What is dangerous uterine bleeding. internal bleeding

Every third representative of the fair sex faces at least once in her life with uterine bleeding. Bleeding is called different in nature and etiology of the discharge of blood from the uterus. The causes can be various gynecological diseases, problems associated with bearing a child, labor activity, and the postpartum period. Less commonly, but also possible bleeding in women, which may be associated with trauma to the genitals or problems with the blood system.

Etiology of bleeding

Dysfunctional bleeding in gynecology is commonly called uterine bleeding. Abundant discharge is the first signal that violations occur in the hormonal background. More often the reason lies in the lack of normal levels of sex hormones.

Pathology can occur in every woman at any age. From the age category, uterine bleeding is classified depending on predisposing factors:

• Pubertal period (12-18 years) - infectious diseases, lack of essential vitamins, excessive physical activity, psycho-emotional trauma.
• Reproductive (18-45 years) - stresses of a different nature, childbirth and abortion with complications, diseases of the endocrine system, inflammatory processes in the reproductive organs.
• Menopause (45-55 years), the work of the ovaries fades away - infectious diseases of a chronic and acute type, injuries provoked by diseases of the psyche or nervous system.

Clinical signs and symptoms of bleeding are expressed either by profuse spotting during menstruation, or by an increase in the duration of critical days, as well as by acyclic discharge between periods. Sometimes there may be no discharge for 6-8 weeks, and then their appearance with varying intensity.

The main reasons for the manifestation of abundant discharge

There are a lot of reasons that can become a catalyst. Therefore, in order to identify the exact cause, they are divided into several categories.

• discharges are caused by deviations associated with different organs and systems;
• bleeding associated with an imbalance in the genital area.

Causes of an extragenital nature:

• infections (measles, syphilis, etc.);
• blood diseases (hemophilia, vasculitis, lack of vitamins of group C, K);
• liver problems;
• diseases of the cardiovascular system;
• disorders in the thyroid gland.

Genital causes are divided into those related to pregnancy and those not related to pregnancy.

Causes related to pregnancy:

1. In the initial stages - problems with pregnancy (natural and ectopic), pathologies of the fetal egg, for example, cystic drift.
2. Late terms - presentation, scarring in the tissues of the uterus, placental abruption, destruction in the tissues of the cervix, other problems associated with gynecology and obstetrics.
3. During labor activity - placental abruption, low location of the placenta, presentation, rupture of the uterus, trauma to the soft tissues of the birth canal, various injuries of the vulva and vagina, delayed postpartum discharge of the placenta, infringement, problems with the attachment of the placenta.
4. Postpartum period - injuries associated with the soft genital tract, lowering the tone of the uterus, endometritis, fibroids, delayed release of the placenta.

Reasons not related to gestation:

• puberty;
• reproductive;
• period of menopause;
• various neoplasms, tumors of the uterus and ovaries;
• rupture of a cyst or the ovary itself;
• damage to the uterus;
• inflammatory and infectious diseases;
• erosion, cervicitis, vaginitis, endometritis.

Uterine bleeding is only a symptom. You can not delay and do nothing. It is imperative to establish the true cause, eliminate it, and then the symptom of manifestation in the form of bleeding will disappear. Therefore, the source must first be eliminated.

Uterine bleeding - signs of manifestation

Such types of allocations cannot be considered unambiguously. Since the body of each of the women is individual and special, the menstrual cycle differs in its duration, intensity and character. There is a category of women whose periods are meager, short, while others, on the contrary, are plentiful and long.

One of the clear signs of the norm is the regularity of menstruation. If the system is broken, and also, if bleeding began to occur between menstruation, then this can already be called bleeding. In other, more understandable words, we can say that bleeding is menstruation that lasts longer than usual or occurred before the expected menstruation. Otherwise, it can be considered within the normal range.

The clinical picture is represented by the following symptoms:

• systematic meager discharge (daub) that does not affect overall well-being;
• discharge during menstruation, in which a large amount of blood is lost, leading to anemia;
• bleeding of unknown etiology in the middle of the cycle not associated with menstruation;
• copious discharge of dark or bright fresh blood, with clots, with shock and aggravation.

Each of these symptoms is subject to treatment, which will be aimed at stopping blood loss. Signs of severe bleeding that are life-threatening for a woman:

• profuse discharge with a stream or large drops of blood, a sanitary napkin or tampon is changed about 2 times per hour;
• general malaise, drowsiness, weakness, dizziness;
• skin blanching;
• pressure drop;
• rapid heartbeat and pulse;
• manifestation of apathy.

If you have at least one symptom, you should urgently call an ambulance. Otherwise, there is a threat of hemorrhagic shock and subsequently death.

