Secondary menorrhagia is a symptom. Menorrhagia: treatment, and in what cases menstruation is dangerous. Causes of pathology and its treatment

Every woman has a different menstrual cycle. For some, it works like clockwork, while for others, its irregularity becomes a regularity. Perhaps every woman has experienced pain during menstruation, and someone has menorrhagia. What it is? In simple words- heavy menstrual bleeding. If you find abnormal abundant discharge in yourself, you should definitely contact a gynecologist, he will help to establish the cause. Large blood loss can lead to fatigue, overwork, and even anemia. Menorrhagia - what is it and how to treat the disease, we will understand in more detail.

Symptoms of the disease

Prolonged and profuse uterine bleeding (menorrhagia) recurs at regular intervals. The following indicators can serve as symptoms of menorrhagia: normally, menstruation lasts from three to five days, while blood loss does not exceed two hundred milliliters. With menorrhagia, this period drags on for a week or more, blood loss can reach five hundred milliliters.

Menstrual flow is not only blood, but biological fluid, which has a mixed composition. But, nevertheless, her great loss turns optimal cycle V serious violation. Perhaps the development of iron deficiency anemia, which provokes sudden fainting and poses a threat to health. Due to heavy discharge during menstruation, a woman is forced to change her sanitary pad every hour.

Often, menorrhagia is accompanied by bruising on the body, bleeding from the gums and nose.

Menorrhagia: causes

Causes of menorrhagia can be:

• Hormonal imbalance when different phases the cycle disrupts the correct ratio of sex hormones.
• Are common hormonal disorders in the body (at work) thyroid gland, ovaries).
• Use of an intrauterine device (contraceptive).
• Hormonal teenage imbalance.
• The use of contraceptives.
• Climax.
• Diseases of the kidneys, liver, cardiovascular system.
• Accompanying menorrhagia uterine myoma, fibromyoma, chronic endometritis, polyps of the endometrium, uterine neck, uterine cavity, endometriosis, adenomyosis, other diseases reproductive system.
• Blood clotting disorders, taking anticoagulants.
• Diseases - hemophilia, thrombocytopathy, vitamin K deficiency.
• Menorrhagia is characteristic of an ectopic pregnancy.
• A sharp change in climate (travel to hot places).
• Psycho-emotional and physical exercise, stress.

Diagnostics

The diagnosis of "menorrhagia" is established by the doctor only after the full examination. Diagnosis begins with an examination of the pelvic organs. In this case, special swabs are taken from the vagina. If there is a suspicion of myoma, the patient is sent for an ultrasound.

Gynecologists strongly recommend women to keep a cycle calendar, to mark in it both the duration and the abundance of menstruation. The indicator is taken as the frequency of changing the sanitary napkin, changing more than once an hour or every hour indicates too copious discharge.

Diagnostics is carried out according to the following indicators:

• History of the patient's complaints (how long ago menstruation became profuse, what preceded this, what drugs were taken, etc.).
• Gynecological history and its analysis ( past illnesses, surgery, pregnancy, infection, etc.).
• Menstrual function and its analysis (first menstruation, cycle regularity, soreness, profusion, etc.).
• Ultrasound of the pelvic organs.
• Gynecological examination.
• Determination of the ratio and level of hormones, coagulogram (blood clotting test).
• Oncomarkers CA-125, SF-199.
• Colposcopy.
• Smear microscopy.
• Pap smear tests for oncocytology.
• Hysteroscopy.
• Biopsy of the cervix.
• Consultation of an endocrinologist-gynecologist.

Menorrhagia: treatment

Therapy depends directly on the cause of the disease. Also, treatment is determined by the duration and abundance of bleeding.

For regulation hormonal balance funds are assigned hormonal contraception which normalize the ratio of progesterone and estrogen. At the same time, menstrual flow is reduced by about 40%.

Iron preparations are prescribed to prevent anemia. Rutin, combined with ascorbic acid, helps to reduce blood loss. Anti-inflammatory drugs such as ibuprofen are often prescribed. To correct severe bleeding, it is necessary to use hemostatic agents: chloride, calcium gluconate, Dicinon, aminocaproic acid.

