light spotting may not always be a cause for alarm, persistent or heavy bleeding outside of your regular menstrual cycle warrants medical attention. Understanding the potential causes and knowing when to seek help can be crucial for maintaining your reproductive health.

What is considered normal menstrual bleeding?

The average menstrual cycle lasts between 21 to 35 days, with normal vaginal bleeding typically occurring for 3 to 7 days. Any bleeding outside of this pattern is considered abnormal and may indicate an underlying issue.

Common Causes of Bleeding Between Periods

There are numerous potential causes of intermenstrual bleeding, ranging from minor hormonal fluctuations to more serious medical conditions. Here are some of the most common reasons:

• Hormonal contraceptives
• Hormonal imbalances
• Stress
• Vaginal injury
• Sexually transmitted infections (STIs)
• Pregnancy complications
• Cervical or uterine abnormalities
• Certain medications
• Underlying medical conditions

How do hormonal contraceptives affect menstrual bleeding?

Hormonal contraceptives, such as birth control pills, patches, implants, and intrauterine devices (IUDs), can cause irregular bleeding, especially during the first few months of use. This is typically due to the body adjusting to the new hormone levels. If irregular bleeding persists beyond three months, it’s advisable to consult with a healthcare provider.

Hormonal Imbalances and Their Impact on Menstrual Cycles

Hormonal imbalances can significantly affect your menstrual cycle, leading to intermenstrual bleeding. The two primary hormones regulating menstruation are estrogen and progesterone. When these hormones become imbalanced, it can result in spotting or irregular bleeding.

What conditions can cause hormonal imbalances?

Several conditions can lead to hormonal imbalances, including:

• Polycystic ovary syndrome (PCOS)
• Thyroid disorders
• Perimenopause and menopause
• Certain medications
• Stress
• Extreme weight loss or gain

If you suspect a hormonal imbalance, it’s important to consult with a healthcare provider for proper diagnosis and treatment.

Stress and Its Effects on Menstrual Health

Stress can have a significant impact on your menstrual cycle, potentially leading to intermenstrual bleeding. When you’re under stress, your body releases cortisol, which can interfere with the normal production of reproductive hormones.

How can stress-related intermenstrual bleeding be managed?

Managing stress-related intermenstrual bleeding often involves addressing the underlying stress factors. Some effective stress management techniques include:

1. Regular exercise
2. Meditation and mindfulness practices
3. Adequate sleep
4. Balanced diet
5. Time management skills
6. Seeking support from friends, family, or a mental health professional

Sexually Transmitted Infections and Intermenstrual Bleeding

Certain sexually transmitted infections (STIs) can cause bleeding between periods. Chlamydia and gonorrhea, in particular, are known to cause this symptom. If you’ve recently had unprotected sex with a new partner and are experiencing intermenstrual bleeding, it’s crucial to get tested for STIs.

What are the signs of STI-related intermenstrual bleeding?

STI-related intermenstrual bleeding may be accompanied by other symptoms such as:

• Unusual vaginal discharge
• Pain or burning sensation during urination
• Pelvic pain
• Pain during sexual intercourse

If you experience any of these symptoms, seek medical attention promptly for diagnosis and treatment.

Pregnancy-Related Causes of Intermenstrual Bleeding

Bleeding between periods can sometimes be related to pregnancy, including early pregnancy, miscarriage, or ectopic pregnancy. It’s essential to take a pregnancy test and consult with a healthcare provider if you suspect pregnancy might be the cause of your intermenstrual bleeding.

What types of pregnancy-related bleeding require immediate medical attention?

While some light spotting can be normal in early pregnancy, heavy bleeding or bleeding accompanied by the following symptoms requires immediate medical attention:

• Severe abdominal or pelvic pain
• Dizziness or fainting
• Fever
• Passing tissue or clots

These symptoms could indicate a miscarriage or ectopic pregnancy, both of which require prompt medical intervention.

Cervical and Uterine Abnormalities

Various cervical and uterine abnormalities can lead to intermenstrual bleeding. These may include:

• Cervical ectropion or erosion
• Cervical or endometrial polyps
• Fibroids
• Cervical or uterine cancer

How are cervical and uterine abnormalities diagnosed?

Diagnosis of cervical and uterine abnormalities typically involves a combination of physical examination and imaging studies. Your healthcare provider may recommend:

1. Pelvic examination
2. Pap smear
3. Colposcopy
4. Transvaginal ultrasound
5. Hysteroscopy
6. Endometrial biopsy

Early detection and treatment of these abnormalities are crucial for maintaining reproductive health and preventing complications.

