What is menorrhagia and how does it affect women’s health. What are the common causes of heavy menstrual bleeding. How is menorrhagia diagnosed and what treatment options are available. When should you seek medical attention for prolonged periods.

What is Menorrhagia and How Does It Impact Women’s Health?

Menorrhagia refers to heavy or prolonged menstrual bleeding that can significantly affect a woman’s quality of life. This condition is more common than many realize, with numerous women experiencing abnormally heavy periods at some point in their lives. While the definition of “heavy” can vary, generally, if you need to change your pad or tampon every 1-2 hours due to saturation or if your period lasts longer than 7 days, it may be classified as menorrhagia.

The impact of menorrhagia on daily life can be substantial. Women with this condition may find it challenging to participate in regular activities, work, or social events during their menstrual cycle. The excessive blood loss can also lead to anemia, causing fatigue, weakness, and other health complications.

How does menorrhagia differ from normal menstrual bleeding?

• Volume of blood loss: Typically exceeds 80 ml per cycle
• Duration: Often lasts longer than 7 days
• Frequency of pad/tampon changes: Every 1-2 hours due to saturation
• Presence of blood clots: Large clots may be passed

Common Causes of Heavy Menstrual Bleeding: Unraveling the Mystery

Understanding the underlying causes of menorrhagia is crucial for proper diagnosis and treatment. The reasons for heavy menstrual bleeding can be diverse, ranging from hormonal imbalances to structural issues within the reproductive system.

Hormonal Causes of Menorrhagia

Hormonal imbalances play a significant role in many cases of menorrhagia. The delicate balance between estrogen and progesterone regulates the menstrual cycle, and any disruption can lead to abnormal bleeding patterns.

• Estrogen dominance
• Progesterone deficiency
• Thyroid disorders
• Polycystic ovary syndrome (PCOS)

Structural Causes of Heavy Menstrual Bleeding

Sometimes, the root cause of menorrhagia lies in physical abnormalities or growths within the uterus. These structural issues can interfere with the normal shedding of the uterine lining, resulting in heavier or prolonged bleeding.

• Uterine fibroids
• Endometrial polyps
• Adenomyosis
• Uterine cancer (rarely)

Other Potential Causes

Several other factors can contribute to or exacerbate menorrhagia:

• Use of certain intrauterine devices (IUDs)
• Bleeding disorders
• Certain medications (e.g., anticoagulants)
• Pelvic inflammatory disease
• Complications related to pregnancy or miscarriage

Diagnosing Menorrhagia: The Path to Understanding Your Symptoms

Accurate diagnosis of menorrhagia is essential for developing an effective treatment plan. Healthcare providers employ a variety of methods to determine the underlying cause of heavy menstrual bleeding.

Initial Assessment and Medical History

The diagnostic process typically begins with a thorough discussion of your symptoms and medical history. Your healthcare provider may ask you to keep a menstrual diary to track the duration and intensity of your periods, as well as the number of sanitary products used.

Physical Examination and Pelvic Exam

A comprehensive physical examination, including a pelvic exam, helps identify any visible abnormalities or signs of underlying conditions that could be causing the heavy bleeding.

Diagnostic Tests for Menorrhagia

Depending on the initial findings, your healthcare provider may recommend one or more of the following diagnostic tests:

1. Blood tests: To check for anemia, thyroid function, and blood clotting disorders
2. Pap smear: To screen for cervical abnormalities or infections
3. Ultrasound: To visualize the uterus and ovaries, detecting fibroids or other structural issues
4. Endometrial biopsy: To examine the uterine lining for abnormal cells or cancer
5. Hysteroscopy: A procedure that allows direct visualization of the uterine cavity
6. Sonohysterography: An ultrasound technique that uses saline to enhance visualization of the uterine cavity

Treatment Options for Menorrhagia: Finding Relief and Restoring Quality of Life

The treatment approach for menorrhagia varies depending on the underlying cause, the severity of symptoms, and individual patient factors such as age and desire for future fertility. Healthcare providers typically start with conservative measures before considering more invasive options.