How to stop bleeding: methods of treatment

An important issue that every woman should pay attention to is how to stop uterine bleeding. It was noted above that blood loss can be life-threatening and lead to death.

All types of bleeding in gynecology are treated in a hospital with initial diagnostic measures to establish the causes.

Methods and methods of treatment directly depend on the age category of the patient, the stage of severity and the reasons that provoked blood loss.

The main method is considered to be cleaning (scraping), after which it is easy to establish the true cause with the help of hysteroscopic analysis. This method is rarely used, during puberty, only if there is simply no other way out.

You can also stop bleeding with the use of hormonal drugs in large doses. These include oral contraceptives: "Non-ovlon", "Regevidon".

In the case of symptomatic therapy, apply:

• drugs with hemostatic properties - "Vikasol", aminocaproic acid;
• "Oxytocin" for uterine contraction;
• in case of severe anemia, iron-containing agents - "Fenuls";
• necessarily vitamin complexes and vasoconstrictive agents - folic acid, Ascorutin, vitamins of group B.

After such therapy, prophylaxis is carried out to avoid relapse. During dysfunctions, a second course of hormone replacement therapy can be performed. It is possible to install an intrauterine device. If concomitant intrauterine disorders are detected, appropriate treatment is carried out, for example, a polyp, fibroids, hyperplasia, endometritis.

Effective drugs with hemostatic properties:

• aminocaproic acid;
• "Vikasol";
• "Etamzilat";
• "Dicinon";
• preparations containing calcium.

To quickly achieve blood arrest, uterine contractions can be used: Oxytocin, Pituitrin, Hyfototsin. Sometimes they are prescribed in addition to hormone therapy.

They can also use folk methods in the form of infusions of yarrow, nettle, shepherd's purse, but a specialist consultation is necessary before use.

What to do with prolonged bleeding?

Many women ask how to stop prolonged bleeding? Here we pay attention, if this is a menstruation that lasts more than 7 days - this is no longer normal, you need to visit a gynecologist.

Especially if you notice signs of anemia, urgently call an ambulance and undergo observation in stationary conditions.

Signs of anemia:

• severe weakness, drowsiness and lethargy;
• low pressure;
• very pale skin;
• dizziness;
• fainting state, fainting.

Uterine bleeding - the discharge of blood from the vagina, characterized by abundance 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.

To save the patient, it is important to immediately give her first aid, to 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 periods usually lasts 25 - 30 days.

Blood from the vagina should not stand out for 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 occur due to:

• physical injury or emotional upheaval;
• deterioration of the work of the endocrine glands;
• malnutrition, vitamin deficiency in the body;
• pregnancy with complications, difficult childbirth;
• genital tuberculosis;
• blood clotting disorders;
• transferred serious 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, overwork, nervous tension, mental disorders;
• uterine fibroids;
• 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 often observed in women during menopause. 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, goes astray, and the formation of follicles in the ovaries is disrupted. Common causes of bleeding from the uterus at the age of extinction of reproductive function are:

• uterine fibroids;
• endometriosis;
• uterine polyposis;
• hormone-dependent ovarian tumors.

Symptoms of uterine bleeding

Common signs of pathological bleeding from the uterus are:

• weakness;
• fainting state;
• dizziness;
• nausea;
• blanching of the skin;
• lowering blood pressure.

Specific symptoms of uterine bleeding are:

• profuse bleeding from the vagina;
• the presence of clots in the blood secretions;
• change the pad every 2 hours, even more often;
• duration of bleeding more than 8 days;
• increased bleeding after sexual intercourse;
• painless bleeding with a dysfunctional origin of the pathology;
• mismatch 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 the normal period 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. During the period 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. During the 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 observed 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, which includes the pituitary, hypothalamus, ovaries, and adrenal glands, controls the production of sex hormones. If the work of this complex system fails, then it 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 or 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.

When taking hormonal drugs, scanty bleeding is usually noted, which means that the body is adapting to synthetic hormones. 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 a threat of spontaneous abortion or an ectopic location of the fetus. With these pathological conditions, severe pain in the lower abdomen is noted.

A pregnant woman who has begun uterine bleeding should immediately contact a supervising doctor.

With the onset of spontaneous abortion, 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 fetus 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 baby developing in the womb.

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;
• blood clotting disorder;
• low contractility of the uterus;
• placental abruption;
• stuck in the uterus afterbirth.

If bleeding from the uterus occurs a few days after childbirth, then you should immediately call an ambulance. The young mother will need emergency hospitalization.

First aid before the arrival of doctors

Abundant 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 your back, remove the pillow from under your head;
• put a high roller made of towels or a blanket under the shins;
• put a bottle of cold water or an ice-filled heating pad on your stomach;
• drink cold still water.