When to Seek Medical Advice for Intermenstrual Bleeding

While occasional light spotting may not always be a cause for concern, certain situations warrant immediate medical attention. It’s important to consult a healthcare provider if you experience:

• Heavy bleeding between periods
• Bleeding that lasts for more than a few days
• Bleeding after sexual intercourse
• Bleeding accompanied by pain, fever, or other concerning symptoms
• Bleeding after menopause
• Any bleeding that concerns you

What information should you provide to your healthcare provider?

When discussing intermenstrual bleeding with your healthcare provider, be prepared to provide the following information:

• The timing and duration of the bleeding
• The amount and characteristics of the blood (e.g., light spotting or heavy flow)
• Any associated symptoms
• Your contraceptive method
• Recent sexual activity
• Any medications you’re taking
• Your overall health history

This information will help your healthcare provider determine the most appropriate diagnostic tests and treatment options.

Diagnostic Procedures for Intermenstrual Bleeding

To determine the cause of intermenstrual bleeding, your healthcare provider may recommend various diagnostic procedures. These may include:

1. Physical examination
2. Pelvic examination
3. Pregnancy test
4. Blood tests
5. STI screening
6. Pap smear
7. Transvaginal ultrasound
8. Endometrial biopsy
9. Hysteroscopy

What is a transvaginal ultrasound and how is it performed?

A transvaginal ultrasound is a diagnostic imaging procedure that uses sound waves to create detailed images of the reproductive organs. During the procedure:

1. A small, lubricated wand-like device (transducer) is gently inserted into the vagina.
2. The transducer emits sound waves that bounce off pelvic organs and structures.
3. These echoes are converted into images on a monitor.
4. The healthcare provider can examine the uterus, ovaries, and surrounding structures for any abnormalities.

This non-invasive procedure can help identify structural issues such as fibroids, polyps, or ovarian cysts that may be causing intermenstrual bleeding.

Treatment Options for Intermenstrual Bleeding

Treatment for intermenstrual bleeding depends on the underlying cause. Some common treatment options include:

• Hormonal therapy (e.g., birth control pills)
• Antibiotics for STIs
• Surgical procedures for fibroids or polyps
• Stress management techniques
• Lifestyle modifications
• Treatment for underlying medical conditions

How effective are hormonal therapies in managing intermenstrual bleeding?

Hormonal therapies, particularly oral contraceptives, can be highly effective in regulating menstrual cycles and reducing intermenstrual bleeding. These medications work by:

1. Stabilizing hormone levels
2. Thinning the uterine lining
3. Suppressing ovulation

However, the effectiveness can vary depending on the individual and the underlying cause of the bleeding. It’s important to work closely with your healthcare provider to find the most suitable treatment option for your specific situation.

Preventing Intermenstrual Bleeding

While not all causes of intermenstrual bleeding can be prevented, there are steps you can take to reduce your risk:

• Maintain a healthy lifestyle
• Manage stress effectively
• Use contraceptives as directed
• Practice safe sex to prevent STIs
• Attend regular gynecological check-ups
• Report any unusual symptoms to your healthcare provider promptly

How can a healthy lifestyle help prevent intermenstrual bleeding?

A healthy lifestyle can contribute to hormonal balance and overall reproductive health. Consider incorporating the following habits:

1. Eat a balanced diet rich in fruits, vegetables, and whole grains
2. Engage in regular physical activity
3. Maintain a healthy weight
4. Limit alcohol consumption
5. Quit smoking
6. Get adequate sleep
7. Practice stress-reduction techniques

By adopting these habits, you can support your body’s natural hormonal balance and potentially reduce the risk of intermenstrual bleeding.

What causes bleeding between periods?

There are many different causes of bleeding between periods. Some may not be anything to worry about, but seek medical advice if you’re concerned.

Hormonal contraceptives

Irregular bleeding, such as bleeding between periods, is common during the first few months of starting hormonal contraception, such as the:

• combined oral contraceptive pill
• progestogen-only contraceptive pill
• contraceptive patch (transdermal patch)
• contraceptive implant or injection
• intrauterine system (IUS)

If you’re concerned about bleeding or it lasts longer than a few months, you should seek medical advice.