Medical Treatments for Heavy Menstrual Bleeding

Several medications can help manage menorrhagia by reducing blood flow or addressing hormonal imbalances:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Reduce pain and blood loss
• Tranexamic acid: Promotes blood clotting to reduce flow
• Hormonal birth control: Regulates menstrual cycles and reduces bleeding
• Progestin therapy: Balances hormones and may reduce bleeding
• Gonadotropin-releasing hormone (GnRH) agonists: Temporarily stop menstruation

Surgical Interventions for Menorrhagia

When medical treatments prove ineffective or inappropriate, surgical options may be considered:

• Endometrial ablation: Destroys the uterine lining to reduce bleeding
• Uterine artery embolization: Blocks blood flow to fibroids, causing them to shrink
• Myomectomy: Surgical removal of fibroids while preserving the uterus
• Hysterectomy: Complete removal of the uterus (considered a last resort)

When to Seek Medical Attention: Recognizing the Red Flags of Menorrhagia

While some variation in menstrual flow is normal, certain symptoms warrant prompt medical attention. It’s crucial to recognize when heavy bleeding crosses the line from inconvenient to potentially dangerous.

Signs That Indicate You Should Consult a Healthcare Provider

• Soaking through a pad or tampon every hour for several consecutive hours
• Needing to use both pads and tampons simultaneously
• Passing blood clots larger than a quarter
• Bleeding that lasts longer than 7 days
• Feeling dizzy, lightheaded, or experiencing shortness of breath
• Severe pain or cramping that interferes with daily activities

Remember, any significant change in your menstrual pattern or sudden onset of heavy bleeding should be evaluated by a healthcare professional.

Living with Menorrhagia: Coping Strategies and Lifestyle Adjustments

While seeking medical treatment is crucial, there are several strategies you can employ to manage the day-to-day challenges of living with menorrhagia:

Practical Tips for Managing Heavy Periods

• Use high-absorbency menstrual products or period underwear
• Keep a change of clothes handy
• Plan activities around your cycle when possible
• Consider using a menstrual cup for longer-lasting protection
• Stay hydrated and maintain a balanced diet rich in iron

Emotional and Physical Self-Care

Dealing with menorrhagia can be emotionally and physically draining. Prioritize self-care with these strategies:

• Practice stress-reduction techniques like meditation or yoga
• Engage in gentle exercise to alleviate cramps and boost mood
• Get adequate rest and sleep
• Seek support from friends, family, or support groups
• Consider counseling if the condition is affecting your mental health

Menorrhagia in Adolescents: Special Considerations and Concerns

Heavy menstrual bleeding in adolescents presents unique challenges and considerations. The onset of menstruation can be a confusing time, and abnormal bleeding patterns may be overlooked or mistaken for normal variation.

Why is menorrhagia in teens a concern?

Adolescents with menorrhagia face several potential complications:

• Anemia and associated fatigue, which can impact academic performance
• Embarrassment and social isolation due to heavy bleeding
• Missed school days and activities
• Potential long-term reproductive health issues if left untreated

Diagnostic and Treatment Considerations for Adolescents

When evaluating and treating menorrhagia in adolescents, healthcare providers must consider:

• The psychological impact of invasive procedures
• Long-term effects of hormonal treatments on development
• Preservation of fertility
• Education and support for both the patient and her family

Parents and caregivers should be alert to signs of heavy menstrual bleeding in adolescents and seek medical advice if concerns arise. Open communication and early intervention can significantly improve outcomes and quality of life for young women experiencing menorrhagia.

Future Directions in Menorrhagia Research and Treatment

As our understanding of menorrhagia evolves, researchers continue to explore new avenues for diagnosis and treatment. Several exciting developments are on the horizon:

Emerging Diagnostic Tools

• Advanced imaging techniques for more precise visualization of uterine abnormalities
• Genetic testing to identify hereditary bleeding disorders
• Biomarker analysis for early detection of underlying conditions

Innovative Treatment Approaches

Researchers are investigating several promising treatment options:

• Targeted drug therapies with fewer side effects
• Minimally invasive surgical techniques for fibroid removal
• Stem cell therapies for uterine tissue regeneration
• Personalized medicine approaches based on genetic profiles

These advancements hold the potential to revolutionize the management of menorrhagia, offering more effective and less invasive options for women struggling with this condition.

As research progresses, it’s crucial for women experiencing heavy menstrual bleeding to stay informed about new developments and discuss emerging options with their healthcare providers. The future of menorrhagia treatment looks promising, with the potential to significantly improve the quality of life for millions of women worldwide.

Menorrhagia | Johns Hopkins Medicine

What is menorrhagia?

Menorrhagia is heavy or prolonged menstrual bleeding. Many women have this type of abnormal uterine bleeding. It can be related to a number of conditions including problems with the uterus, hormone problems, or other conditions. While heavy bleeding can make it tough to take part in normal daily life at times, there are treatments to help.

