Metrorrhagia treatment tablets. What is metrorrhagia: methods of diagnosis and treatment. Prevention and recovery

Non-menstrual bleeding from the genitals is a sign of uterine bleeding. This pathology is a dangerous symptom of gynecological diseases.

Appointment with a gynecologist - 1000 rubles. Comprehensive pelvic ultrasound - 1000 rubles. Appointment based on ultrasound or test results - 500 rubles (optional)

You cannot hope that the bleeding will stop on its own: due to blood loss, anemia will begin, and the cause of the discharge will become chronic. The result will be purulent inflammation, atrophy of the tissues of the uterus and adjacent organs, cancerous tumors and other dangerous pathologies.

Symptoms of uterine bleeding

Any discharge of blood from the vagina, in addition to bleeding, is already considered bleeding.

In this case, two menstrual disorders are distinguished:

Menorrhagia, which is heavy uterine bleeding that occurs at regular intervals (during menstruation);
Metrorrhagia- irregular bleeding.

Pathological (disease-related) discharge can be distinguished from physiological discharge by several criteria. Characteristic symptoms of bleeding:

Rich color due to blood admixture: blood red, scarlet, burgundy;
Duration: bleeding begins outside the menstrual period (metrorrhagia) or menstruation lasts longer than normal - from 5 days (menorrhagia);
Consistency: may contain blood without impurities, blood with mucus admixtures or the inclusion of dark burgundy or burgundy-gray clots;
Smell: not typical of menstrual discharge - during uterine bleeding, the discharge smells like blood, spoiled fish, meat, etc.

The volume of discharge in menorrhagia and metrorrhagia is also different:

During menstruation (menorrhagia), the discharge is very copious - about 80 ml per day (hygienic products have to be changed more often than after 2-3 hours);
Outside of menstruation (metrorrhagia), the volume of excretion varies - blood smears (in common parlance - daub), drips or continuously flows.
With persistent menopause, even a drop of blood is pathological.

Uterine bleeding is accompanied by symptoms of diseases associated with blood loss. The woman suffers from: dizziness, weakness, flickering spots in the eyes, ringing in the ears, shortness of breath, increased heartbeat. Gradually the symptoms intensify, fainting is possible. At the same time, pathology makes itself known - the cause of bleeding. Most often, abdominal pain begins, temperature rises, etc.

Causes of menorrhagia and metrorrhagia

Uterine bleeding is a symptom of diseases of the uterus, ovaries and pregnancy pathologies.

Causes of bleeding outside of pregnancy:

Injuries received during gynecological manipulations - examinations, abortions, diagnostic curettages, removal of tumors, etc.;
, which is an ulcer at the entrance to the organ;
Hormonal disorders resulting from the growth of the endometrium - the mucous membrane of the uterus, etc.;
Inflammation of the uterus, ovaries;
, .

Causes of bleeding during pregnancy and after childbirth

Bleeding during pregnancy, even slight, indicates the onset of a miscarriage or premature birth.

The reasons for these are pathologies of the uterus, cervix, hormonal disorders (genetic, leading to miscarriage, or infectious).

After childbirth, bleeding is associated with postpartum complications - ruptures, injuries, uterine inversion.

Causes of bleeding during menopause

After the extinction of sexual function, the woman’s hormonal background changes. On this basis, diseases associated with a lack of certain hormones develop. This includes various tumors, polyps, cysts, endometrial growths, uterine prolapse, etc. A symptom of all of these pathologies is discharge mixed with blood.

Causes of sudden and severe bleeding

- Uterine trauma. Such injuries can be caused by rough sex, especially rape, criminal surgical abortions (they are done through acquaintances in underground conditions, when gynecologists refuse to operate due to timing or contraindications), etc.
- Miscarriage. If a woman has lost her child and does not go to the clinic, severe uterine bleeding is possible.
- Polyp torsion, cyst rupture, tube rupture during ectopic pregnancy. All these conditions are also accompanied by severe uterine bleeding.

First aid for uterine bleeding

It is impossible to cure the pathology on your own, as well as to identify the cause of this condition. Therefore, you need to contact a gynecologist and undergo a series of studies: tests and ultrasound.

In case of severe bleeding, when the blood flows without stopping, you need to call an ambulance. Before the doctors arrive, you need to provide first aid to the patient. It consists of the following actions, you can:

Lay the patient on a flat surface, placing a pillow under her feet - they should be approximately 20 - 30 cm above body level;
Apply a cold object (for example, a bottle of cold water) to the lower abdomen;
The patient should be given sweet drinks.

If you are pregnant, you should call an ambulance in any case.

Do I need to see a doctor? Or maybe everything will go away on its own? It won't work!

Uterine bleeding, be it weak (smearing or in the form of drops) and even more so strong (in this case the blood does not stop), discharge, is life-threatening, as they are a sign of serious diseases of the female organs - the uterus and ovaries. In addition, blood loss leads to anemia, weakening of the body, and there are deaths.