You may also bleed between periods if you:

• miss any combined pills
• miss any progestogen-only pills
• have a problem with your patch or vaginal ring
• are on the pill and are also sick or have diarrhoea

Other causes

Some other causes of bleeding between periods include:   

• taking the emergency contraceptive pill
• injury to the vagina – for example, from having penetrative sex
• recently having an abortion – seek medical advice if you’re bleeding heavily
• sexually transmitted infections (STIs) such as chlamydia – it’s a good idea to get tested if you’ve recently had unprotected sex with a new partner
• recently having a miscarriage
• reproductive hormones not working normally – this is common in women approaching the menopause or in women with polycystic ovary syndrome (PCOS)
• stress
• vaginal dryness
• harmless changes to the neck of the womb (cervix) – this may be called cervical ectropion or cervical erosion
• cervical cancer – if you’re aged 25 to 64, you should be having regular cervical screening tests to detect any changes to your cervix; even if you’re up-to-date with screening tests, you should see a GP about irregular bleeding, particularly bleeding after sex, to eliminate the possibility of cervical cancer
• womb (uterus or uterine) cancer – this is more common in post-menopausal women and most cases of endometrial cancer are diagnosed in women over the age of 50; see a GP if you’re over 40 and have bleeding between periods to eliminate the possibility of uterine cancer
• vaginal cancer or vulval cancer
• cervical or endometrial polyps – non-cancerous (benign) growths in the womb or the lining of the cervix
• fibroids

When to seek medical advice

If you’re concerned about bleeding between periods, you should:

• see a GP
• visit a sexual health or genitourinary medicine (GUM) clinic

A healthcare professional will talk to you about your symptoms. Depending on your situation, they may suggest doing some tests, such as:

• tests for STIs, which may include an examination of your genitals
• a pregnancy test
• a cervical screening test, if you’re aged 25 to 64 and not up-to-date with these
• a pelvic ultrasound scan

To diagnose some conditions, you may need an examination, such as:

• a speculum examination – a smooth, tube-shaped tool (a speculum) is inserted into your vagina to examine your vagina and cervix
• an internal examination of your vagina with gloved fingers (bimanual examination)

Find out the answers to more questions about women’s health

Further information

• Heavy periods
• Period pain
• Stopped or missed periods
• Find services: sexual health

Page last reviewed: 5 November 2019
Next review due: 5 November 2022

Vaginal Bleeding Between Periods: Causes, Prevention & Diagnosis

You may experience bleeding between periods due to stress, medication changes, and certain health conditions.

Abnormal vaginal bleeding between periods is also called intermenstrual bleeding, spotting, and metrorrhagia. When bleeding occurs between normal periods, there are many possible causes.

While some causes may be easy to treat, others can indicate a serious underlying condition. Whether you notice spotting or heavier bleeding between periods, it’s important to see your doctor for testing, diagnosis, and treatment options. Potential causes of bleeding between periods include:

• a growth in your uterus or cervix
• stress
• a change in medication
• a miscarriage
• vaginal dryness
• a hormone imbalance
• cancer

Bleeding between periods isn’t a normal part of the menstrual cycle.

The average cycle lasts 21 to 35 days. Normal vaginal bleeding, also known as your period, can happen for a few days to a week. Any bleeding outside of this is considered abnormal and can be caused by a variety of factors. These include:

1.

Hormonal imbalance

Estrogen and progesterone are the two hormones that regulate your cycle. You may have spotting if they get out of balance. The following can all affect your hormone balance:

• dysfunctional ovaries
• thyroid gland problems
• starting or stopping birth control pills

As well, some women spot during ovulation as a result of hormonal changes.

When starting any type of hormonal contraceptive, abnormal bleeding is common during the first three months, according to the National Health Services of the United Kingdom. These contraceptives include:

• birth control pills
• intrauterine device
• contraceptive patch
• contraceptive implant or injection

2. Pregnancy complications

Complications during pregnancy can cause spotting. Both a miscarriage and an ectopic pregnancy can cause bleeding. An ectopic pregnancy occurs when a fertilized egg implants itself in the fallopian tube instead of the uterus.

Spotting during pregnancy may not mean you’re having a miscarriage. However, if you’re pregnant and experience any vaginal bleeding, you should contact your doctor immediately.

3. Uterine fibroids

Uterine fibroids are noncancerous growths that form in the uterus. They aren’t uncommon in women who’ve given birth.

4. Infection

Vaginal bleeding between periods may indicate an infection of your reproductive organs. Infection can cause inflammation and bleeding. Causes include:

• sexually transmitted infection
• vaginal douching
• intercourse
• pelvic inflammatory disease, which is marked by inflammation of the reproductive organs that leads to scarring

5. Cancer

Less commonly, a cancer of any of these organs can cause bleeding:

• cervix
• vagina
• uterus
• ovaries

6. Rare causes

Other possible causes of vaginal bleeding are rare and include:

• insertion of an object into the vagina
• extreme stress
• diabetes
• thyroid disorders
• significant weight gain or loss

You should consult your doctor any time you have abnormal vaginal bleeding. The cause of the bleeding could be serious and should be determined. See your doctor right away if you’re pregnant and have vaginal bleeding.