What causes menorrhagia?

During your menstrual cycle, if an egg is not fertilized, the uterine lining breaks down, and bleeds. The egg and the uterine lining are then shed during your period.

Hormone problems or conditions that affect the uterus can result in heavy bleeding. Other diseases or bleeding disorders can also cause it.

Hormone problems include:

• Imbalance of estrogen and progesterone or other hormones

Problems with the uterus include:

• Fibroids (non cancerous)
• Cancer
• Pregnancy problems (such as a miscarriage or ectopic pregnancy)
• Use of an intrauterine device (IUD)

Other conditions such as thyroid, kidney or liver disease, cancer or bleeding disorders can also cause heavy bleeding.

What are the symptoms of menorrhagia?

If you have to change your pad or tampon every 1 to 2 hours because it is soaked, or bleed longer than 7 days, see your doctor. Spotting or bleeding between periods is also a sign of a problem.

The symptoms of menorrhagia may look like other conditions or medical problems. Always consult your healthcare provider for a diagnosis.

How is menorrhagia diagnosed?

Your healthcare provider will ask you about your medical history and about your periods. You will also have a physical exam including a pelvic exam. You may be asked to keep track of your periods and how many pads or tampons you use for a few months if you haven’t already done so.

• Blood tests. These check for anemia and test how fast your blood clots.
• Pap test. For this test, cells are collected from the cervix and examined. It’s used to check for cancerous changes, infection, or inflammation.
• Ultrasound. Using sound waves and a computer, your healthcare provider can check for fibroids or other problems inside the uterus.
• Biopsy. Examining a tissue sample from the uterine lining can help your healthcare provider find cancer or other abnormal tissue.

Other tests include:

• Hysteroscopy. Using a viewing instrument inserted through the vagina, your healthcare provider can see the cervix and the inside of the uterus.
• Dilation and curettage (D&C).This procedure involves scraping and then examining the uterine cavity.

How is menorrhagia treated?

Your healthcare provider will consider your age and overall health and your personal preferences when finding the best treatment for you.

Treatment for hormone problems may include:

• Prostaglandin inhibitors. These are nonsteroidal anti-inflammatory medicines (NSAIDs), including aspirin or ibuprofen. They help reduce cramping and the amount you bleed.
• Birth control pills. These stop ovulation and result in lighter periods.
• Progesterone. This is a type of hormone treatment.

Treatment for problems with the uterine lining (endometrium) may include:

• Ablation. Healthcare providers use this procedure to destroy the lining of the uterus (endometrium).
• Resection. In this procedure, the lining of the uterus is removed.
• Hysterectomy. This is the surgical removal of the whole uterus.
• Iron supplements. If you have anemia as a result of the heavy loss of blood, you may need iron supplements.

When to seek medical care

See your healthcare provider if:

• You have to change your pad or tampon every 1 to 2 hours because it is soaked
• Bleed longer than 7 days
• Have spotting or bleeding between periods

Key points

• Menorrhagia is heavy or prolonged menstrual bleeding. It is a common problem in women.
• It is caused by hormone problems, problems with the uterus, or other health conditions.
• Menorrhagia is diagnosed with a pelvic exam, ultrasound, pap test, and sometimes a biopsy.
• Treatment includes hormones, or other medicine, or procedures to treat the uterine lining or remove the uterus.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Heavy periods – Better Health Channel

Summary

Read the full fact sheet

• Heavy or abnormal periods may be an indication of other health problems.
• About 25% of women lose lots of blood when they have their period.
• Learn more about the effects of heavy periods, the causes, treatment options and where to get help.

About 25% of women lose lots of blood when they have their period. The amount of blood loss from your period can change at different times in your life.

Irregular vaginal bleeding is any bleeding from a woman’s vaginal area and usually refers to bleeding that is not part of a regular period. The range of causes includes infection and hormonal changes. If you suffer from ongoing bleeding problems, see your local doctor for a full assessment to make sure there is no underlying disorder causing the problem.

What is a heavy period?

A heavy period (also called ‘abnormal uterine bleeding’) is when you lose more than 80ml (1/3 cup) of blood each cycle.

Signs of heavy periods include:

• bleeding that lasts longer than seven to eight days
• bleeding or ‘flooding’ of your pad or tampon (especially the largest sizes)
• needing to change your pad or tampon every two hours or less
• needing to change your pad or tampon overnight
• blood clots that are larger than a 50-cent piece.