When uterine bleeding is strictly prohibited:

• be in a standing and sitting position;
• lie with your legs pressed to your stomach;
• take a hot bath;
• do douching;
• put a heating pad on the stomach;
• drink hot drinks;
• take any medication.

Medical therapy

Treatment of diseases that caused bleeding from the uterus is carried out in stationary conditions. 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.

The following is a list of medications 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 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 the blood vessels in patients prone to bleeding.

Treatment with folk remedies

To stop and prevent uterine bleeding, you can use decoctions and infusions of medicinal plants. Listed below are the most popular and effective folk recipes for stopping blood.

• Yarrow infusion. You need to take 2 teaspoons of dried vegetable raw materials, 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. A tablespoon of dried nettle leaves is taken, poured with a glass of boiling water. The solution is boiled over low heat for 10 minutes, then filtered. Ready decoction is taken in a tablespoon 3 times a day before meals.
• Shepherd's Bag Flask. A tablespoon of dried vegetable raw materials is taken, poured with a glass of boiling water. The container with the solution is wrapped in a warm towel, left for an hour to infuse. Ready infusion is filtered, taken in a tablespoon 3 times a day before meals.

It must be remembered that folk remedies cannot be a full-fledged replacement for medicines, they are used only as an addition to the main therapy.

Before using herbal remedies, be sure to consult a medical specialist to rule out intolerance to the medicinal plant and other contraindications.

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Higher education (Cardiology). Cardiologist, therapist, functional diagnostics doctor. I am well versed in the diagnosis and treatment of diseases of the respiratory system, gastrointestinal tract and cardiovascular system. Graduated from the academy (full-time), has a lot of work experience behind her.

Specialty: Cardiologist, Therapist, Doctor of Functional Diagnostics.

Uterine bleeding is a dangerous condition that threatens not only the health, but also the life of a woman. That is why doctors strongly recommend that at the first signs of this pathological condition, immediately resort to qualified medical care - in this case, everything is decided not even by hours, but by minutes. In order for the appeal to doctors to be timely, you need to know not only the signs of uterine bleeding, but also its possible causes.

Causes of uterine bleeding

In fact, there are a lot of reasons and provoking factors that lead to the development of uterine bleeding. In this material, only the most significant, frequently encountered of them will be considered.

Intermenstrual bleeding

They are especially common in women aged 30-40 years, and process disorders can provoke such a condition. Such disorders are caused by hormonal imbalance, which, in turn, leads to active growth of the endometrium (the inner lining of the uterus) and an increase in the permeability of blood vessels - bleeding in this case can be different in intensity and duration.

Separately, it is worth mentioning that uterine bleeding can occur directly during menstruation - this condition in medicine is called menorrhagia, characterized by profuse and prolonged bleeding.

Factors that can lead to disturbances in the hormonal system of a woman's body:

Diseases of the internal organs of the reproductive system

This category also includes tumors of a malignant / benign nature, and rupture of the ovary against the background of a progressive (inflammatory process), and trauma to the uterus (for example, after some medical manipulations), and in the cervical mucosa, and an inflammatory process in the cervical canal ().

Uterine bleeding due to diseases of the genital organs occurs quite rarely.. Firstly, all of the above pathologies are accompanied by a severe clinical picture and therefore women seek medical help. Secondly, in some pathologies, doctors can predict a high probability of the condition in question and leave the woman in a medical institution to control the situation.

note: Uterine bleeding can also develop during pregnancy. In this case, there is a danger not only to the life of the woman, but also to the life of the child.

Royal

If such a pathological condition has developed (first trimester), then the reasons will be:

• pregnancy that develops with disorders - for example,;
• pathology of the fetal egg - for example, a malignant tumor in the chorion, cystic drift;
• started spontaneous abortion or.

pregnancy, uterine bleeding can develop against the background of premature detachment of the placenta, pathological processes in the cervix, which led to its destruction.

At any stage of pregnancy, the pathological condition in question may occur due to an existing scar on the uterus. It usually remains after performing or abdominal operations for gynecological diseases, and during the next pregnancy, the uterus begins to grow, stretch, which leads to rupture of the scar.

What indicates uterine bleeding

Uterine bleeding often develops acutely, that is, a woman immediately understands what is happening to her, since too much blood begins to stand out from the vagina. But often the condition under consideration develops gradually, all the signs appear one after another, and therefore it is important to quickly find out the reasons for the deterioration in well-being.

Common signs of uterine bleeding that has begun:

• severe general weakness, increased and mild;
• the skin of the face becomes pale, and the upper / lower limbs become cold to the touch;
• the woman is in a semi-conscious state;
• seizures are extremely rare, almost never happen, but exceptions are possible.