Diagnosis of the causes of menorrhagia and metrorrhagia

The gynecologist determines the cause of bleeding based on test results and ultrasound.

will show whether there is prolapse of the genital organs, neoplasms or erosion on the cervix. During pregnancy, cervical insufficiency is clearly visible. Also, already at this stage, injuries from the spiral, after sexual intercourse, etc. are visible;
.The gynecologist conducts an examination with a device equipped with magnifying glasses. Using a colposcope, internal pathologies of the cervix are identified, and the nature and stage of erosion is determined.
will determine whether there are injuries, neoplasms, or inflammation of female internal organs.
and show STI infections (STDs), precancerous conditions,.
will determine whether there is a hormonal imbalance.

If this is not enough, you will have to undergo an MRI (tomography) to obtain images of the organs in 3D format at high magnification.

Treatment of bleeding in menorrhagia and metrorrhagia

First of all, the gynecologist stops the bleeding. Pregnant women are prescribed drugs that relax the uterus and hormones that stop a miscarriage. The rest of the women are prescribed various hemostatic drugs, hemoglobin-supporting drips are placed, and in severe cases a blood transfusion is required.

At the same time, the disease itself is being treated. Depending on the cause, antibiotics and hormones may be taken. If neoplasms or erosion are detected, surgery is performed to remove polyps or fibroids, cauterize the erosion, curettage the uterus, etc. The list of possible measures is endless.

It is important to understand that only a timely visit to a gynecologist, high-quality diagnosis and effective treatment will help stop bleeding and get rid of the disease. Advanced pathologies accompanied by bleeding lead to removal of the uterus, infertility and severe purulent inflammation, since blood and lack of air in the uterus are an ideal environment for the development of putrefactive bacteria.

Treatment of bleeding during pregnancy

Bleeding during pregnancy is dangerous - it is a sign of an ectopic pregnancy, the onset of a miscarriage or early labor. If you notice discharge, especially accompanied by nagging pain (abdomen, lower back), you need to call an ambulance. You need to lie down until the ambulance arrives. You can take a No-shpa tablet, which relieves uterine spasms.

Treatment for bleeding during pregnancy depends on the cause:

Ectopic pregnancy . Pregnancy outside the uterus is a common occurrence, and only an obstetrician-gynecologist can distinguish it from normal. Severe bleeding with an ectopic is a sign of rupture of the organ where the fetus has taken root. In this case, an urgent operation is performed.
Miscarriage or premature birth. At first a slight spotting appears, after a while the discharge intensifies. This occurs when the cervix opens and the fetus comes out.

With timely treatment, pregnancy can be saved. The gynecologist will prescribe hormonal medications and vitamins that relax the uterus. If a miscarriage occurs, the uterus is curetted. If this is not done, the remaining placenta will fester, resulting in blood poisoning.

Treatment of bleeding after childbirth or surgery

Discharge after pregnancy should last no longer than 2 weeks. Symptoms such as abdominal pain and an unpleasant smell of discharge indicate that inflammation of the uterus has begun. If you have such symptoms, contact your gynecologist. The doctor will take swabs for infections and perform an ultrasound of the pelvis.

Pathological uterine bleeding after childbirth is a sign of inflammation, non-healing wounds, incomplete discharge of the placenta and other complications after pregnancy. Treatment in this case also depends on the cause. Strong antibiotics are often needed. Therapeutic curettage may be required. With timely help, problems go away and the body recovers. Advanced pathology guarantees peritonitis - purulent inflammation of the uterus and peritoneum.

Treatment of bleeding during menopause

The first stage of menopause lasts up to 2 years. During this period, scanty discharge, similar to menstruation, is not dangerous. Heavy bleeding or blood after the onset of persistent menopause is a consequence of tumors, prolapse of internal organs and other processes associated with the aging of the body.

The gynecologist will prescribe blood tests for clotting and (indicating cancer), conduct. If tumors are found, a biopsy will be required.

To treat bleeding during menopause, a modern technique is often used - tumors are removed. If everything is really bad, the uterus is removed. After menopause, it is quite possible to live without this organ.

Is it possible to cure uterine bleeding with folk remedies?

Uterine bleeding is a symptom of a huge variety of diseases and requires especially careful attention due to the likelihood of serious consequences for life and health. Any discharge of blood from the vagina that is not associated with normal menstruation should definitely be perceived as a reason for an urgent visit to a gynecologist.

Having noticed signs of uterine bleeding, many women try to treat themselves, resorting to traditional medicine, which can lead to tragic consequences. Folk remedies against uterine bleeding, such as infusions of nettle, viburnum, horsetail and shepherd's purse, do demonstrate some effectiveness, but are used only as an addition to the main therapy after consultation with the attending physician.

Where to go for diagnosis and treatment of menorrhagia and metrorrhagia in St. Petersburg?