If you have other serious symptoms in addition to bleeding, you may need emergency medical attention. These include:

• pain
• fatigue
• dizziness
• fever

Diagnosis

When you see your doctor about bleeding between periods, be prepared to answer questions about your symptoms.

It’s helpful to keep a record of your cycle. Take note of when your periods begin and end, the heaviness and duration of your flow, and when and how much you bleed between periods. Your doctor will want to know about any other symptoms that you’ve experienced and any medications you’re taking.

Your doctor will also likely give you a physical exam, including a pelvic exam.

Diagnostic tests can help your doctor find the cause of the bleeding. Your doctor may draw blood to check hormone levels. You may need to have cultures taken or tissue removed from your cervix or the lining of your uterus for testing, which is called a biopsy. Your doctor may also want to perform an ultrasound.

Treatment

There is no specific treatment for vaginal bleeding between periods. Treatment will vary based on what’s causing your abnormal vaginal bleeding.

In some cases, this kind of abnormal bleeding will resolve on its own. However, for some women, the underlying cause requires treatment. Ignoring the problem and failing to see a doctor can lead to a worsening of the problem. If the cause of the bleeding is an infection, cancer, or another serious disorder, the consequences could be life-threatening.

You may not be able to prevent bleeding between periods depending on the cause. However, in some cases, preventive measures can help.

Maintain a healthy lifestyle and a normal weight because being overweight can lead to abnormal periods.

If you take birth control pills, do so as directed to avoid a hormonal imbalance. Exercise moderately to maintain health and reduce stress.

To manage pain, use ibuprofen (Advil) or naproxen (Aleve, Naprosyn), which can actually help reduce bleeding. Avoid taking aspirin (Bufferin), which may increase your risk of bleeding.

Women’s uterine bleeding – causes and treatments

The reasons why a woman may experience bleeding from the uterus, vagina or other part of the genital tract, prevailing in different age groups, are different. Regardless of age, their danger lies in the occurrence of anemia (anemia), if the blood loss is large enough, and bleeding occurs regularly. If a woman is not pregnant and is not in labor, then the following types of bleeding can be distinguished, the source of which is the uterus:

• Dysfunctional bleeding in girls – occurs at a young age, a little after menarche, due to hormonal failure in the ovaries
• Dysfunctional bleeding in women of reproductive age – require increased attention of the doctor, as they can serve as a harbinger of infertility.
• Climacteric bleeding – occur due to hormonal changes in the female body and may indicate in favor of the proliferative process, both benign and malignant. More often still benign: the occurrence of polyps, myomatous nodes due to hyperestrogenemia (an excess of the female sex hormone estrogen)
• Postmenopausal bleeding – occurs some time after the onset of menopause, in which there was no blood discharge from the genital tract. They can be a symptom that speaks of the process of tumor formation in the organs of the female reproductive apparatus.
• Postcoital bleeding is a special type of uterine bleeding that occurs after intercourse. It can be based on different reasons, both formidable and not dangerous to the health of a woman.

According to the moment at which bleeding from the genital organs was detected, they can be classified into menorrhagia: this is the name of bleeding that coincides with menstruation, but at the same time, the volume of blood lost is clearly higher than normal; as well as metrorrhagia: such bleeding does not coincide with the onset of the menstrual cycle, but is noted by a woman before or after critical days.

It should also be noted three conditions that require immediate, urgent, speedy seeking medical help

• A) Bleeding from the genital tract during pregnancy. It is important to note that such bleeding can rapidly pick up speed and lead to serious complications for both the fetus and the expectant mother.
• B) Bleeding that does not stop for a long time, which is accompanied by symptoms of anemia. The latter include pallor of the skin, lowering blood pressure, dizziness when trying to stand up or even sit down, persistent headaches, a rare and weakened pulse on the radial arteries (on the wrist), fainting.
• C) Internal bleeding. It should be considered if the bright symptoms of anemia are combined with the absence of visually recognizable blood discharge from the genital tract, especially if the patient also has a feeling of severe pain in the abdomen, and its anterior wall is very dense to the touch, board-like.

Uterine bleeding in women in the reproductive period

Many women have to suddenly notice vaginal bleeding between periods, or too much increase in the latter. If spotting, in a small amount of discharge occurs at the time of ovulation (the release of an egg from a ruptured ovarian follicle), as a rule, on the 14-18th day of the cycle, depending on its duration in a particular woman (28-32 days), then this should be considered normal . However, severe sudden bleeding should alert the woman, as it may indicate a gynecological pathology. If metrorrhagia that suddenly arises intensifies or simply does not end for a long time, then you need to consult a doctor who will stop the bleeding, and also prescribe the necessary examinations to understand the causes of its occurrence.