If at the time of such a deterioration in well-being it is possible to measure blood pressure, then its indicators will be low, but the pulse may be rapid.

The above signs of the onset of uterine bleeding are non-specific, and it will be extremely difficult to diagnose the condition in question from them. But there are also local symptoms, that is, specific signs:

• there is bloody vaginal discharge;
• if uterine bleeding began during menstruation, then a woman on a pad may notice a large number of clots that have come out of the vagina, and the pad or tampon itself gets wet quickly, they have to be changed every 1-2 hours;
• the absence of pain, but in rare cases there may be sensations that mimic contractions, with localization in the lower abdomen.

Help with uterine bleeding

If there are signs of uterine bleeding, you should immediately call the ambulance team and go to a medical facility! There should not be any self-administration of drugs or drugs from the category of "traditional medicine". A woman must understand that the condition in question threatens her life.

How to help a woman in a hospital

First, a patient with signs of uterine bleeding will be placed on the lower abdomen with a cold compress or an ice pack - this will lead to narrowing of the blood vessels and reduce the intensity of bleeding. Secondly, specialists will quickly find out the possible causes of uterine bleeding:

Thirdly, the woman will be prescribed drug therapy. It is selected on a strictly individual basis and only after the doctor is convinced that urgent surgical intervention is not required.

Hormonal preparations - Jeanine, Regulon, Non-ovlon

You can stop uterine bleeding with these drugs only for women who have not yet given birth, but are at risk for the occurrence of neoplasms in the endometrium. Such drugs can also be used for those patients who underwent diagnostic curettage of the uterus (3 months before the incident) and after examining the biomaterial, no pathologies of the endometrium were found.

The doctor calculates the dosage and regimen on an individual basis, but, as a rule, on the first day a woman should take a maximum of 6 tablets until the bleeding stops, and then every day the dose is reduced by 1 tablet from the original amount.

Note:this method of stopping uterine bleeding is characterized by duration, slowness, and therefore it can not be used categorically when assisting a woman with a diagnosis.

Hemostatic drugs

It is understood that doctors may prescribe:

Any medications should be taken only under the supervision of specialists.. They will monitor the dynamics of the pathological condition, because in the absence of a decrease in the intensity of bleeding, a woman may be prescribed surgical intervention.

Surgery

It is used only in cases where uterine bleeding cannot be stopped by drugs for 2 days and there is not even a decrease in its intensity in the first hours of assistance. Doctors may use the following surgical methods to stop uterine bleeding:

• cryodestruction- with special devices that contain liquid nitrogen, they affect the layer of the uterus, which has undergone pathological changes and "bleeds";
• laser removal of the endometrium– ablation, it is possible to use electromagnetic energy, a ball electrode and a loop;
• scraping with a surgical instrument the uterine cavity or the walls of the cervical canal.

How can you help at home

If it is not possible to seek qualified medical help immediately after the first signs of uterine bleeding appear, then something can be done at home. But such measures are classified as "first aid" and do not mean that you can do without medical help!

Action algorithm:

1. A woman should lie down in bed so that her lower limbs are in an elevated state (a cushion or pillow is placed under them).
2. An ice pack can be applied to the lower abdomen (both frozen dumplings and meat from the refrigerator are suitable), but it must be wrapped in a towel so that hypothermia does not occur. Cold is applied for a maximum of 15 minutes, then a break of 1-2 minutes is taken and it can be used again. This procedure lasts a maximum of 2 hours.
3. A woman should make up for the loss of fluid - she needs to drink enough water, you can replace it with rosehip broth or sweet tea with lemon.

Note:the use of drugs with a hemostatic effect is allowed - Vikasol, tincture of nettle or water pepper, aminocaproic acid. Be sure to consult a doctor before using medications, at least by phone!

Uterine bleeding should not be ignored. Many sources recommend using various decoctions of medicinal herbs, but this should never be done! Traditional medicine in case of uterine bleeding can lead to the death of a woman, as it is not always effective. In any case, the help of specialists will be needed, and if it is provided in a timely manner, the forecasts will become favorable.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

The pathological condition under consideration can be a symptom of very serious ailments and can lead to certain complications. Therefore, uterine bleeding, regardless of intensity and duration, is a reason for immediately contacting a doctor for a full examination and receiving qualified assistance.

What is considered uterine bleeding, what is the danger of bleeding from the uterus?

Uterine bleeding, which lasts no more than a week, and, in general, does not affect the general condition of the woman - menstruation, which is considered a normal condition.