Help with uterine bleeding depends on the strength of the pathology, the cause of the bleeding, and the condition of the woman. We have everything to diagnose and treat any menstrual irregularities. You can go through with us for just 1000 rubles. The type and cost of tests are determined depending on the expected diagnosis.

Metrorrhagia is the appearance of spotting (uterine bleeding) during the intermenstrual period. The appearance of such bleeding can occur on different days of the cycle and have different intensity. There are physiological causes that can lead to metrorrhagia and pathological ones.

Physiologically, it is worth noting the appearance of slight bleeding before the onset of ovulation. Otherwise they are called “breakthroughs”. Their appearance is associated with sudden changes in hormone levels.

The following pathological conditions should be noted:

Uterine bleeding associated with pregnancy: spontaneous termination of pregnancy leading to miscarriage; presence of placental polyp; disrupted ectopic pregnancy; hydatidiform mole; Choriocarcyonoma.
Uterine bleeding caused by various injuries.
Metrorrhagia caused by diseases of the vagina: colpitis, senile colpitis, vulvaginitis, volumetric processes of the vagina, foreign bodies of the vagina.
M. associated with diseases of the cervix: cervicitis, polyp of the cervical canal, endometriosis of the cervix, tumor processes of the cervix, cervical fibroids.
A large group of uterine diseases leading to uterine bleeding: uterine fibroids, adenomyosis, uterine and endometrial tumors, endometrial polyps, endometrial hyperplasia, endometritis, uterine tuberculosis.
Uterine bleeding can also be caused by ovarian diseases: tumor processes in the ovaries, inflammation.

In addition, metrorrhagia can occur in situations where absolutely healthy women incorrectly use drugs for hormonal contraception: errors in taking combined oral contraceptives, use of drugs for emergency contraception. Bleeding may also occur in cases of completion of long-term hormone replacement therapy; if the IUD is incorrectly positioned in the uterine cavity.

One of the most common causes of metrorrhagia is various types of hormonal disorders; disorders of the blood coagulation system, extragenital diseases.

Also, bloody discharge from the vagina can be observed after any manipulations and surgical interventions (sampling of cervical tissue by biopsy; conization of the cervix; laser and radio wave surgery of the cervix; curettage of the uterine cavity, etc.).

Thus, the range of reasons that lead to the appearance of metrorrhagia is very large. Therefore, in cases where such signs appear, it is necessary to consult a doctor in order to identify the cause of the bleeding. It is necessary first of all to exclude organic diseases. For these purposes, ultrasound diagnostics, general clinical research methods, bacteriological diagnostic methods, PCR, and the study of hormonal status are used.

Treatment of metrorrhagia depends on the cause of bleeding. In case of severe anemia, specific therapy is carried out aimed at increasing the number of red blood cells. Acute and massive uterine bleeding requires immediate treatment in a hospital setting.

Since menopause affects many organs and systems in the body, a variety of symptoms and signs, both specific and nonspecific, are formed. Due to such a variety of clinical pictures, it is very easy not to notice any important symptom that indicates a pathological process that is in no way connected with menopause. For example, metrorrhagia deserves attention.

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Definition

Metrorrhagia is uterine bleeding. It can be of varying intensity and have different causes. The negative feature of such bleeding is that women often mistake it for menstrual bleeding and do not seek help in a timely manner. With this approach, the disease that caused them can already progress quite significantly. Therefore, it is very important to know the symptoms of metrorrhagia and be able to distinguish it from menstrual bleeding.

How does it manifest?

In any period, both reproductive and menopause, it can be quite difficult to distinguish such bleeding from menstrual bleeding. At the same time, during a period of hormonal imbalance due to changes, it is even more difficult to do this, since the menstrual cycle is disrupted and becomes extremely irregular. In this case, it is impossible to track whether the bleeding is menstrual or acyclic.

Premenopausal

Metrorrhagia in premenopause is diagnosed a little easier. Since during this period the menstrual cycle is more or less regular. Therefore, the appearance of acyclic bleeding cannot be ignored. Moreover, if the blood loss is very significant, then the woman consults a doctor, usually in a timely manner. But even with small acyclic bleeding you need to consult a doctor.

In menopause

Menopause is the actual last menstruation. If at this moment, simultaneously with menstruation, the manifestation of metrorrhagia began, then it is extremely difficult to distinguish it. The main diagnostic sign may be very severe pain and profuse bleeding. In addition, if the discharge has not stopped after 6 days and is still of high intensity, then you should consult a doctor.

In perimenopause

Throughout menopause, it is necessary to monitor the cyclicity of discharge. Copious, clearly acyclic discharge should be a reason to consult a doctor. Associated symptoms may include headaches, asthenia, weakness, anemia, nausea, and rapid heartbeat. Sometimes there is severe pain in the lower abdomen. Body temperature may rise.

Postmenopausal

At least one year must pass after the last menstruation. If there was no bleeding during this time, then we can say that postmenopause has occurred. During this period and after it, there cannot be any bleeding from the vagina at all. Therefore, any appearance of bloody discharge is considered a deviation from the norm and requires immediate consultation with a doctor, since metrorrhagia in postmenopause may indicate a serious pathology.