In addition to ovulation, the cause of uterine bleeding that occurs between two adjacent periods can be a sharp change in the amount of the female sex hormone estrogen in the blood, which is produced by the ovaries, any pathological process in which can cause the above manifestation. In addition, such metrorrhagia may be based on the end or start of the use of hormonal contraceptives, a significant decrease in the level of thyroid hormones, the use of emergency contraceptives, as well as other drugs that somehow include estrogen. In addition, bleeding between periods may be due to an infectious, tumoral process of the genital organs or their trauma, miscarriage, the consequences of recent gynecological manipulations.

Treatment of the bleeding described above is given according to the underlying cause. If metrorrhagia was caused by a gynecological disease, then the right treatment for this disease will also serve to stop bleeding.

Uterine bleeding in young girls

Bleeding from the genital tract that occurs in girls aged 12-18 years is called pubertal or juvenile. If such bleeding is severe, then there may be a threat to the health and life of a teenage girl, and therefore it is necessary to quickly consult a doctor who can prescribe adequate treatment so that these bleeding do not pass into the reproductive period, in which, in this case, risk of infertility for this patient.
Quite often, juvenile metrorrhagia occurs in the winter-spring period due to a lack of vitamins and trace elements in the girl’s body. Often, stress, infectious processes or unhealthy diet can also be the main cause.
Most often in the pubertal period, bleeding in girls occurs after a delay in menstruation (several weeks), and lasts more than seven days, either increasing in intensity or decreasing, which can eventually lead to large blood loss and anemia. Such a process needs to be stopped, and therefore it is necessary to contact an obstetrician-gynecologist immediately.

At the same time, both sudden and severe bleeding, and prolonged and sluggish bleeding can lead to anemia. The symptoms of anemia are similar regardless of the cause that caused it: pallor of the skin, weakness, dizziness when trying to sit or stand up, a drop in blood pressure, short-term loss of consciousness.

In case of self-cessation of metrorrhagia in a girl, you still need to see a doctor, since the goal of treatment, in this case, will be to prevent anemia and a terrible complication – hemorrhagic shock.

Climacteric uterine bleeding

It is impossible to ignore the discharge of blood from the genital tract during menopause, as it can be a symptom of a pathological process, even uterine cancer. For many women, menopause is quite difficult. Along with uterine bleeding, jumps in blood pressure, mental disorders, and metabolic disorders can occur.

Usually the cause of climacteric bleeding from the genital tract is a massive hormonal restructuring in the woman’s body, but they can also indicate tumor growth.
Menopausal bleeding can be classified into:

• Premenopausal metrorrhagia
• Postmenopausal metrorrhagia

In the premenopausal period, bleeding from the genital tract most often occurs due to improper production of sex hormones due to disorders associated with the ovulation process, which in turn leads to changes in the change in the functional layer of the endometrium (epithelial lining of the uterus). Such bleeding can be repeated for several years with different strength and frequency. Anemia in this case is rare, in comparison with adolescent girls, however, if it occurs, it can be combined with uterine fibroids or with more complex and dangerous pathological processes in the female body.

Bleeding that occurs in the postmenopausal period is the most dangerous, as it requires an immediate diagnostic search to exclude malignant neoplasms. Such metrorrhagia is an indication for diagnostic hysteroscopy (curettage of the uterine cavity and cervical canal).

Postcoital bleeding

If bleeding occurs in a woman immediately after intercourse, then it is called postcoital (coitus-coitus. Sin.: penetration, copulation, copulation, sexual intercourse). Such discharge of blood from the genital tract can be caused by a number of reasons:

• Mechanical injury of the genital tract
• Sexually transmitted diseases (often chlamydia)
• Inflammatory diseases of the genital tract (vaginitis – in the vagina, cervicitis – in the cervix, etc. )
• Erosions and polyposis (requiring surgical treatment)
• Due to certain drugs, including hormones
• Dysplastic changes (replacement of the epithelium with the wrong one for this section of the genital tract) up to the tumor process

If bleeding is accompanied by a sharp pain syndrome and occurs suddenly during or after copulation, then you need to call an ambulance, because the situation can be life-threatening. In this case, you need to pay attention to the symptoms in case a woman has internal bleeding, which may be accompanied by acute pain in the abdomen, groin, lower back, weakness, dizziness, fainting, profuse sweating (“breaks through cold sweat”).

Timely visit to a doctor usually contributes to a speedy recovery.