In the event that bleeding from the uterus is intense, and / or it lasts longer than menstruation usually lasts, this indicates the presence of a systemic disease, or disturbances in the reproductive system.

Pathological uterine bleeding has no age restrictions. They can occur during adolescence, menopause, and also in reproductive age.

The main consequence of uterine bleeding is the development in a woman anemia of various degrees. This pathology is manifested by frequent dizziness, general loss of strength. The skin becomes pale, blood pressure drops sharply.

The lack of therapeutic measures in case of heavy blood loss is a serious danger to life!

Causes of uterine bleeding at different ages of a woman

There are many reasons that can provoke the release of blood from the uterus, but the most common of them are the following:

• Hormonal imbalance. Blood loss during menstruation increases with an increase in the level of estrogen or progesterone in the circulatory system.
• Blood disease.
• Errors in the work of the thyroid gland, which are represented by such ailments as hyper- or hypothyroidism.
• Adenomyosis. With this pathology, the patient experiences severe pain during menstruation. The bleeding is intense.
• Polyps.
• Erosive changes in the cervix.
• Injury to the uterus during surgical procedures or during childbirth.
• Serious malfunction of the liver.
• Violations in the functioning of the cardiovascular system: sharp jumps in blood pressure, atherosclerosis, etc.
• Internal uterine fibroids.
• Cancer of the reproductive organs.
• Complications during childbearing, as well as ectopic pregnancy.
• Taking contraceptive hormonal pills or using an intrauterine device. In the first case, the dosage of drugs should be adjusted, or changed to others. If the cause of abundant bleeding from the uterus is a spiral, it must be removed.
• Complications during childbirth: damage to the soft birth canal, incomplete exit of the fetal egg, infringement of the placenta, decreased uterine tone, etc.

As mentioned above, the condition under consideration is characterized by the absence of age restrictions.

Video: Uterine bleeding

1. At the age of 12 to 18 years, the following phenomena can provoke disruptions in hormonal regulation:

1. Deficiency of vitamins in the body, which may be the result of inadequate nutrition.
2. Severe injury.
3. Blood clotting disorders.
4. Malfunctions of the adrenal glands and / or thyroid gland.
5. Tuberculosis of the pelvic organs.
6. A history of various childhood infectious diseases: measles, whooping cough, rubella, etc.

Dysfunctional uterine bleeding at such an early age may also be present in girls whose birth - or gestation - was accompanied by certain difficulties.

2. At the age of 18 to 45 years, the pathological condition in question is diagnosed quite rarely.

The main culprit of uterine bleeding in a similar age interval is ovarian dysfunction, which may be the result of the following phenomena:

• A sharp change in climatic conditions.
• Work in hazardous conditions.
• Taking medications that affect the work of the hypothalamus and / or pituitary gland.
• Prolonged stay in a stressful situation, mental exhaustion.
• Living in a region with poor environmental conditions.
• Ectopic pregnancy.
• Abortion (including spontaneous).
• Inflammatory ailments that are of a chronic nature and adversely affect the ovaries. Such diseases include:
  - Cancers of the ovaries.
  - Cancer tumors, benign neoplasms of the body / cervix.
  — Endometriosis, .

3. At the age of 45 to 55 years, the presence of uterine bleeding may be the result of a violation of ovulation against the background of an irregular release of gonadotropins

Although in some cases, the cause of bleeding from the uterus at this age may be some female diseases.

Clots with bleeding from the uterus - the norm or pathology?

The presence of clots during bleeding can be triggered by the following phenomena:

1. The specifics of the structure of the organs of the reproductive system, which contributes to stagnant blood processes. Doctors often associate such an anomaly with the period of intrauterine development, when the uterus undergoes certain modifications.
2. Hormonal imbalance, in which there is a rapid and excessive growth of the endometrium. Its exfoliation can occur before the timing of menstruation, or during it.

Causes and danger of uterine bleeding during pregnancy

Bleeding while carrying a child is a dangerous signal that requires urgent medical measures, otherwise a miscarriage or premature birth (depending on the gestational age) may occur.

Even with scanty spotting, you should immediately go to the hospital!

The main thing is not to get behind the wheel, because the load in this case must be minimized.

There may be several reasons for this pathological condition:

First 12 weeks:

• Pregnancy disorders (miscarriage, etc.).
• Cancer in the region of the chorion.
• Bubble drift.

After the 12th week - and until the end of pregnancy:

• Degenerative changes in the cervix.
• Detachment / placenta previa.
• A scar on the uterus that remained after a caesarean section or surgical procedures.
• Cuweler's mother.