Causes

Metrorrhagia can occur for the following reasons:

The presence of neoplasms in the uterus;
Endometriosis;
Damage to the mucous membrane;
Infectious or inflammatory process;
Adenomyosis;
Miscarriage;
Polyps;
Cardiovascular diseases.

Correct identification of the cause is the basis for successful treatment.

Diagnostics

To diagnose the disease, a number of studies are carried out:

Blood test for hemoglobin and platelets;
Ultrasound using the transvaginal method to determine the thickness of the endometrium, the condition of the mucosa, and the presence of neoplasms;
Scraping of the mucous membrane;
Vaginal smear;
Colposcopy;
Inspection using mirrors.

Based on these studies, it is concluded that a diagnostic scraping is necessary. This manipulation is quite traumatic, so it is not performed unless absolutely necessary.

Treatment

Treatment is prescribed depending on what disease caused the symptom.

In the presence of benign formations, hyperplasia, endometriosis, hormonal drugs are usually prescribed - combined oral contraceptives. They are used one tablet per day for a period of 3 to 6 months. Hormones help the tumor to dissolve. The cost of such drugs as Janine, Marvelon, Regulon ranges from 600 to 1500 rubles;
Some types of cysts and polyps require their surgical removal;
Oncological processes also require specific treatment;
Infectious and inflammatory processes require treatment depending on their characteristics. Often, antibiotics and anti-inflammatory drugs are prescribed.

Since metrorrhagia is accompanied by significant blood loss, iron supplements may be additionally prescribed to normalize hemoglobin.

B vitamins and magnesium in large quantities are also indicated. They will help relieve the unpleasant symptoms of significant blood loss.

Prevention

Prevention as such is quite difficult. This is due to the fact that the phenomenon of metrorrhagia is not a disease, but a symptom. Moreover, it can be caused by many reasons. Therefore, prevention comes down to general rules for maintaining the health of the reproductive system and a healthy lifestyle:

A balanced diet with reduced calorie content. Avoiding salty, spicy, fried, fatty, preservatives, and dyes. Small meals at least five times a day;
Maintaining genital hygiene. The use of barrier contraception during sexual intercourse;
Quitting bad habits - alcohol, smoking;
Periodic examinations by a gynecologist;
Avoiding physical inactivity. Moderate exercise, without excessive, especially strength, loads;
Normalization of the daily routine.

Compliance with these rules will ensure that metrorrhagia during menopause is unlikely.

Video

Bleeding from the genital tract is considered normal, which appears at intervals of 21-35 days and lasts from three to six days. If the regularity or volume changes, then there must be a pathological reason for the cycle failure. Metrorrhagia is the occurrence of bleeding from the genital tract outside of normal menstruation. This symptom can appear at any age - in adolescents, women of reproductive age, during menopause.

The ICD-10 code for metrorrhagia corresponds to several categories. N92 includes heavy, irregular and frequent menstruation, and N93 other abnormal bleeding from the uterus that may occur after coitus (N93.0) or for unspecified reasons (N93.8-9).

What is metrorrhagia, causes of pathology

The most common causes of metrorrhagia are hormonal disorders, inflammatory diseases and problems with the blood coagulation system. But each age has its own characteristics.

In teenagers

The appearance of spotting not associated with menstruation in adolescents is called juvenile uterine bleeding. It is often explained by the immaturity of hormonal structures, but groups of factors have been identified that can contribute to the appearance of an unpleasant symptom.

Antenatal period. During intrauterine development, a girl develops genital organs and several million eggs. Some of them will be atretic in the future, and the rest will form the ovarian reserve for life. Unlike men, who produce sperm constantly, women do not produce new eggs. Therefore, any negative influences during intrauterine development can lead to pathology of the reproductive system in the future.
Mental trauma. Stress and heavy physical activity affect the production of hormones along the hypothalamus-pituitary-adrenal cortex chain. This leads to disruption of the secretion of gonadotropic hormones, persistence of the follicle and changes in the synthesis of sex hormones.
Hypovitaminosis. The lack of vitamins C, E, K affects, which leads to fragility of blood vessels, impaired hemostasis and the secretion of prostaglandins, as well as a decrease in the process of platelet adhesion during the formation of blood clots.
Infections. Girls with NMC of the metrorrhagia type often experience chronic tonsillitis, influenza, acute respiratory infections and other infections. Tonsillogenic infectious processes have a particular impact on the hypothalamic region.
Increased function of the pituitary gland. The secretion of FSH and LH in girls with bleeding is erratic. The maximum release can occur at intervals of one to eight days, and the concentration is several times higher than that in healthy people. Bleeding at this age is often anovulatory.
Blood clotting disorders. Often these are hereditary pathologies of the hemostatic system. With them, juvenile bleeding is observed in 65% of cases. Often these are thrombocytopathy, von Willebrand syndrome, idiopathic thrombocytopenic purpura.