Your period shouldn’t interrupt your daily activities, or cause stress or anxiety.

Effects of heavy periods

Heavy blood loss from your period can affect you in many ways.

For example, you might:

• feel tired, exhausted or dizzy
• look pale
• have low iron levels
• have cramping and pain in your lower abdomen
• worry that bleeding will soak through your clothes.

What causes heavy periods?

In many cases, it’s hard to know the exact cause of heavy periods. The cause in about 50% of women who have heavy periods is the uterus lining growing more than usual. This lining sheds to create a period.

Other common causes of heavy periods include:

• complications of pregnancy, including ectopic pregnancy or miscarriage
• polycystic ovary syndrome (PCOS)
• endometriosis – when cells similar to those that line the uterus grow in other parts of the body
• endometrial polyps – growths in the inner lining of the uterus
• endometrial cancer
• adenomyosis – when the endometrium grows inside the muscle of the uterus
• fibroids – non-cancerous growths within the uterus wall
• intrauterine device (IUD).

Getting a diagnosis

See your doctor if you are worried about heavy periods.

They might ask about your general health, medical history, sexual activity and plans to get pregnant.

Tests

Your doctor may do some tests to learn more about your heavy periods.

For example, they might do:

• a physical examination of your vagina and uterus
• a pregnancy test
• an iron test
• a cervical screening test
• various blood tests
• an ultrasound.

Your doctor may refer you to a specialist if:

• there is evidence of fibroids, adenomyosis or polyps on your ultrasound
• your bleeding doesn’t improve after six months of treatment.

Treatment options

Treatment options depend on the cause of your heavy periods. Your doctor might prescribe medicine or a change of contraception (for example, an intrauterine device or IUD). They might also suggest surgery for more serious conditions.

For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s HealthExternal Link.

Where to get help

• GP (doctor)
• Gynaecologist
• Family planning clinic
• Sexual Health VictoriaExternal Link. Tel: (03) 9257 0100
• Jean Hailes for Women’s HealthExternal Link

• Hallberg L, Högdahl AM, Nilsson L, Rybo G. Menstrual blood loss – a population study. Variation at different ages and attempts to define normality. Acta Obste Gynaecol Scand. 1966;45(3):320–51.
• Heavy menstrual bleeding; assessment & management. NICE guideline [NG88] www.nice.org.uk/guidance/ng88External Link. March 2018
• Quinn S, Higham J. Outcome measures for heavy menstrual bleeding, Womens Health 2016;(1) 21-26.
• Davies J, Kadir RA. Heavy menstrual bleeding: an update on management. Thromb. Res 2017, 151(1):70-77.
• Kocaoz S, Cirpan R, Degirmencioglu AZ. The prevalence and impacts heavy menstrual bleeding on anemia, fatigue and quality of life in women of reproductive age. Pak J Med Sci. 2019;35(2):365-370. doi:10.12669/pjms.35.2.644.

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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 fibroids. 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

Treatment of uterine bleeding | Dobromed

Uterine bleeding – discharge of blood from the vagina, characterized by profuseness and duration. This pathological condition poses a danger to the life and health of a woman, is a sign of serious diseases of the reproductive system. In order to save the patient, it is important to immediately give her first aid, find out the cause of the outpouring of blood. Natural bleeding from the vagina is called menstruation. Menstrual bleeding is characterized by cyclicity, repeated at regular intervals. The period between menstruation usually lasts 25 – 30 days. Blood from the vagina should not stand out longer than 8 days, otherwise we can talk about pathology. Violation of the menstrual cycle is a reason to immediately contact a gynecologist. The doctor will find out the cause of the pathological phenomenon, help get rid of the disease at an early stage, until complications arise.

Causes of uterine bleeding

The likelihood of uterine bleeding depends on the age of the patient. In girls from 12 to 18 years old, abundant discharge of blood from the vagina is a consequence of a hormonal imbalance. And hormonal disruptions at a young age arise due to:

• physical trauma or emotional upheaval;
• deterioration of the endocrine glands;
• malnutrition, deficiency of vitamins in the body;
• pregnancy with complications, difficult delivery;
• genital tuberculosis;
• bleeding disorders;
• severe infectious diseases.