Treatment of menorrhagia can also be carried out by physiotherapy (applications with ozocerite, diathermy).

Surgical methods

In some cases, in the treatment of menorrhagia, there is a need for surgical intervention (the uterine cavity, the cervical canal are scraped, endometrial polyps, fibroids are removed).

Indications for surgical treatment serve:

• Damage, as well as physiological disorders of the genital organs.
• Recurrent menorrhagia.
• Iron-deficiency anemia.
• Drug therapy did not give the desired effect.
• Surgical treatment of menorrhagia reviews is ambiguous. But in most cases, this allows the patient to gain health and forget about this disease.

Surgical procedures are divided into two types: hysterectomy and hysteroscopy.

Hysterectomy

Menorrhagia (what it is, we found out) is treated like this surgically, as a hysterectomy is the removal of the uterus, which is carried out through the vagina or a small incision in abdominal cavity. This type of surgical intervention for young women is extremely rare, only in exceptional cases because it is impossible to get pregnant after a hysterectomy.

This operation, according to patients, brings significant relief, sex drive while not decreasing sex life remains at the same level, and even becomes brighter. The advantages of the operation include the fact that the patient's body recovers very quickly (within a few days), significant surgical scars missing. From the practice of hysterectomy, it can be concluded that in most cases the cycle stops after surgery, the discharge no longer bothers, menopause occurs over time.

Hysteroscopy

During hysteroscopy, the walls of the uterus are examined using a special tool that is equipped with optical system. The procedure allows you to diagnose and at the same time eliminate any violations. A hysteroscopy procedure is performed in a hospital or in outpatient settings. The effectiveness of the operation is up to 85%. Before the intervention, the patient's Rh factor and blood type are determined, a gynecological smear is taken, as well as tests for hepatitis B and syphilis.

Complications and consequences

TO various violations in the reproductive system causes menorrhagia, what is it that any woman needs to know. Having found at least some symptoms of the disease, you should immediately contact a gynecologist. Untimely intervention and belated elimination of the causes of menorrhagia can lead to:

• the development of anemia;
• infertility;
• emergence and further development malignant tumors reproductive system;
• a significant deterioration in the quality of life, possible loss working capacity.

If a woman is regularly examined by a gynecologist (once every six months), then problems identified in time and properly prescribed treatment will protect her from a disease such as menorrhagia.

Folk remedies

Menorrhagia - what is it and is it possible to alleviate the symptoms of the disease folk ways? In some cases, yes, you can resort to grandmothers' recipes to alleviate the condition, but it is necessary to treat the causes of the disease only under the supervision of a doctor.

Fesalis tincture gives positive effect. She prepares ahead of time. It is necessary to infuse dried fesalis roots (50 g) in half a liter of vodka. The medicine is infused for two weeks, the contents must be shaken periodically. You need to take 20-30 drops before meals three times a day.

Take dry raspberry leaves, chop, pour three tablespoons of boiling water (half a liter). The medicine is infused for up to six hours in a wrapped form. Four times a day you need to drink a decoction in a warm form for half a glass.

Make a collection, it will include: leaves of white amela, blackberry, shepherd's purse grass. You need to take 50 g of the collection, a liter of dry red wine, mix. Bring the mixture to a boil after five hours. Next, everything needs to be cooled, and then filtered. The drug should be taken three times a day, 50 ml.

In any case, with menorrhagia, be sure to consult a gynecologist for help. Human body It's a complex system and it's different for everyone. It may turn out that the means that helped one may harm another. Only a doctor with the right diagnostic methods is able to accurately identify the cause of the disease and prescribe the correct treatment.

Prevention

The prevention of menorrhagia includes a number of the most simple rules, observance of which gives a chance to avoid this insidious disease, this includes:

• Complete and timely treatment various infections, inflammation of the pelvic organs.
• Constantly lead menstrual calendar, which allows you to track the regularity of the cycle, the duration and abundance of secretions.
• If possible, exclude from life psycho-emotional and intense physical activity, overwork, as well as abrupt change climate.
• Give up bad habits.
• Lead healthy lifestyle life ( proper nutrition, sports).
• Observe personal hygiene.
• Visit your gynecologist twice a year for periodic checkups.