Bleeding in adolescents can be of three types:

hypoestrogenic;
normoestrogenic;
hyperestrogenic.

In this case, there are characteristic changes in the ovaries and endometrium according to ultrasound. With hypoestrogenism, the thickness of the endometrium is reduced, and there are small cystic changes in the ovaries. With the hyperestrogenic type, the endometrium cannot grow up to 2.5 cm, which significantly exceeds the norm. At this time, cystic formations from 1 to 3.5 cm are visualized in the ovaries.

In potential mothers

Metrorrhagia during the reproductive period may be associated with the following conditions:

hormonal pathologies;
tumors;
pathological conditions of the cervix;
for complications of pregnancy.

Hormonal pathologies include non-inflammatory diseases of the reproductive organs:

endometrial hyperplasia;
myoma;
endometriosis.

In this case, a state of relative hyperestrogenia is noted. The thickness of the endometrium increases significantly, and if there is a malnutrition, bleeding can begin in the middle of the cycle. With endometriosis, the cause of bleeding may be the emptying of endometrioid foci, which form cavities in the body of the uterus.

Dysfunctional bleeding often occurs during the reproductive period. They occur when the hormonal functions of the ovaries are disrupted. Triggering factors can be:

infection;
stress;
injury;
unfavorable environment;
metabolic syndrome.

Metrorrhagia usually appears after a long delay in menstruation, sometimes up to three months. The bleeding itself can last up to seven days, releasing a large amount of blood with clots, which leads to anemia.

The release of blood during ovulation may be physiological in nature. It is also called “breakthrough” and is explained by a sharp jump in sex hormones. Also, spotting bleeding sometimes occurs in women who have started taking combined oral contraceptives. However, it is considered normal only during the period of adaptation to the drug in the first three months.

Cervical erosion may be accompanied by postcoital bleeding. Also, bleeding may occur with endometritis.

A woman may not be aware of her pregnancy in the early stages. Especially if she has an irregular menstrual cycle, delays often occur. Therefore, metrorrhagia may be associated with early miscarriage. But even with a diagnosed pregnancy, bleeding from the genital tract speaks in favor of an abortion that has begun.

In the later stages, metrorrhagia is a sign of bleeding from the placenta previa or abruption of a normally located placenta. In this case, pain may appear in the lower back and lower abdomen. In each of these cases, emergency medical attention is required. The consequences of delay in such a situation are intrauterine fetal death.

Over 45 years old

Menopausal metrorrhagia can be cyclical or acyclic in nature. Its origin may be different:

organic - associated with pathology of the cervix, endometrium, myometrium, ovaries or vagina;
inorganic - in connection with atrophic processes in the endometrium and anovulation;
iatrogenic - due to taking medications for replacement therapy;
extragenital- associated with pathology of other organs.

Metrorrhagia in premenopause is often associated with endometrial polyps. For women aged 45-55 years, the main reason is endometrial hyperplasia. Based on structural changes, it can be without cell atypia and atypical, which can develop into oncology.

Women aged 55-65 years have a peak incidence of endometrial cancer. Therefore, metrorrhagia in postmenopause always makes one think about a tumor.

Pre- and postmenopause are characterized by bleeding due to fibroids located submucosally (in the muscular layer of the uterus) and myosarcoma. Before menopause, adenomyosis may be the cause. Pathology of the ovaries, cervix, atrophic processes in the vagina lead to metrorrhagia less often.

In postmenopausal women, metrorrhagia often occurs in the absence of menstruation and in women who do not take hormone replacement therapy.

Diagnostic methods

When examining a teenager, a conversation is held with her mother. The doctor pays attention to the course of pregnancy and childbirth, the presence of diabetes mellitus in the mother, and endocrine pathologies that can affect the girl’s health. An external examination reveals the following signs that are associated with hypothalamic dysfunction:

light stretch marks on the skin;
excess hair growth;
hyperpigmentation in the armpits, neck and elbows.

Girls are often obese or overweight.

Laboratory tests include:

blood chemistry- reflects the state of metabolism of proteins, fats and carbohydrates;
fasting blood glucose- tendency to diabetes;
sex steroids in urine- analysis of hormone metabolism;
blood hormones - LH, FSH, estriol, progesterone, testosterone, EDHEA, cortisol.

Additionally, TSH, T3 and T4 are examined. Antibodies to thyroid peroxidase are also determined. In some cases, registration of circadian rhythms of LH, prolactin, and cortisol is used.

Instrumental diagnostic methods for teenagers are as follows:

Ultrasound through the vagina;
MRI of the pelvis;
X-ray of the brain;
osteometry of the hands;

When choosing a diagnostic method for women of reproductive age, the doctor is guided by the existing clinical picture. In case of metrorrhagia caused by an interrupted pregnancy, determination of the level of sex or pituitary hormones is not necessary. In such a situation, general clinical blood tests and pelvic ultrasound are sufficient.