In women of mature age, uterine bleeding is a rare occurrence, usually associated with impaired ovarian function. In this case, the provocateurs of the pathological condition are:

• stress, fatigue, nervous tension, mental disorders;
• uterine fibroids;
• endometriosis;
• advanced endometritis;
• uterine polyps;
• oncology of the uterus or cervix;
• tumor formations in the ovaries;
• ectopic pregnancy, miscarriage, medical or instrumental abortion;
• infectious diseases of the reproductive organs;
• climate change, unfavorable ecological situation in the place of residence, harmful working conditions;
• taking medications that can disrupt the systemic work of the hypothalamus and pituitary gland.

Uterine bleeding is common in menopausal women. This is due to a decrease in the synthesis of gonadotropin by the pituitary gland. As a result, the level of sex hormones in the female body begins to jump, the menstrual cycle goes astray, and the formation of follicles in the ovaries is disrupted. Common causes of uterine bleeding at reproductive age are:

Symptoms of uterine bleeding

• weakness;
• fainting;
• dizziness;
• nausea;
• blanching of the skin;
• cardiac tachycardia;
• lowering blood pressure.
• copious bleeding from the vagina;
• presence of clots in blood secretions;
• change pad every 2 hours, even more often;
• duration of bleeding more than 8 days;
• increased bleeding after intercourse;
• painless bleeding with a dysfunctional origin of the pathology;
• discrepancy between the onset of bleeding and the period of menstruation.

The duration of menstruation normally does not exceed 8 days, and bleeding that persists longer than normal is pathological. Unhealthy should be considered vaginal bleeding, the period between which is less than 21 days. During menstruation, 80-120 ml of blood flows out per day, with uterine bleeding, the daily volume of blood is more than 120 ml.

Types of uterine bleeding

Bleeding from the uterus, depending on the age of the patients, are divided into five types.

1. During infancy. In the first week of life, a newborn girl may have slight bleeding from the vagina. This is not a pathological phenomenon, the child does not need medical intervention. Infant bleeding is caused by a sharp change in the hormonal background in a girl who was born, and disappear on their own.
2. Before puberty. During this period, vaginal bleeding in girls is rare. The cause of the pathological condition is most often a hormone-dependent ovarian tumor, due to which the sex gland synthesizes too many hormones. As a result, the girl has a false maturation of the reproductive system.
3. During puberty. Uterine bleeding during puberty, attributable to 12-18 years, is called juvenile.
4. During the reproductive period. Bleeding from the uterus, observed in the period of 18 – 45 years, are organic, dysfunctional, breakthrough, as well as due to pregnancy and childbirth.
5. In menopause. During the period of extinction of the reproductive function, bleeding from the vagina is most often associated with pathologies of the genital organs or with a decrease in the synthesis of hormones.

Dysfunctional bleeding

This type of uterine bleeding during the reproductive period is the most common. The pathological condition is diagnosed in both girls and older women during menopause. The cause of dysfunctional blood secretions is the failure of the synthesis of sex hormones by the endocrine glands. The endocrine system, including the pituitary, hypothalamus, ovaries and adrenal glands, controls the production of sex hormones. If the work of this complex system fails, then the menstrual cycle is disturbed, the duration and abundance of menstruation changes, the likelihood of infertility and spontaneous abortion increases. Therefore, with any changes in the menstrual cycle, you should immediately contact a gynecologist. Dysfunctional uterine bleeding can be ovulatory and anovulatory. Ovulatory bleeding is manifested by a change in the duration and abundance of blood discharge during menstruation. Anovulatory bleeding occurs more often, due to the lack of ovulation due to a violation of the synthesis of sex hormones.

Organic bleeding

Such bleeding is caused either by severe pathologies of the reproductive organs, or by blood diseases, or by serious disorders of the internal organs.

Breakthrough bleeding

Such uterine bleeding is also called iatrogenic. They are diagnosed after exceeding the dosage and course of taking certain medications, frequent use of hormonal contraceptives, as well as after surgery to install a spiral and after other surgical procedures on the organs of the reproductive system. In this situation, it is recommended to consult a doctor about changing the dosage of the medication. In most cases, with breakthrough bleeding, gynecologists advise patients to increase the dosage of the hormonal agent for a certain time. If after this measure the amount of blood released does not decrease, but increases, then you need to urgently undergo a medical examination. In this case, the cause of the pathological condition may be a serious disease of the reproductive system. If uterine bleeding occurred after the installation of the spiral, then the contraceptive device most likely injured the walls of the uterus. In this situation, you should immediately remove the spiral and wait for the healing of the uterine walls.