Video: Uterine bleeding: causes, how to stop, treatment

What to do with uterine bleeding - first and emergency medical care for sudden heavy or prolonged mild bleeding from the uterus

When the pathological condition under consideration appears, it is forbidden to perform the following measures:

1. Apply heat to the abdomen.
2. Take a warm shower, and even more so - a bath.
3. Do douching.
4. Take any drugs that promote uterine contraction without first consulting a doctor.

Before the arrival of the ambulance, you should adhere to the following recommendations:

• Adoption of a horizontal position. It is advisable to put your feet on a hill. This will minimize the severe consequences and help the patient remain conscious.
• Applying cold to the lower abdomen within 1-2 hours. Take 5 minute breaks every 15 minutes.
• Plentiful drink. For these purposes, sweet tea or still water will do. You can also prepare a rosehip decoction: the vitamin C contained in it has a positive effect on strengthening the walls of blood vessels.
• Taking hemostatic drugs. Possible only after consultation with a doctor. With extreme caution, they should be taken by pregnant women: such medicines have certain side effects. This group of drugs includes Aminocaproic acid, Dicinon, water pepper tincture, Vikasol.

If the bleeding is prolonged and/or intense, the following treatment may be provided to women within the hospital:

1. Taking oral combined contraceptives

Actual if the cause of uterine bleeding is a hormonal failure in the body. This method is only suitable for nulliparous women who do not have endometrial cancer.

When diagnosing anemia, the type of treatment in question is unacceptable: it takes a long time. For each patient, the doctor individually calculates the dosage of the drug. However, often the initial dose is 6 tablets. With each subsequent day, the dosage decreases.

2. Treatment with hemostatic drugs

Their reception should be carried out under the supervision of a doctor. The lack of the desired effect may require surgical treatment.

Among the most popular hemostatic agents are:

1. Aminocaproic acid. Most often, drip administration of the drug is used: 100 ml each. in a day. A contraindication to the use of this drug is DIC in a patient.
2. Traneksam. It is a very powerful hemostatic agent, which is also endowed with anti-inflammatory, anti-allergic properties. When the drug in question is combined with other hemostatic drugs, there is a risk of blood clots.
3. Dicynon. It can be administered intramuscularly or by ingestion of 1 tablet 4 times a day. Due to the absence of the effect of increased blood clotting, this remedy can be used for a long period of time.
4. Oxytocin. Favors to increase the tone of the uterus, narrowing the lumen of blood vessels. There are a number of certain diseases in which the specified drug is prohibited from injecting patients: myocarditis, hypertension, serious disorders of the kidneys in pregnant women, etc.

3. Surgery

It is indicated in the absence of positive effects from drug therapy for 2 days after the start of its use.

Acute pathological uterine bleeding is a common problem faced by practicing gynecologists. Even single such cases sometimes require immediate medical attention. The causes of this pathology are numerous. To solve the problem and understand how to stop uterine bleeding, it is necessary to take into account the woman's age, her menstrual function and medical history, risk factors for endometrial pathology and blood coagulation.

Etiology of acute abnormal uterine bleeding

The etiology of uterine bleeding can be multifactorial. This pathology is classified as associated with structural abnormalities of the uterus and disorders in the blood coagulation system. This happens for reasons:

• polyp;
• hyperplasia;
• adenomyosis;
• leiomyomas;
• cancerous processes of the body and cervix;
• coagulopathy;
• ovulatory dysfunction;
• endometriosis;
• pregnancy;
• iatrogenic factors.

Determining the most likely etiology is essential in choosing the most appropriate and effective way to control bleeding for a particular patient and is achieved through history taking, physical and gynecological examination and blood tests.

Clinical examination of hemostasis disorders in a woman with excessive menstrual bleeding

Initial screening for an underlying disorder of hemostasis in such women should be based on their medical history. A positive test result includes the following circumstances:

• heavy menstrual bleeding, starting with menarche;
• postpartum hemorrhage;
• operations accompanied by blood loss;
• violations of the coagulation system in the treatment of teeth.

In this case, the following conditions must be taken into account:

• hematomas once or twice a month;
• frequent nosebleeds;
• persistent bleeding from the gums;
• symptoms of coagulopathy in close relatives.

History or anamnesis

Obtaining a thorough anamnesis is necessary to focus on the circumstances of the bleeding. This takes into account concomitant symptoms and past causes of menstrual irregularities, details of the gynecological and medical history, and data from relevant laboratory and radiological tests.

Up to 13% of women with heavy menstrual bleeding have a variant of von Willebrand's disease and up to 20% of patients may have bleeding disorders. Other causes of coagulopathy, such as decreased clotting factors, hemophilia, and platelet dysfunction, can occur in any age group. In addition, with systemic diseases such as leukemia and liver failure, as well as with medications such as anticoagulants or chemotherapy drugs, clotting may decrease and this may cause bleeding. All this is taken into account in the development of tactics for solving the upcoming question: how to stop uterine bleeding.