In older women, bleeding can be a symptom of many gynecological diseases. Diagnosis is aimed at establishing not only the cause, but also the location of bleeding: from the uterus, vagina, ovaries, cervix. The following examination methods are used:

taking anamnesis;
verbal assessment of blood loss;
in premenopause, determination of beta-hCG;
blood chemistry;
general blood analysis;
coagulogram;
hormones: LH, FSH, estriol, progesterone;
thyroid hormones;
markers CA-125, CA-199;
Transvaginal pelvic ultrasound;
Doppler mapping;
MRI of the pelvis;
smear for oncocytology;
endometrial biopsy;
hysteroscopy;
separate diagnostic curettage.

It is not necessary that the entire list of diagnostic techniques will be used for every woman. Some of them are performed when indicated.

Tactics for choosing therapy

Treatment of metrorrhagia depends on the patient's age, her general condition and the cause of the bleeding. Therapeutic measures can be conservative and surgical.

For young girls

In adolescence, conservative hemostatic therapy is more often used during bleeding present at the time of treatment. For this purpose, combined hormonal contraceptives are used, but they are not taken one tablet per day, but according to a specific regimen, which may include from four tablets per day. To avoid recurrent bleeding, COCs continue to be used after it has stopped, but as usual.

Curettage of the uterine cavity is not used in girls. Manipulation is allowed only in cases of severe endometrial hyperplasia or polyp. In this case, the hymen is injected with lidase, and all manipulations are carried out with special baby mirrors.

In mature women

To properly stop bleeding, the main thing is to identify the cause. If it is an abortion or dysfunctional uterine bleeding, endometrial hyperplasia, then the main treatment method is curettage.

Medicines to stop bleeding can also be used:

"Dicynon";
aminocaproic acid;
calcium gluconate.

Hormonal hemostasis is rarely used, only in women under 30 years of age with minor bleeding due to ovarian dysfunction. Subsequently, they are recommended to take monophasic hormonal contraceptives “Yarina”, “Zhanin”, “Marvelon”.

Against the background of existing endometriosis and fibroids, as well as endometrial hyperplasia, women who do not plan to have children in the coming years are recommended to install the Mirena hormonal system.

Removal of the uterus as a method of stopping bleeding during reproductive age is used extremely rarely. Usually only when combined with fibroids, severe endometriosis, and with severe contraindications to hormonal therapy.

During menopause

The first stage of treatment is to stop the bleeding. For this purpose, curettage, hysteroscopy, and resectoscopy are used. In severe cases, especially if there is oncology, a hysterectomy is performed.

The appearance of uterine bleeding in the intermenstrual period is called dysfunctional uterine bleeding or metrorrhagia. Uterine bleeding is not uncommon; it is one of the main reasons why women visit a gynecologist.

Today, metrorrhagia does not pose a threat to a woman’s life - of course, provided that she consults a doctor in time. However, this dysfunction can cause a whole bunch of troubles:

iron deficiency anemia;
problems in sexual life;
feeling unwell.

What is the menstrual cycle?

Before understanding why dysfunctional uterine bleeding occurs, it is necessary to understand what changes occur in a woman’s body during a normal menstrual cycle.

The menstrual cycle normally has two phases. The first phase begins with the onset of menstrual bleeding. During this period, hormones are formed in the woman’s body that promote the maturation of eggs and the growth of the inner mucous membrane of the uterus.

When the egg matures, a special luteinizing hormone is released, which causes ovulation - the release of the egg from the ovarian follicle. From this moment on, the second phase of the menstrual cycle begins.

The egg is captured by the villi of the uterine (fallopian) tube and begins to move along it into the uterine cavity. At the site of the ruptured follicle, the so-called corpus luteum forms in the ovary. It secretes the hormone progesterone, which prepares the woman’s body for a possible pregnancy.

If fertilization of the egg does not occur, it dies. The woman’s brain does not receive a signal about the attachment of the fertilized egg. As a result, the corpus luteum ceases its activity. This leads to rejection of the internal mucous uterine layer, that is, to the occurrence of menstrual bleeding.

What is metrorrhagia

A special time is allocated for menstruation in the cycle - they begin on the 20-25th day and last about a week. Menstruation occurs due to the fact that the unfertilized egg needs to be removed from the body, as well as the uterus needs to be cleared of thickened endometrium. A change in the structure of this layer is necessary to attach the cell into which the sperm has penetrated to the wall of the uterus, but if fertilization has not occurred, the endometrium is expelled. Such an event is accompanied by bleeding, because the capillary network is damaged.

Women who have a regular menstrual cycle sometimes notice that their period comes too early - this condition is called metrorrhagia. In this case, a woman may experience the same weakness and pain in the lower abdomen as during menstruation, but the discharge often differs in color - it is brownish.