Metrorrhagia after medical abortion

Bleeding after medical abortion usually stops in most women with therapy. And the cycle is completely normalized within 1-2 months. However, if, due to metrorrhagia after an abortion, two sanitary pads are completely soaked within one hour, then the bleeding should already be considered severe and requiring immediate intervention by a gynecologist.

Treatment of bleeding from the genital tract

The goals of treating metrorrhagia are usually limited to stopping the actual bleeding and replenishing the lost blood volume, finding and eliminating the already found cause of metrorrhagia, preventing the recurrence of bleeding and treating its consequences (anemia, hemorrhagic shock).

Uterine bleeding should be treated according to its cause. Often, the bleeding itself stops when its cause is eliminated surgically or conservatively.
Therapy should be cumulative: hormonal, symptomatic, restorative (helps restore the female body). The treatment is usually based on hormonal therapy and symptomatic – drugs that increase blood clotting and uterine contraction.
In addition to a conservative approach, a surgical approach is often used: this happens if the bleeding is strong enough and / or prolonged. Such treatment usually begins with a diagnostic hysteroscopy.

It should be remembered that a visit to a gynecologist should be an indisputable and indispensable component of the treatment of uterine bleeding. There should be no talk of self-treatment, because in the case when the cause of bleeding is serious enough, the latter can cost a woman’s health, and often life itself.

To prevent uterine bleeding, every woman should visit a gynecologist twice a year for an examination. In this case, early diagnosis of diseases associated with the genital tract will become possible, which will allow you to quickly and gently carry out therapeutic measures without waiting for dangerous bleeding.

Uterine bleeding symptoms and treatment in Moscow Make an appointment. Treatment at home and in the clinic – Clinic SINAI near the metro station Dobryninskaya, Serpukhovskaya in Moscow

Uterine bleeding is the discharge of blood from the uterine cavity. Unlike the normal menstrual cycle of a woman, it is characterized by abundance, intensity, and duration. Bleeding is due to a serious disease or pathology. In any case, the manifestation of this disease should not proceed without medical attention. Girls of any age are at risk. Even in the first days after uterine life, bloody discharge from the genitals can be observed.

Every woman should know her cycle. It is considered normal if it is regular, occurs monthly and lasts, on average, 5 days. They start out sparsely, gain in abundance towards the middle, and just as slowly go down. A healthy woman has no pain syndromes during menstruation. Everything else is a deviation or congenital pathology of the uterus. It can also mean a serious gynecological disease, hormonal failure. If menstruation occurs with pain, dizziness and weakness, contact your gynecologist immediately.

It should be understood that the onset of early menstruation in girls under the age of 11 years, as well as the resumption of bloody discharge in women after menopause (after 55 years), is a serious pathological abnormality, and should not occur without medical supervision. There is no menstruation during pregnancy.

Sometimes, within the normal range, there may be small bloody discharge that occurs in the intervals of menstruation. The cause may be a hormonal failure as a result of ovulation. The walls of the vessels thin out a little, so blood blotches can come out along with the secretions. Duration 1 to 2 days maximum. Also, colds and inflammatory processes can have such a side effect.

This pathology has the first and main symptom – the discharge of blood from the vagina. The amount of blood loss in a woman increases dramatically. This can be noticed when changing special hygiene products too often. The cycle lasts more than 7 days. Its interval changes. After sexual intercourse, bleeding is observed. Bleeding after menopause, when the cycle has been stopped for a long time.

Cause. Types of bleeding.

Uterine bleeding is caused by ovarian dysfunction. There is a failure in the system of work of the hypothalamus, pituitary gland and ovaries. The release of the pituitary hormone is disrupted, which provokes the immaturity of the follicle. Ovulation and the menstrual cycle are disturbed. The follicle does not mature in the ovary and the corpus luteum does not mature. The production of estrogen and progesterone stops. The endometrium is shed, resulting in uterine bleeding. It stands out for a long time and plentifully.

During bleeding, the risk of developing diseases of the uterus and adnexal system, cancer, mastopathy, adenoma carcinoma increases.

There are many reasons that can cause uterine bleeding. It is necessary to determine the type of blood loss, and understand what caused it. The cause can be both a disease of the genital organs and a failure in their functions.

Non-genital disorders include the following causes:

• Certain infectious diseases (measles, influenza).

• Cirrhosis of the liver.

• Hypertension.

• Atherosclerosis.

• Urinary disorders.

• Changes in the thyroid gland.

• Blood diseases.