Bleeding due to pregnancy and childbirth

In the first months of pregnancy, bleeding from the uterus is a sign of either threatened spontaneous abortion or ectopic location of the fetus. In these pathological conditions, there are severe pains in the lower abdomen. A pregnant woman who has begun uterine bleeding should immediately contact a supervising doctor. When a spontaneous abortion begins, the fetus can be saved if the correct treatment is started in time. In the last stages of a miscarriage, you will have to say goodbye to pregnancy, in this case, curettage is prescribed. In an ectopic pregnancy, the embryo develops in the fallopian tube or cervix. Menstruation is delayed, some symptoms of pregnancy are noted, but the embryo is not found in the uterus. When the embryo reaches a certain stage of development, bleeding occurs. In this situation, the woman needs urgent medical attention.

In the third trimester of pregnancy, uterine bleeding is deadly for both the mother and the developing child.

The causes of the pathological condition in the later stages of gestation are placenta previa or abruption, rupture of the uterine walls. In these cases, the woman urgently needs medical attention, usually a caesarean section is performed. Patients who have a high risk of the above pathologies should be kept. Uterine bleeding can also occur during childbirth. In this case, its causes may be the following pathological conditions:

• placenta previa;
• bleeding disorder;
• low uterine contractility;
• placental abruption;
• stuck in the uterus afterbirth.

If bleeding from the uterus occurs several days after delivery, an ambulance should be called immediately. The young mother will need emergency hospitalization.

First aid before the arrival of doctors

Excessive bleeding from the vagina must be stopped or at least reduced before the arrival of doctors. This is a matter of life and death for a woman. In most cases, with competent first aid, bleeding stops, but in 15% of cases, the pathological process ends in death.

Every woman should know how to help herself before the arrival of the doctors, what can and cannot be done.

A sick woman, waiting for doctors at home, should do the following:

• lie on her back, remove the pillow from under her head;
• place a high roll made of towels or a blanket under the shins;
• place a cold water bottle or ice-filled heating pad on the abdomen;
• drink cold still water.

It is strictly forbidden:

• to stand or sit;
• lie with your legs pressed to your stomach;
• take a hot bath;
• douching;
• put a heating pad on the stomach;
• drink hot drinks;
• take any medication.

Drug therapy

Treatment of diseases that caused bleeding from the uterus is carried out in a hospital. In addition, the doctor prescribes medicines to the patient to help stop the bleeding. Hemostatic drugs are taken only on the recommendation of a medical specialist, taking drugs at one’s own discretion is strictly prohibited. Below is a list of medicines most commonly used to stop bleeding.

• Etamzilat – This drug stimulates the synthesis of thromboplastin, changes the permeability of blood vessels. Blood clotting increases, as a result, bleeding is weakened. The drug is intended for intramuscular injection.
• Oxytocin – A hormonal drug often used during childbirth to improve uterine contractility. As a result of contraction of the uterine muscles, bleeding stops. The drug oxytocin is prescribed for intravenous administration with the addition of glucose, has a large list of contraindications.
• Aminocaproic acid – This medicinal substance does not allow blood clots to dissolve under the influence of certain factors, due to this, bleeding is reduced. The medicine is either taken orally or given intravenously. Treatment of uterine bleeding with aminocaproic acid is carried out under close medical supervision.
• Vikasol – The drug is based on vitamin K. With a deficiency in the body of this vitamin, blood clotting worsens. The drug is prescribed to patients who have a tendency to uterine bleeding. However, vitamin K begins to act only 10-12 hours after it enters the body, so it is not advisable to use the drug to stop the blood in emergency cases.
• Calcium gluconate – The drug is prescribed for calcium deficiency in the body. Deficiency increases the permeability of the vascular walls, worsens blood clotting. This drug is also not suitable for emergency use, but is used to strengthen blood vessels in patients prone to bleeding.

Treatment with folk remedies

Decoctions and infusions of medicinal plants can be used to stop and prevent uterine bleeding. Listed below are the most popular and effective folk recipes for stopping blood.

• Yarrow infusion – You need to take 2 teaspoons of dried plant material, pour a glass of boiling water. The solution is infused for about an hour, then filtered. The infusion is taken in a quarter cup 4 times a day before meals.
• Nettle decoction – Take a tablespoon of dried nettle leaves, pour a glass of boiling water. The solution is boiled over low heat for 10 minutes, then filtered. Ready broth is taken in a tablespoon 3 times a day before meals.
• Infusion of shepherd’s purse – Take a tablespoon of dried plant materials, pour a glass of boiling water. The container with the solution is wrapped in a warm towel, left for an hour to infuse.