Abnormal uterine bleeding: signs, classification and consequences

With bloody discharge from the genital tract, every woman is familiar. They appear regularly and last for several days. Monthly bleeding from the uterus is observed in all healthy women of fertile age, that is, capable of giving birth to children. This phenomenon is considered the norm (menstruation). Nevertheless, there are abnormal uterine bleeding. They occur when violations occur in the body. Most often, such bleeding occurs due to gynecological diseases. In most cases, they are dangerous, since they can have serious consequences.

Determination of abnormal uterine bleeding

Abnormal uterine bleeding is a condition in which an abnormal vascular wall of the body or cervix occurs. It is not associated with the menstrual cycle, that is, it appears independently of it. Bloody discharge can often occur. In this case, they occur during the period between menstruations. Sometimes abnormal uterine bleeding occurs rarely, for example every few months or years. This definition is also suitable for prolonged menstruation lasting more than 7 days. In addition, an abnormal loss of blood from 200 ml is considered for the entire period of "critical days". This problem can occur at any age. Including adolescents, as well as among women who are in the menopause period.

Abnormal uterine bleeding: causes of onset

The causes of the appearance of blood from the genital tract can be different. Nevertheless, this symptom is always an occasion for urgent medical treatment. Often abnormal uterine bleeding occurs due to oncological pathologies or diseases that precede them. Due to the fact that this problem is one of the reasons for the removal of the genital organ, it is important to find out the cause in time and eliminate it. There are 5 groups of pathologies, which can lead to bleeding. Among them:

1. Diseases of the uterus. Among them: inflammatory processes, ectopic pregnancy or the threat of interruption, myoma, polyps, endometriosis, tuberculosis, cancer, etc.
2. Pathologies associated with the secretion of hormones by the ovaries. These include: cysts, oncological processes of appendages, early puberty. Also, bleeding can occur as a result of thyroid dysfunction, stressful situations, and contraceptive use.
3. Pathologies of blood (thrombocytopenia), liver or kidney.
4. Iatrogenic causes. Bleeding caused by surgery on the uterus or ovaries, the introduction of the IUD. In addition, iatrogenic causes include the use of anticoagulants and other medications.
5. Dysfunctional uterine bleeding (DMC). Their etiology is not fully understood. These bleedings are not associated with diseases of the genital organs and are not caused by other listed reasons. It is believed that they arise because of the violation of hormonal regulation in the brain.

The mechanism of bleeding from the genital tract

The pathogenesis of abnormal bleeding depends on what kind of cause they were caused. The mechanism of development in endometriosis, polyps and oncological processes is similar. In all these cases, not the uterus itself is bleeding, but pathological elements that have their own vessels (myomatous nodes, tumor tissue). Ectopic pregnancy can proceed according to the type of abortion or rupture of the tube. The latter option is very dangerous for a woman's life, as it causes massive intra-abdominal bleeding. Inflammatory processes in the uterine cavity cause an angina of the vessels of the endometrium. If the hormonal function of the ovaries or the brain is disturbed, changes occur in the menstrual cycle. As a result, there may be several ovulations instead of one or, on the contrary, a complete absence. The same mechanism has oral contraceptives. The introduction of an intrauterine device can cause mechanical damage to the organ, thereby leading to bleeding. In some cases, the cause can not be established, so the mechanism of development also remains unknown.

Abnormal uterine bleeding: classification in gynecology

There are a number of criteria according to which uterine bleeding is classified. They include the cause, frequency, period of the menstrual cycle, as well as the amount of fluid lost (light, medium and heavy). The etiology is distinguished: uterine, ovarian, iatrogenic and dysfunctional bleeding. DMC differ in the nature of violations of the menstrual cycle. Among them:

1. Anovulatory uterine bleeding. They are also called single-phase DMCs. They arise due to short-term persistence or atresia of follicles.
2. Ovulatory (2-phase) DMC. These include hyper- or hypo-function of the yellow body. Most often this is the abnormal uterine bleeding of the reproductive period.
3. Polymenorea. Blood loss occurs more often than once every 20 days.
4. Promenorea. The cycle is not broken, but "critical days" last more than 7 days.
5. Metrorrhagia. This type of disturbance is characterized by random hemorrhage, without a certain interval. They are not associated with the menstrual cycle.

Symptoms of uterine bleeding

In most cases, it is not immediately possible to establish the cause of the appearance of blood from the genital tract, since the symptoms are almost the same for all DMCs. These include pain in the abdomen, dizziness and weakness. Also, with constant blood loss there is a decrease in blood pressure and pallor of the skin. To distinguish DMK among themselves, it is necessary to calculate: how many days it lasts, in what volume, and also set the interval. For this purpose it is recommended to mark each menstruation in a special calendar. Abnormal uterine bleeding of the pubertal period is characterized by a duration of more than 7 days and an interval of less than 3 weeks. At women of fertile age menometrorrhagia are usually observed. In the climacteric period, bleeding is abundant, prolonged. The interval is 6-8 weeks.

Diagnosis of bleeding from the uterus

To detect abnormal uterine bleeding, it is important to monitor your menstrual cycle and periodically visit a gynecologist. If this diagnosis is still confirmed, it is necessary to be examined. For this, general tests of urine and blood (anemia), a swab of the vagina and cervix are performed, a gynecological examination is performed. It is also necessary to do ultrasound of the pelvic organs. It allows to determine the presence of inflammation, cysts, polyps and other processes. In addition, it is important to pass tests for hormones. This applies not only to estrogens, but also to gonadotropins.

Than bleeding from the uterus is dangerous

Abnormal bleeding from the uterus is a rather dangerous symptom. This sign can talk about a broken pregnancy, a tumor and other pathologies. Massive bleeding leads not only to loss of the uterus, but even to death. They are found in diseases such as ectopic pregnancy, torsion of the foot of the tumor or myomatous node, apoplexy of the ovary. These conditions require immediate surgical care. Non-viable short-term bleeding is not so terrible. Nevertheless, their reasons may be different. They can lead to malignant polyps or fibroids, infertility. Therefore, the examination is extremely important for women of any age.

How to treat uterine bleeding?

Treatment of abnormal uterine bleeding should begin immediately. First of all, hemostatic therapy is necessary. This concerns abundant blood loss. On the area of the uterus, a bubble with ice is applied, intravenously injected saline or erythrocyte mass. Also, surgical treatment is performed (most often removal of one of the appendages). With unbearable bleeding, conservative therapy is prescribed. It depends on the cause of DMC. In most cases, these are hormonal drugs (preparations "Jess", "Yarina") and hemostatic medicines (solution "Dicinon", tablets "Calcium Gluconate", "Ascorutin").