Menorrhagia in adolescents

What is menorrhagia in women, now it is clear, the question arises - at what age can this disease manifest itself? The practice of gynecologists shows that already in adolescence menorrhagia can cause normal course vital activity. Girls aged 13-16 complain of prolonged and heavy bleeding, violations of the cycle. At the appointment, the doctor, first of all, pays attention to height, weight, the formation of sexual characteristics, excludes diseases that inhibit development. General state health (visiting sports, working capacity, activity during menstruation) also indicates a certain predisposition to gynecological diseases. In a conversation with adolescents, the doctor should explain that nothing terrible is happening in the body, and qualified treatment will help to quickly correct the situation.

Diagnosis in adolescents

In addition to the fact that the girl is undergoing an initial examination by a gynecologist, with menorrhagia, she is sent for a blood test for hemoglobin. The doctor should find out if there are any signs iron deficiency anemia. If the rate is too low, in some cases the gynecologist recommends hospitalization with a blood transfusion procedure. This safe measure is very effective for menorrhagia in adolescence. The doctor also recommends a girl in without fail keep a menstrual calendar under the guidance of a mother or sister, clearly mark the days, duration and abundance of discharge.

Treatment of menorrhagia in girls

The treatment of menorrhagia largely depends on the fact whether heavy bleeding is observed for the first time or whether this is a regular occurrence. In the primary case, the girl is assigned to receive certain oral contraceptives several times a day for a week. A side effect may be nausea. Another variant - alternative means that normalize the cycle and cause menstrual-like bleeding. The drugs should be taken 12 days a month for six months (six cycles).

With regular menorrhagia, special drugs are prescribed that affect the uterine mucosa, reduce the volume of secretions. Such funds are used only during menstruation.

The effect of the treatment of menorrhagia in adolescence is generally manifested after six months, when the cycle is restored. The patient should be regularly examined by her gynecologist.

Menorrhagia is a gynecological pathology that contributes to the violation of the cycle, as a result of which critical days profuse bleeding occurs. The disease represents serious danger for women's health, as it leads to inflammation of the pelvic organs. Before starting treatment, you need to understand what provoked the appearance of this problem.

Let's figure out what it is - menorrhagia. The second name of the pathology is hyperpolymenorrhea. This term in medicine refers to heavy menstruation.

In the case of menorrhagia, a woman loses more than 80 ml of blood in one desquamation. For comparison: the discharge does not exceed 50 ml, while clots with a pathological etymology are not observed on the pad.

During the exfoliation of the uterine endometrium in women suffering from this pathology, the mood and well-being deteriorate significantly. - scarlet. Often, copious discharge contains mucus and suspicious clots.

Menorrhagia in women often leads to impaired performance and the development of anemia. This negatively affects their quality of life.

According to statistics, 30% of women who visit a gynecologist with a problem of prolonged and suffer from menorrhagia.

Pathology is classified into primary (occurs with the first desquamation) and secondary (during the reproductive period).

Symptoms

Menorrhagia in women is characterized by the manifestation of such symptoms:

1. Prolonged and profuse bleeding during menstruation - main feature this pathology, the volume menstrual blood exceeds 80 ml.
2. Painful blood loss during menstruation.
3. Lack of appetite.
4. The presence in the secretions of large clots and mucus.
5. Iron-deficiency anemia.
6. Dizziness due to severe blood loss.

To diagnose the disease, the gynecologist assesses the degree of development of the woman's secondary sexual characteristics. This is required to exclude the appearance of pathological processes.

Hypermenorrhea is usually very painful. Discomfort occur in the lower abdomen and lower back. But this is not the main symptom of this pathology, because most women experience it during normal menstruation.