Bleeding may start during pregnancy. This can carry a number of reasons, such as an ectopic pregnancy, as well as:

• scar on the uterus;

• endometritis;

• fibroids;

• chorionepitheloma;

• birth canal injuries;

• ovarian pathology;

• uterine rupture;

• destruction of uterine tissue;

• departed placenta;

• placental abruption or previa.

Bleeding during pregnancy

Bleeding can occur in women who are not pregnant. Can be called:

• gross sexual activity;

• taking contraceptives;

• trauma to the external part of the genitals;

• any injury to the uterus;

• inflammatory processes such as vaginitis, erosion, cervicitis;

• cyst and its rupture;

• ovarian rupture;

• intrusion of mucosa into uterus;

• benign and malignant tumors, such as fibroids;

• menopausal, juvenile and reproductive bleeding.

Bleeding during menopause

Women may experience uterine bleeding during menopause. They are of a different nature. This comes from the frequency of ovulation and the production of hormones. A fairly common occurrence, but you should consult a specialist. They may also indicate tumors. The reason for the urgent visit to the doctor is:

• Abundant discharge that special hygiene products cannot cope with.

• Discharge with clots.

• Exceeding the duration of menstruation by more than 3 days.

• Severe pain syndrome.

• Remember that they can indicate polyps, fibroids, imbalances, tumors and other serious diseases of the female reproductive system.

Bleeding due to hormonal imbalance

If the hormonal system changes or is disturbed, a woman may experience uterine bleeding. Women of all ages are prone to this problem. With improper brain function, the level and production of the hormone is not controlled. An example of such a disease is the pathology of the pituitary gland.

Lethargy and chronic fatigue, malnutrition and exhaustion of the body can cause this problem. Violations of this type occur in the girl’s body during the first menstrual cycle, as well as after abortion, childbirth and during pregnancy. Prolonged bleeding caused by medical abortion is gaining popularity. The use of hormonal drugs and heredity are attributed to a number of causes.

Treatment should be selected individually, it is necessary to determine the cause that caused the disease.

Bleeding during pregnancy

Uterine bleeding during pregnancy most often indicates miscarriage, ectopic pregnancy or damage to the placenta. These causes are accompanied by severe pain in the lower abdomen, nausea, vomiting, and malaise. The blood is bright red or dark scarlet in color, most often with clots.

The cervix can be damaged during pregnancy during a gynecological examination or sexual intercourse. This bleeding is usually not prolonged or heavy. In the second or third trimester, bleeding may begin due to damage or placenta previa.

Bleeding is a serious threat to the health and life of mother and child. It should be understood that uterine bleeding is very dangerous for pregnant women. The woman should immediately call an ambulance.

Bleeding due to caesarean section

This bleeding is caused by hemostasis. To do this, a medical intervention is carried out, in which the walls of the uterus are thoroughly cleaned. A caesarean section leaves behind a scar on the uterus, which prevents it from contracting normally. A caesarean section takes a long time to heal and can cause uterine bleeding. A woman should be under medical supervision, and after healing, when the first signs appear, immediately seek help.

Hypotonic bleeding is very difficult to stop because it occurs immediately after uterine contraction. Hypotensive shock may occur. In this case, doctors must immediately proceed to rescue, and have a supply of blood for recovery.

The last degree of severity of uterine bleeding after cesarean is the removal of the uterus. It is used in cases where the salvation of the patient directly depends on stopping the bleeding, and other methods are powerless.

Gynecologists classify bleeding according to various criteria. The most common are:

Hypotonic. The fertilized egg lingers in the myometrium of the uterus. The reason is hypotension. The contraction of the muscle tissue of the uterus after childbirth occurs spontaneously. A critical state occurs when it is completely absent. The bleeding should be stopped immediately. Replenish the volume of circulating blood. Continuous measurement of blood pressure and pulse. Treatment is aimed at the speedy restoration of the motor function of the uterus.

Hypotonic occurrence after childbirth requires removal of the placenta. It is this action that helps to restore the healthy functioning of the walls of the uterus. Massage if necessary. Apply ice or irritate the uterus with a swab dipped in ether. If hypotension does not stop, the therapy of atony is started.

Atonic. Atonic appear when the uterus is not able to contract. In gynecology, non-contractility of the uterus is called the uterus of Kuveler. Zero tone of the uterus does not make it possible to stop bleeding with the help of special injections and drugs. To clamp the uterine artery, a thick suture is placed on the lip of the uterus, secured with additional clamps. The inefficiency of the method is considered as preparation for the removal of the uterus. Critical blood loss is considered from 1.2 liters. Electrical stimulation makes attempts to reduce blood vessels. Constantly infuse blood to avoid fainting.