Anovulatory metrorrhagia

Anovulatory metrorrhagia is a type of metrorrhagia, which is characterized by a single-phase hormonal course and the absence of ovulation - the release of an egg from the follicle. Simply put, during ovulation, hormonal levels are controlled by two factors: the ovaries and the corpus luteum, which remains after the egg leaves the follicle. Hormones of the corpus luteum regulate the movement of the reproductive cell through the fallopian tubes and uterus, and the ovaries secrete active substances that cause thickening of the endometrium.

In the case of anovulatory metrorrhagia, there is no release of hormones from the corpus luteum, because it simply does not form due to the lack of ovulation, but the ovaries provoke thickening of the uterine mucosa. When the amount of hormones begins to decrease, the endometrium sloughs off and comes out.

Causes of anovulatory metrorrhagia

Why might a woman not ovulate during her menstrual cycle? There are several reasons why anovulatory uterine bleeding occurs:

unstable hormonal levels;
taking oral contraceptives;
neoplasms in the uterus or ovaries;
sudden changes in weight, intense physical activity, stress (these factors rarely cause bleeding without ovulation).

Unstable hormonal levels are typical in most cases for teenage girls and women during menopause. During this period, the ovaries are not functioning properly, so anovulation may occur during regular periods. In this case, two bleedings will occur in one cycle, but only one with the release of the egg.

Hormonal disruptions that cause metrorrhagia are also possible in adult girls due to stress, dieting, and intense physical activity.

Oral contraceptives help to avoid unwanted pregnancy, but they are hormonal based, so their effect extends to the entire reproductive system. Properly selected birth control pills can even regulate the menstrual cycle. If a woman buys them on her own, and they do not suit her, then the hormonal balance is disrupted. This can cause anovulatory uterine bleeding, scanty periods and other disruptions in the menstrual cycle.

Neoplasms in the uterus and ovaries are another cause of anovulatory metrorrhagia, because of which this condition cannot be ignored. If a woman develops uterine fibroids, an ovarian cyst, or cervical cancer, bleeding may occur due to hormonal disorders or due to the destruction of genital tissue, which causes bleeding. Then metrorrhagia will be accompanied by severe pain, and the discharge will not be brown, but red.

Symptoms of anovulatory metrorrhagia

The symptoms of anovulatory metrorrhagia are difficult to describe, because it is in many ways similar to menstruation:

pain appears in the lower abdomen;
weakness, loss of appetite;
brownish or red blood with clots is discharged from the vagina;
discomfort appears in the lumbar region.

Anovulatory bleeding can be distinguished only by the date of occurrence, so it is very important for every woman to keep track of menstruation using a regular pocket calendar or programs on the phone. They should record information about previous periods and outline the approximate date of the next one. If menstruation comes more than a week earlier, we can talk about metrorrhagia.

Complications of anovulatory metrorrhagia

Anovulatory metrorrhagia, which occurs constantly, has its negative consequences, especially if menstruation occurs soon after it. Firstly, a woman loses more blood, so her immunity decreases and hemoglobin drops.

Secondly, if the endometrium is constantly shedding twice per cycle, the lining of the uterus becomes inflamed.

Thirdly, anovulatory bleeding disrupts hormonal levels and the menstrual cycle, ovulation occurs with a delay or is completely absent, so it is much more difficult to get pregnant. Even if fertilization occurs, the risk of miscarriage will be high, because the endometrium is constantly exfoliating, and the egg has nothing to attach to.

Differences

The mechanism of menstruation has long been worked out by nature. The entire monthly cycle is divided into two parts. One part of this process is visually confirmed in the form of secretions, and the second takes place secretly in the body.

With the onset of bleeding, the female body begins to actively synthesize hormones that are responsible for the maturation of the egg and the growth of the uterine mucosa. At the moment when the egg is ready, a large release of luteinizing hormone occurs. He is entrusted with another mission - he must cause ovulation.

From the moment the egg leaves the follicle, the second part of the menstrual cycle begins. The egg moves through the fallopian tube, and in the place where the burst follicle was located, a corpus luteum is formed, which is responsible for the synthesis of progesterone.

From this moment the woman is ready for pregnancy. If fertilization does not occur, the egg dies. The need for the corpus luteum disappears and it dissolves. There comes a moment of rejection of the uterine mucosa, which, together with a small amount of blood, is excreted from the body. This process does not pose any danger to the woman, although it may be accompanied by unpleasant sensations.

The formation of dysfunctional uterine bleeding has completely different mechanisms. There are many reasons why such bleeding occurs, but doctors identify several main ones:

Prolonged stress.
Difficult working conditions associated with great physical and mental stress.
Chronic diseases of the genital area.
Benign and malignant tumors of the uterus and ovaries.
Hormonal imbalance in the body.

The cause of bleeding can be infections of the nervous system or operations performed. The risk group includes women with chronic tonsillitis and often suffering from acute respiratory diseases.