Causes

The causes of polymenorrhea are such violations:

1. Hormonal disbalance. The presence of signs of thyroid disease, leading to hormonal imbalance, is often observed in puberty.
2. Diseases of the reproductive system. For example, polyps, adenomyosis. Pathologies of the uterus provoke the occurrence of menorrhagia in 80% of cases.
3. Illnesses that provoke a violation of blood clotting. For example, it may be a deficiency of vitamin E. Also causes problems with clotting long-term use antibiotics and some hormonal drugs.
4. Diseases of the pelvic organs, liver or heart. Profuse blood loss in menstrual period- this is one of the symptoms of the disease.
5. hereditary predisposition. Menorrhagia is often passed from mother to daughter.

Not only dysfunction of the ovaries and uterus leads to the emergence of this pathology. It can be provoked by the use of an intrauterine device. IN this case heavy and painful menstruation is a side effect.

Secondary menorrhagia often occurs due to psycho-emotional stress or physical overwork. Its appearance is provoked by factors that Negative influence on the functioning of the body.

Menorrhagia in adolescence

In puberty age period hormonal background is unstable. Menorrhagia in adolescents occurs mainly from the age of 13. The main reason for its appearance is an imbalance in the body's production of progesterone and estrogen. It has a negative effect on the process of maturation of the outer uterine layer - the endometrium.

If the mother of a teenage girl suffered from this pathology, then the probability of its occurrence with the first menstruation is very high. Menstruation will be profuse and painful. This condition leads to apathy and loss of efficiency.

Girls suffering from this disease should regularly undergo gynecological examination to avoid possible complications.

Prevention

If dysmenorrhea occurs during menstruation ( strong pain), and large blood clots, needs to be urgently medical examination. Postponing a trip to the gynecologist is not recommended, since the development of menorrhagia often leads to dangerous consequences such as anemia.

To prevent the occurrence gynecological pathologies necessary:

1. Avoid excessive physical activity.
2. Eliminate contributing factors psycho-emotional stress and stress.
3. Get enough sleep, timely treat insomnia.
4. Avoid frequent shift climatic conditions.
5. Eat foods rich in vitamins B, C.

Types of treatment

In order to prevent the occurrence of complications, it is important to start treatment of menorrhagia in a timely manner. Doctors use hormonal or non-hormonal therapy. Regardless of the cause of the disease, it is not recommended to treat it yourself.

At hormone therapy prescribed drugs that regulate the balance of hormones in the body - oral contraceptives. Usually gynecologists advise taking medications containing progesterone and estrogen.

In case of heavy blood loss on critical days, it is recommended to take ascorbic acid and routine. Contraindicated in menorrhagia long time use medications that promote blood clotting, as they have a toxic effect on the body.

Non-hormonal treatment profuse blood loss involves taking antipyretic, analgesic and anti-inflammatory drugs, such as Naproxen or Ortofen. The duration of their use is determined by the gynecologist.

With severe anemia and obvious physiological damage to the genital organs, it is indicated surgical intervention. Curettage of the uterine cavity is carried out. But such an operation will not help to completely get rid of the pathology, therefore, it is planned to be repeated.

Prolonged and heavy menstruation, which is more like dysfunctional bleeding, is called menorrhagia (synonym: hypermenorrhea). The blood is allocated scarlet color, almost always with clots, less often - pure.

For comparison: healthy periods go up to 7 days, and with menorrhagia this condition lasts up to 10 days or more. Women do not always go to the doctor because of hypermenorrhea, believing that it is due to the nature of the body.

Causes of menorrhagia

This pathology may indicate a disease that should be treated. Some of them are serious:

- fibroids (uterine fibroids)

- endometriosis, adenomyosis

- inadequate blood clotting

- Thyroid dysfunction.

From less hazardous conditions pay attention to:

- contraception (intrauterine device)

- intense physical activity, debilitating diets.

It should be noted that these causes can be called less dangerous only at the beginning of the disease.

Other conditions

Is there some more causal factors independent of the woman. These include:

- violation of ovulation process,

- deficiency of female sex hormones.

If the causes of heavy periods, especially with clots, are based on failures in ovulation, this may be due to:

- excessive activation of the fibrinolytic activity of the endometrium (because of this, blood clotting decreases)

- violation of the biosynthesis of prostaglandins (hormone-like substances); this condition is provoked by: aspirin, butadione, indomethacin.