Physical examination

Physical examination of a patient with uterine bleeding should begin with an assessment of acute blood loss and the main symptoms, which are hypovolemia, anemia, and findings that suggest an etiology of the disease. The woman's condition should be assessed so that the doctor can determine that she has uterine bleeding and not bleeding from other areas of the genital tract. Thus, a gynecological examination, including examination of the cervix in speculums and bimanual palpation, should be performed by a gynecologist in order to detect any trauma to the genitals, vagina, or cervix. All this allows us to draw conclusions, which was the cause that caused vaginal bleeding. A gynecological examination will also determine the volume, intensity of bleeding, the condition of the uterus, internal genital organs, or structural lesions of the reproductive organ (leiomyoma).

Laboratory research

Laboratory evaluation of patients with this disease is necessary. All adolescents and women are carefully examined for hemostasis disorders. Taking into account the clinical picture, it is required to take into account the pathology of the thyroid gland, liver dysfunction, sepsis, leukemia, etc. Taking samples of endometrial tissue should be performed in all women. This is especially true for patients over 45 years of age. Endometrial biopsy should also be performed in women younger than 45 years of age with a history of exposure to unconjugated estrogens (eg, observed in patients with obesity or polycystic ovary syndrome), a primary bleeding event, or with persistent such manifestations. The decision as to whether to perform a pelvic ultrasound should be based on a clinical assessment of the data.

Initial laboratory testing requires:

• determination of the group and Rh factor;
• pregnancy test;
• registration of activated partial thromboplastin time;
• prothrombin time;
• determining the amount of fibrinogen;
• initial testing for von Willebrand disease;
• determining the level of thyroid-stimulating hormone;
• detection of serum iron, total iron-binding capacity and ferritin;
• liver function tests;
• detection of chlamydia trachomatis.

Control of acute abnormal uterine bleeding in non-pregnant women of reproductive age

The initial assessment of a patient with acute abnormal uterine bleeding should be to test her for signs of hypovolemia and potential hemodynamic instability. Measures to stop bleeding include intravenous administration of conjugated estrogens, the appointment of combined oral contraceptives, oral progestins and tranexamic acid. Decisions should be based on the patient's medical history and contraindications to therapy. Surgery should be considered for those women who are not clinically stable. The choice of surgical intervention should be based on the patient's underlying comorbidities underlying the pathology and the woman's desire to have children in the future. Once an acute episode of bleeding has been resolved, transition to long-term maintenance therapy is recommended.

Uterine bleeding is defined as bleeding from the body of the uterus if it is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy. This pathology can be acute or chronic. Acute bleeding is a situation that requires immediate intervention to prevent further blood loss. An acute process can occur spontaneously or in conditions of chronic spotting or bleeding. The overall assessment of a patient who has this pathology should go through three stages:

• determination of the amount of blood loss;
• clarification of the most probable etiology;
• choosing the right treatment.

Treatment

Limited evidence, expert opinion and recommendations decide how to quickly stop uterine bleeding. The choice of the method of therapy in this case depends on the clinic and etiology, taking into account the main medical problems. The two main goals of management are to stop bleeding and control to reduce menstrual blood loss in subsequent cycles. Medical therapy is considered the preferred primary treatment option. However, certain situations may necessitate surgical intervention.

Basic drugs

How to stop uterine bleeding? The drugs that are used for this purpose are hormonal agents. They are considered the first line of medical therapy for patients with acute bleeding. Treatment options include combined oral contraceptives and oral progestins.

Antifibrinolytic drugs such as tranexamic acid are used to prevent fibrin degradation and are effective in treating patients with any form of bleeding. Tranexamic acid effectively reduces the rate of intraoperative blood loss and removes indications for blood transfusion in surgical patients.

Patients with coagulation disorders or those who are suspected of bleeding may develop unpredictable reactions to hormonal and non-hormonal treatments. For such patients, consultation with a hematologist is recommended, especially if the bleeding is difficult to control or the gynecologist cannot cope with this pathology on his own. Desmopressin may help treat patients with von Willebrand's disease if the woman is known to respond to this drug. It can be administered as an intranasal inhalation, intravenously or subcutaneously. This remedy should be used with caution due to the risk of fluid retention and hyponatremia. It should not be given to patients with massive bleeding receiving intravenous resuscitation. Recombinant factor VIII and von Willebrand factor are also available and may be necessary to control major bleeding. Other disadvantage factors may require factor-specific substitutions.