Juvenile. Occur during puberty. The main cause is ovarian dysfunction. Infection, psychological trauma, excessive physical activity, colds, malnutrition can cause juvenile bleeding. Climatic conditions are reflected. Treatment is carried out only in a hospital. Depending on the severity, this can lead to anemia. At the first detection, you should immediately call an ambulance, take a horizontal position, apply cold to the groin area and take a hemostatic drug.

Dysfunctional. Occurs when the ovaries fail. The absence of menstruation for a long time and copious discharge are characteristic of this species.

Anuvulatory. Women undergo bleeding during menopause and adolescents. It is caused by a violation of the follicles and progesterone, during the absence of ovulation. It is also called single-phase, during bleeding, the corpus luteum does not form. A dangerous type of bleeding can cause the development of malignant tumors. Duration lasts more than 10 days. Bleeding is observed during a malfunction of the pituitary gland, after infections, poisoning and stress.

Profuse. Not accompanied by pain. The amount of fluid lost can vary. The reasons can be different, from a miscarriage to taking hormonal drugs.

Clots during uterine bleeding

There are cases when a woman observes the presence of clots during bleeding. Doctors explain this with an anomaly that was transferred by the uterus in utero. The uterine cavity holds blood, forming clots. Such menstruation brings a lot of discomfort to a woman, especially during a hormonal crisis. This anomaly sometimes causes the appearance of a large number of clots. The anomaly can also be acquired. They are associated with lifestyle, profession and addiction to bad habits.

Menstruation with clots causes severe pain. To exclude an anomaly, you should apply for a gynecological consultation. To exclude the possibility of the appearance of clots on a hormonal background, take an analysis for hormones and check the thyroid gland. The presence of clots and pain indicate endometriosis. If the diagnosis is confirmed, then the disease requires urgent special treatment.

Stop uterine bleeding

Upon arrival of the ambulance, the following actions are carried out:

• apply cold to the abdomen;

• with heavy bleeding, the woman is carried in a horizontal position;

• urgent hospitalization;

• specialist assistance;

• the introduction of the desired solution, depending on the type of uterine bleeding.

If the patient has not given birth and has no tumors, treatment in the hospital is carried out with the help of hormonal drugs. Treatment begins with an increased dose, gradually increasing from 6 tablets per day to 1 piece. In the absence of anemia, gestogens are used. Prescribe hemostatic drugs, such as Vikasol, Dicinon, Ascorutin.

During puberty, girls are prescribed drugs that strengthen blood vessels and stop blood flow. It is recommended to take vitamins. Phytotherapy and hormonal preparations for regulating the menstrual cycle. Women of childbearing age undergo surgery for endometriosis, fibroids. Pathology of the uterus and ovaries, oncological diseases, after menopause, requires only surgical intervention, removal of the appendages and uterus.

It is very important for proper treatment to undergo an examination in time and establish the cause that caused the bleeding. Women experiencing this pathology should immediately seek medical help.

First Aid

An ambulance should be called immediately. During pregnancy, the woman’s condition deteriorates sharply, because blood loss is plentiful. Every minute counts. If it is not possible to contact the medical team, you should take the woman to the hospital yourself. The reaction should be quick, with uterine bleeding a serious threat to life looms. In case of dysfunctional bleeding, do not apply any warm heating pads to the stomach, do not use drugs, douching, taking a bath.

Before the ambulance arrives, the woman can be helped on her own by doing the following:

1. Put the woman to bed. In a horizontal position, it is desirable to raise the legs above the head. Place a pillow or roll up a blanket. With impressive bleeding, this will help the patient not to lose consciousness.

2. Apply cold to the abdomen. If there is no heating pad or ice, replace it with any item from the refrigerator, after wrapping it in a cloth. A plastic cold water bottle will do. It is possible to achieve vasoconstriction and reduce bleeding with the help of cold for no more than 15 minutes. Take 5 minute breaks.

3. Give the woman plenty to drink. This will replace the drip at home. Make sweet tea or water.

4. Take medication seriously when you are pregnant. If there is no opportunity to consult a doctor, you must read the insert and find out the minimum dose. Be sure to read the side effects. Upon the arrival of medical workers, tell the name of the drug that the woman took and its dosage.

Diagnosis

At the first sign of uterine bleeding, contact your gynecologist immediately. Women should keep a calendar where the nature, symptoms, well-being and duration of the menstrual cycle are noted. This will help the gynecologist prescribe the correct treatment and complete the course of therapy faster. Performing ultrasound diagnostics, taking smears of the cervix for the presence of cancer. Blood tests are performed to determine the level of hormones. A biopsy is done to examine the endometrium under a microscope. Proper diagnosis is the key to optimal rehabilitation.