Causes of primary menorrhagia, with or without clots, include congenital anomalies uterus leading to an increase in bleeding surface area.

Consequences of untreated menorrhagia

Without taking the necessary measures, constant heavy periods lead to health threatening consequences:

– anemia

- exhaustion

- metabolic disorders

- diseases of the liver, kidneys, heart.

How does pathology manifest itself?

Symptoms of menorrhagia with clots appear big amount blood released during menstruation, and the accumulations of tissue of a darker color that come out with it. In addition to this main symptom, there are:

- extended cycle of menstruation (from 10 days)

- the volume of menstrual blood increases by 100 ml / day

due to large blood loss: dizziness

- lack of appetite, iron deficiency anemia.

Basically, menorrhagia in women is determined by heavy bleeding. If normal periods were observed before, a secondary type of pathology is diagnosed. This menstruation may be accompanied by large clots, pain in the lower abdomen. However, such pains can also occur during normal periods, they are considered the norm, therefore they are not one of the main signs of menorrhagia.

Diagnosis of hypermenorrhea

When a girl has heavy periods from the first menstruation, they are called primary. This pathology is also treated. In addition to heavy periods, menorrhagia often does not manifest itself in any way, the woman does not show other symptoms. Then to exclude serious illnesses diagnostics is prescribed to monitor the condition of the epithelium of the uterus, cervix, tubes, ovaries.

Blood analysis

First of all, it is carried out full analysis blood. A laboratory study reveals such a symptom of hypermenorrhea as altered red blood cells. Almost all of them are smaller than normal and irregular in shape.

An important criterion for assessing menstruation is the amount of blood loss (with or without clots). Discharge can only be measured by counting the number of pads and tampons. A doctor may ask a woman to keep a diary during her period. You should do this as accurately as possible, do not forget to make notes and notes daily.

The survey also includes:

– inspection pelvic organs

- thyroid study

- taking a smear from the cervix

- histology of the endometrium (in women older than 40 years).

For histology, a fragment of the endometrium is taken in one of 2 ways:

— aspiration biopsy(a tip is inserted into the uterine cavity with a syringe, which sucks a tissue sample)

— diagnostic curettage(carried out under general anesthesia in hospital).

Drug treatment

Treatment for heavy periods depends on the presence of a serious disease that led to this condition. If it is detected (for example, a fibroid or infection is determined), necessary measures, and menstruation will be restored after the cause is eliminated.

If no serious pathology is found, menorrhagia is treated medicines. The goal is to reduce bleeding, pain during menstruation, and also bring the duration of bleeding to normal (3-7 days).

In most cases, the doctor prescribes one of 3 schemes:

1. Mefenamic acid, Ibuprofen, Naproxen, Diclofenac.

2. Preparations of tranexamic acid.

3. Oral contraceptives of a certain group.

Scheme 1 effectively and quickly copes with heavy periods with and without clots, normalizes the cycle. However, these drugs have toxic effect on the gastrointestinal mucosa, so their reception is possible only a short time. Method 2 is contraindicated in women who have been diagnosed with thrombosis of any etiology and stage.

Treatment with contraceptives

Significantly reduce the volume of menstrual blood oral contraceptives. Prescribe only drugs that contain estrogen and progesterone. Together with them, it is possible to take mefenamic acid. Such treatment contributes to the disappearance of cramps in the lower abdomen during menstruation and the regulation of the cycle.

The prognosis of treatment is favorable in most cases. The main thing is to contact a gynecologist after the onset of symptoms, that is, after the first case of heavy periods, especially if they are with clots. Ignoring given state may result in a health hazard.

Operation: only in rare cases

Rarely, when treatment does not help to cope with strong secretions A hysterectomy (removal of the uterus) is performed. As a rule, women who no longer plan to have children agree to this option. In addition, it makes sense for patients in premenopause to wait for the onset of menopause. Then the disease will stop by itself.