Patients with bleeding disorders or platelet dysfunction should avoid non-steroidal anti-inflammatory drugs because of their effect on platelet aggregation and their interaction with substances that can affect liver function and the production of blood clotting factors.

Surgery

How to stop uterine bleeding with endometrial hyperplasia or with myoma? The need for surgical treatment is based on the clinical stability of the patient, the severity of bleeding, the presence of contraindications for therapeutic treatment, lack of response to medications and comorbidities. Surgical options include endometrial dilatation and curettage, endometrial ablation, uterine artery embolization, and hysterectomy. The choice of the method of surgical intervention is made on the basis of the above factors plus the desire of the patient to maintain fertility in the future.

Specific procedures such as hysteroscopy, polypectomy, myomectomy may be required if structural abnormalities are suspected as the cause of the identified pathology. And so the question of how to stop uterine bleeding with myoma or polyposis is decided in favor of surgical methods. Dilation and curettage alone (without hysteroscopy) is an inadequate tool for evaluating uterine dysfunction and may provide only temporary relief from bleeding. If they are carried out with concomitant hysteroscopy, then this may be of importance for those patients in whom intrauterine pathology is suspected, or it is desirable to obtain a tissue sample to identify certain processes. Case reports of uterine artery embolization and endometrial ablation have shown these procedures to be successful in managing bleeding. Endometrial ablation, although readily available at most centers, should only be considered if other treatments have failed or are contraindicated. This procedure should only be performed when the woman has no plans for future childbearing and uterine cancer has been reliably excluded as the cause. Hysterectomy is used as a definitive treatment for excessive bleeding, which may be necessary for patients who do not respond to medical therapy.

Thus, it was listed in what ways and how to stop uterine bleeding in the hospital.

Special cases

In most cases, a woman does not know why she has bleeding, and does not suspect that she has certain predisposing factors for the development of this uterine pathology. But sometimes there are diseases that the patient knows about, and it is her information, as well as additional examination methods, that help in clarifying the diagnosis and choosing a specific treatment strategy.

Bleeding during pregnancy

During perimenopause, the most common cause of abnormal bleeding is hormonal changes that prevent ovulation. Regular but much more severe periods are very common in the years leading up to menopause. For women in their 40s, low-dose birth control pills can also help control heavy uterine bleeding. How to stop it and deal with other perimenopausal symptoms, including hot flashes, night sweats, premenstrual syndrome, and headaches? This will help the use of tableted contraceptives when used on an ongoing basis. After the age of 50, with hormone replacement therapy (which consists of lower doses of estrogen and progesterone than pills), it is possible to eventually wean the patient off hormones altogether if the menopausal symptoms gradually decrease.

In perimenopause, some people choose not to take birth control pills, so other conservative methods of stopping bleeding can be used in this case. The progesterone-IUD is one such option, and it provides a great opportunity for birth control that can last five years. The device secretes progesterone, a hormone that works in the lining of the uterus, resulting in menstruation without complications. An IUD is the preferred option for women who need reversible methods of contraception.

How to stop uterine bleeding surgically? Removal of the endometrium is a minimally invasive procedure that has proven effective in treating severe perimenopausal bleeding and may even help some patients avoid hysterectomy. Ablation procedures have been used quite successfully to reduce the amount of bleeding, in some cases leading to a complete cessation of the menstrual cycle. This procedure is not a method of birth control and is used only for women who have completed childbearing.

For patients who have not been helped by medications and less invasive options, this perimenopausal surgery may be the best option to address the issue of how to stop uterine bleeding. For endometriosis, fibroids, hyperplasia, polyps, hysterectomy is the most preferred method for women with such changes. In this case, the amputation of the uterus is possible using various options. The doctor should know the concomitant diseases of such a woman.

How to stop uterine bleeding at home

Bleeding in any case requires a visit to a doctor to determine the cause and prescribe adequate treatment. Before the arrival of the ambulance, it is necessary to take a horizontal position and raise the legs at the same time. You can put a heating pad with ice on the lower abdomen. Compresses and warming procedures are strictly contraindicated. How to stop uterine bleeding at home, what decoctions and preparations can be used? This is well known to older women. "Vikasol", "Ditsinon", "Oxytocin", "Tranexamic acid" - these are the drugs that should be in every woman's first aid kit. These medicines help in deciding how to stop uterine bleeding at home.

Folk remedies

Traditional medicine recipes are used in the treatment of many diseases. How to stop uterine bleeding folk remedies? This question interests both young girls and older women. Most often, in this case, a decoction of nettle leaves, yarrow, shepherd's purse, tincture of water pepper is used. Decoctions are also prepared from cucumber lashes, yasnotki, pepper mountaineer. However, such treatment can only be used as an auxiliary method and only after consulting a doctor.