The differences between periods and bleeding are very easy to spot. If menstruation begins with a certain frequency, then bleeding does not have a clear schedule. They can start at any time. A diagnosis such as bleeding is always made after a delay in menstruation, which lasted from one and a half to three months, followed by heavy bleeding lasting more than seven days.

Externally, abnormal uterine bleeding may be manifested by pale skin. A woman often complains of dizziness, drowsiness, and palpitations. If the bleeding is not so profuse, then it occurs without any special symptoms.

Climax

The woman's age also does not matter. Similar deviations from the norm can be found in both young and old age. If the bleeding started unexpectedly, for no apparent reason. talk about acute metrorrhagia.

But most often doctors have to deal with another form of this pathology. Namely, with a situation where the bleeding is prolonged, to the point that the cyclicity of menstruation is completely disrupted. Doctors call this condition chronic metrorrhagia.

Anovulatory metrorrhagia is one of the special cases of dysfunctional uterine bleeding. Teenage girls or women who have begun menopausal changes in their bodies are most susceptible to such bleeding. This diagnosis is made based on the patient’s complaints and examination results. The main complaint in this case is irregular periods.

During such bleeding, ovulation does not occur, and therefore, the body does not go through the stage of formation of the corpus luteum. Only the first part of the monthly cycle passes. Under the influence of hormones, the uterine mucosa grows, then when the level of hormones drops, it is rejected and bleeding begins, which is anovulatory metrorrhagia.

For most women, such changes occur due to a delay in menstruation. If menstruation begins on schedule, then it lasts longer than usual, more than seven days. Menstrual irregularities such as metrorrhagia are always associated with serious diseases.

Metrorrhagia during menopause has its own characteristics. In older women, ovarian function gradually weakens. This process primarily manifests itself in disruption of the cyclicity of menstruation. They become irregular, and at some point they stop altogether.

This state of the female body is called postmenopause. The onset of bleeding during this period is a rather alarming signal. Typically, such bleeding manifests itself in malignant tumors of the cervix, uterus and ovaries. Therefore, if a year has passed since your last period, and bleeding suddenly starts again, you need to consult a doctor.

Treatment

If there are complaints about irregular periods, a diagnostic curettage of the uterus is performed. During this manipulation, tissue must be collected for histological examination. Curettage stops bleeding.

Doctors approach the treatment of uterine bleeding in different ways. The treatment regimen depends entirely on the factors that led to the onset of bleeding.

However, each treatment is designed to solve several problems at once. First of all, stop the bleeding. Next, eliminate the possibility of the problem reoccurring. And the last task is to eliminate the consequences of bleeding.

Stopping bleeding is called hemostasis. Currently, there are a lot of drugs that have a hemostatic effect. Along with hemostatic agents, drugs that contract the uterus are also prescribed.

Also, the course of treatment does not exclude hormonal therapy. The patient is prescribed medications containing a high proportion of female sex hormones. But such drugs are not prescribed to women over 35 years of age. For hormonal therapy, Femoden, Marvelon, and Rigevidon are used.

At the beginning, the patient should take four tablets. Then, as the amount of discharge decreases, the dose is reduced by two tablets. The entire course of treatment lasts 21 days, even if the bleeding has stopped.

After hormonal treatment, periods may continue to be heavy for some time. When prescribing drugs belonging to the hormonal group, it is necessary to take into account existing concomitant diseases, as well as possible contraindications.

Hospitalization is usually carried out for women diagnosed with metrorrhagia, whose age has reached thirty years. If necessary, the doctor may prescribe a hysteroscopy. This procedure is necessary in order to assess the condition of the uterine mucosa and perform gentle removal of the endometrium. During this examination, other concomitant pathologies may be identified.

In case of severe bleeding, when there is a threat to life, a hysterectomy may be performed for medical reasons. Most often this happens if uterine fibroids are detected against the background of severe bleeding.

This method of treatment is indicated for those women who suffer from frequent uterine bleeding and cannot, due to their health status, undergo a course of treatment with hormonal drugs.

The main task that doctors face after stopping bleeding is to restore the cyclicity of menstruation and normalize its duration. A secondary consequence of metrorrhagia is the development of iron deficiency anemia.

To eliminate it, iron supplements and an appropriate diet consisting of foods that increase hemoglobin levels are prescribed. Also, women who have suffered bifunctional uterine bleeding are prescribed vitamin complexes with a high iron content.

Folk

Traditional medicine suggests using hemostatic preparations to treat metrorrhagia. For example, a fee including:

nettle leaves;
shepherd's purse grass;
viburnum bark;
burnet root;
yarrow grass;
jasmine grass;
St. John's wort herb;
fireweed leaf;
meadowsweet flowers.

This complex collection is poured with boiling water, infused and taken a third of a glass 4-5 times a day before meals. The course of treatment is long, up to three months. Each of the hemostatic preparations may have its own contraindications, so you should consult your doctor before taking it.

The use of medicinal herbs will be much more effective if it is carried out in conjunction with medications prescribed by a doctor. Improvements from taking it will become noticeable within a few weeks.