Menorrhagia is profuse menstruation, which is characterized by a significant (exceeding physiological norm) blood loss. Menorrhagia symptoms are obvious - this is general weakness accompanied by profuse bleeding. Anything that is outside the norm can be dangerous, so you should always consult a doctor. Idiopathic menorrhagia requires careful diagnosis, after which appropriate treatment can be prescribed. The diagnosis of menorrhagia treatment may involve surgical and therapeutic methods. The entire treatment process is supervised by a gynecologist.

As already mentioned, menorrhagia is blood loss that exceeds normal performance. Recall that normally a woman loses up to 150 ml of blood during menstruation. If the norm is violated, then this can serve as a manifestation of any inflammatory processes in the female genital area, ovarian dysfunction, uterine fibroids, neuropsychic overwork. All other causes will depend on the cause of the underlying disease. Menorrhagia is one of the typical variants of hypermenstrual syndrome (that is, heavy periods), in which menstrual bleeding lasts more than 7 days.

Prolonged and heavy menstruation disturbs about 30% of all women, but not all of them turn to a gynecologist with this problem. There is primary menorrhagia, which occurs in parallel with the first menstruation, and secondary - developing after a period of normal menstruation.

The main manifestation of menorrhagia is prolonged and heavy menstruation. Often there are blood clots of various sizes. Severe and prolonged blood loss often leads to anemia, that is, to a lack of blood. This complication manifested by deterioration general well-being, dizziness, causeless weakness, development fainting. Quite often, with menorrhagia, bleeding from the nose and gums, bruises and bruises on the body can be noted. With menorrhagia, menstruation can be so heavy that a woman simply has to change her pad or tampon every hour, and in some cases every 30 minutes.

Menorrhagia causes different, and in each case they are individual. According to experts, in about 80% of all cases, menorrhagia is a symptom of a number of serious gynecological diseases. For example, fibroids or endometriosis (adenomyosis) of the uterus. Hormonal imbalance is very important. Also, heavy menstruation can be associated with any violations of the blood coagulation process (thromocytopenia) or with a violation of the thyroid gland. That is why, in addition to a gynecologist, it is advisable for a woman to consult with other doctors of the relevant profile, in particular with an endocrinologist. Do not forget about the work of the heart, liver and metabolic process.

Very often the reason heavy menstruation there may be intrauterine contraceptives, as well as dysfunctional uterine bleeding. Women who are actively involved in sports should be aware that heavy physical exertion can also cause menorrhagia. A similar reaction in the body can cause all sorts of diets that are not selected in accordance with individual characteristics organism. Not infrequently, menorrhagia manifests itself as a family disease transmitted through the female line of inheritance. Complicate the whole situation various diseases kidneys, thyroid gland, heart, pelvic organs.

Since adolescents often experience instability hormonal background, then girls aged 13-16 often suffer from heavy menstruation. The main explanation for this is an imbalance between the levels of estrogen and progesterone, which directly affect the maturation and rejection of the endometrium of the uterus. It can also occur with a passion for the thyroid gland, genital tract infections, poor blood clotting. The reasons can also include hereditary forms of coagulopathy (that is, a violation of hemostasis). As a rule, adolescents do not tolerate menorrhagia, so they require immediate medical advice. If not assigned the right treatment, then 30% of girls develop polycystic ovaries in the future.

Menorrhagia treatment requires immediate treatment to avoid further problems. The method of treatment for menorrhagia is chosen depending on the cause and duration of menstrual bleeding. Everyone knows that self-medication only aggravates the situation, so it is better not to do this. As drug therapy, to regulate the hormonal balance, long-term use of hormonal contraception is prescribed. The composition of oral contraceptives includes estrogen and progesterone, which prevent the excessive growth of the endometrium, reducing the amount of discharge during menstruation by about 40%. Selection oral medications carried out by a gynecologist on an individual basis.

Women with menorrhagia are given long-term iron supplementation to avoid likely development iron deficiency anemia. Taking rutin and ascorbic acid will help reduce blood loss. The complex of treatment includes anti-inflammatory drugs (for example, ibuprofen), which affect the amount and duration spotting. If the patient develops heavy bleeding, then it is necessary to prescribe hemostatic drugs - calcium chloride or calcium gluconate, dicinone, aminocaproic acid. In case of hormonal imbalance, homeopathic treatment effectively shows itself.

As additional methods treatments use intrauterine systems with levonogestrel. The main action contraceptive action, namely the obstruction of the proliferation of the endometrium, with a decrease in its thickness and blood supply. But, if metrorrhagia was caused by the use of intrauterine contraceptive, then this method should be abandoned. Finally, women with this diagnosis are advised to rest and balanced diet. At the end of menstrual bleeding, a course of physiotherapy is prescribed.

The main indications for surgical intervention with menorrhagia:

— mechanical damage or physiological disorders of the genital organs.

- recurrent menorrhagia

- inefficiency therapeutic method treatment.

- Severe iron deficiency anemia.

With a therapeutic and diagnostic purpose for menorrhagia, hysteroscopy is performed, which allows you to diagnose any pathology of the uterus and eliminate it. By scraping the uterine cavity, bleeding is prevented for several menstrual cycles, after which menorrhagia resumes. If a woman has long and profuse menstrual bleeding or she is diagnosed with fibroids and polyps, then they resort to extirpation of the uterus - that is complete removal uterus. As a rule, the uterus is removed after 40 years, and in young age this operation only done in very severe cases.

Menorrhagia is prolonged heavy bleeding from the uterine cavity. The beginning and end of bleeding coincides with the menstrual cycle.

Symptoms of menorrhagia in women

Menstrual cycle healthy woman is 21 to 35 days, in which the menstrual phase takes 2 to 7 days. For menorrhagia, duration menstrual phase increases from 8 to 14 days and has a number of other characteristic features:

• pads (tampons) are changed every 1-2 hours, and their number exceeds 4 pieces. per day;
• there is a need to change the gasket at night;
• heavy bleeding accompanied by the appearance of blood clots;
• appear pain in the lumbar region, lower abdomen;
• the color of the secreted blood is scarlet or brown;
• the volume of secreted blood reaches 80-150 ml, while the rate of blood loss these days is up to 44 ml (2-3 tablespoons).

During and after menstruation, women experience fatigue, shortness of breath, dizziness, bleeding from the nose or gums, and bruising may appear on the body. Against the background of a large blood loss, anemia develops.

With abundant painful menstruation a visit to the doctor is necessary measure, since menorrhagia can be a symptom of serious gynecological diseases that require immediate long-term treatment.

Examination methods

During the conversation with the patient, the gynecologist finds out whether stress, prolonged depression, overwork, and a change in climatic conditions could have provoked menorrhagia. Then carried out gynecological examination with the sampling of material from the vagina and cervical canal For laboratory research, tests for hormonal studies are prescribed, ultrasound and hysteroscopy are performed.

At the beginning of the examination, the patient takes an analysis to determine the level chorionic gonadotropin(hCG) in the blood to exclude menorrhagia as a complication of the first trimester of pregnancy. By clinical analysis blood, hemoglobin and erythrocytes are determined, according to biochemical analysis blood level serum iron and bilirubin. Hormonal studies to determine the causes of heavy menstruation are carried out in accordance with the phases of the cycle and include an analysis of the level of sex hormones in the blood: follicle-stimulating (FSH), luteinizing (LH), progesterone, estradiol. The cervix is ​​examined for possible infection, inflammatory process, dysplasia, cancer. An endometrial biopsy is done to rule out possible violations at the cellular level. Used to identify the cause of a disease following methods examinations:

1. Ultrasound is performed to determine the condition of the uterus, ovaries and other organs pelvic floor; with menorrhagia, it is prescribed if there is a suspicion of the presence of uterine fibroids or endometrial polyps.
2. Sonohysterography is a method of examination carried out after the introduction of fluid into the uterine cavity. This method allows you to identify changes in the myometrium, to consider vascular structure polyps, examine the condition of the walls of the uterus.
3. Hysteroscopy - a study in which injection into the uterine cavity occurs physiological saline or carbon dioxide which improves the diagnosis of her condition. This method allows you to quickly eliminate the causes of heavy periods and take a tissue biopsy.

The examination allows you to identify factors that affect the occurrence of bleeding and prescribe effective treatment. The main causes of menorrhagia can be:

1. Changes in hormone levels. At risk are women whose age suggests hormonal changes organisms are girls puberty as well as women going through the developmental phases of menopause.
2. Diseases reproductive organs. These diseases include: uterine fibroids (causes bleeding and an increase in the area of ​​the endometrium; in most cases it is benign education), cervical polyps (the appearance of which is usually provoked hormonal changes in the body, injuries, inflammations), endometrial polyps (they are outgrowths from the endometrium with a loose vascular structure), endometrial hyperplasia (thickening of the mucous membrane of the uterine cavity), inflammatory processes pelvic organs, oncological diseases cervix, endometrium.
3. Use of intrauterine contraceptives (intrauterine devices). In this case, you can get rid of the disease only by removing the spiral and selecting alternative method contraception.
4. Blood clotting disorders provoked by thrombocytopenia, vitamin K deficiency, von Willebrand disease (episodic spontaneous bleeding), taking certain medications.
5. Stress, severe restriction of food intake, heavy physical exertion.

A timely examination and identification of the cause of menorrhagia allow us to develop the necessary medical tactics to eliminate the disease.

Treatment methods for the disease

In the practice of treating menorrhagia, drug therapy, surgical and unconventional methods treatment.

Medical therapy – one of the most priority methods of treatment, since it excludes surgical intervention in the body and preserves the woman's ability to conceive a child. In this case, the following groups of drugs are used:

• Antifibrinolytic - aimed at preventing and stopping bleeding. These drugs include aminomethylbenzoic acid and tranexamic acid, which are used as directed by a doctor until bleeding stops. These drugs do not cause side effects, except for mild disorders in the work of the gastrointestinal tract.
• Hormonal agents - are designed to restore the balance of estrogen and progesterone in the patient's body, to narrow the endometrial vessels. The efficiency of using micronized progesterone is about 30%; drugs - antigonadotropins are applicable for long-term treatment (more than 20 days). Termination of hormone therapy is fraught with a repetition of heavy monthly bleeding, so it is important to constantly monitor the patient's condition. The effectiveness of therapy is 20-30%.
• Non-steroidal anti-inflammatory drugs - are used in the treatment of bleeding as anti-inflammatory and analgesic drugs, while exerting a depressing effect on the production of prostaglandins. The most common drugs in this group are: Aspirin, Paracetamol, Ibuprofen, Diclofenac, Piroxicam. The effectiveness of their application is 20-30%.
• Gonadotropin-releasing hormone (GnRH) antagonists, danazol, are intended for preoperative preparation organism. Their action is aimed at suppressing the production of estrogen by the ovaries, restoring its level to normal. The effect of drugs reduces the foci of endometriosis and eliminates pain in the pelvis.
• Intrauterine contraceptive systems - help to reduce the layer of the endometrium, reduce its blood supply. After 3 months of use, such systems can reduce blood loss in women with menorrhagia by 90%.

Scheme drug treatment effective and allow women of childbearing age to conceive and bear a child after menorrhagia.

Surgical treatments used when medical therapy fails or fails. These methods include:

• Curettage - curettage of the uterine cavity. This procedure rarely used in medical practice, since the possibility of recurrence of symptoms of the disease after surgery is about 50%.
• Destruction of the endometrium is a resection of the thickness of the endometrium of the uterus using an electric current. This technique in 85% of cases relieves the patient of bleeding.
• Hysterectomy (removal of the uterus) - is the most extreme method for women reproductive age, as it completely excludes the possibility of conceiving and bearing a child.

Non-traditional methods of treatment can be used as aids treatment of menorrhagia. The most common use of decoctions medicinal herbs: cuff ordinary; meadow geranium; collection of yarrow, chamomile, horsetail, horse chestnut, shepherd's bag. An effective remedy from heavy monthly bleeding is stinging nettle, shepherd's purse, angelica, cat's foot.

Self-medication with uterine bleeding is unacceptable, since it can lead to a number of complications that transfer the disease from initial stage into neglected or incurable. Timely appeal And correct setting diagnosis will allow you to choose desired method treatment to completely eliminate menorrhagia.