"I was cleaned" or "I was made cleaning" - I often hear these phrases from my patients, and they sound the same unbearable for me as the movement of foam on glass. "Cleaning" we have the spaticrally called the scraping of the uterus - the most frequent procedure running in gynecology in the overwhelming majority without any readings to it.

The very fit of the name is "cleaning" - already reflects the rude, top and primitive approach to solving the problem. By the way, the term smoothly switched from medical jargon to the lexicon of many women who even believe that they need from time to time "pass" or be cleaned. " Perhaps they invest in this meaning as in the notorious "cleaning of the organism from slags", assuming that "Dirt" accumulates in this body.

Before continuing the story, it is necessary to explain what is specifically in question.

Scraping is an outpatient medical procedure, which is performed under intravenous anesthesia, during which, with the help of a special curette, remove (scraping) of the uterine mucosa. The procedure is called therapeutic and diagnostic, as it is removed by the fabric changed by the disease (if there is such), which can be explored under the microscope and put an accurate diagnosis. From the previous proposition, it is clear that the scraping is carried out not only in the presence of the disease, but if it is suspected, that is, for the purpose of diagnosis.

While everything is clear, logical and obvious. However, there is another side of this manipulation. The procedure is performed by an acute iron curette, with the help of which the mucous membrane of the uterus actually "moves" and the inevitable injury of the uterus itself occurs. As a result, there is a risk of several serious complications: damage to the endometrium sprout layer (violating its growth in the future), the appearance of adhesions in the uterine cavity, the development of inflammation.

Moreover, this procedure Promotes the development of such a disease as adenomyosis (endometriosis of the uterus) - due to the boundaries of the border between the layers of the uterus, which contributes to the germination of endometrial in the muscle of the uterus. As a result, the transferred scraping can lead to problems with conception or launch the development of adenomyosis.

It is quite obvious that such a procedure should be done strictly according to the testimony and seriously assess the ratio of "benefit - risk". But this is possible anywhere, but not with us, and it is very sad.

Scraping "just in case"

I think that in more than 80% of cases, scraping is carried out in vain, that is, either completely without indications, or in cases where it is possible to solve the problem of medication or by a simple outpatient procedure.

Here are the situations in which you may be offered to perform scraping.

• You have a long bleeding for a long time or uterine bleeding happened.
• On the ultrasound, you had a polyp endometrial, endometrial hyperplasia, adenomyosis, uterine or chronic endometritis.
• You plan to carry out surgical treatment in relation to the mioma of the uterus.
• You have suspicion of ectopic pregnancy.
• You complained that you have abundant menstruation, there are intermented bleeding or brown "cargo" allocations up to and / or after menstruation.

In general, the "cleaning" is sent very often even in the absence of the reasons that I listed above. Scraping often accompany any surgery in gynecology. He's trying to do all the time "at the same time" to "just in case check", whether everything is fine. So should not be, it is too frivolous to a fairly traumatic procedure.

So, the instruction, how to avoid scraping.

• If you do not have abundant uterine bleeding (as they say, "pours on the legs"), but simply go long bleeding and excluded pregnancy (uterine and ectopic), check with the opportunity to stop the bleeding of medication from the doctor. Yes it is possible. Against the background of the drug (immediately I warn you that this is a hormonal drug, but it is safe) bleeding can stop, and it will be necessary to re-evaluate your condition after another menstruation. In many cases, the treatment carried out is enough, and it will not be necessary to do anything more.
• If during the ultrasound, you found a polyp or endometrial hyperplasia, do not hurry to agree on scraping. Ask the doctor about the opportunity to appoint you the drug in this cycle and after repeat the ultrasound after the end of the next menstruation. Eexley polyp or hyperplasia will confirm - alas, scraping under the control of hysteroscopy should be done. But you have a very big chance that after menstruation readings will not be for the procedure.

Polyp - It will grow on the uterus mucous membrane (similar to a finger or mushroom), most often benign. There are polyps that themselves are rejected during menstruation, and those growing from a spike layer. The latter require deletion.

Hyperplasia - thickening of the mucous membrane of the uterine cavity. There are two types: simple and complex. A simple hyperplasia occurs most often, it is not dangerous, for its development there should be a mandatory reason (functional cyst in the ovary, polycystic ovarian syndrome and a few more). It is usually enough 10 days of receiving the drug so that it passes and no longer repeated.

Complex hyperplasia is a bad hyperplasia, an error in the endometrium structure, is usually found after 35 years, more often on the background of excess body weight. It is in charge of the removal of mucosa (scraping) and then a multi-month course of hormonal drugs or installation of intrauterine hormonal spiral "Mirena". The exact diagnosis is possible only with histological examination.

• If you are offered to make scraping only with the diagnostic goal before the operation or to clarify the state of the mucous membrane, - ask the doctor to start with the endometrium biopsy (another name - "Pipel-biopsy" or "aspiration biopsy"). This is a simple outpatient procedure that does not require any anesthesia. The thin tube is set in the uterine cavity and suck a small amount of fabric, which is then sent to the laboratory for the study. This is quite informative analysis.

Important: The material obtained as a result of scraping or biopsy is only the mucous membrane of the uterus, it does not carry any information about other diseases. The fact is that it is often prescribed to evaluate the uterine misa for its characteristics; So here - no information scraping will give.

• Remember, almost all modern ultrasound devices allow you to assess the mucous membrane of the uterus and identify signs of pathology in it. If the doctor, when ultrasound, writes that the endometrium is not changed, and you do not have abundant menstruation, intermented bleeding, the probability that you have pathology that requires scraping is close to zero.
• In general, the main manifestations of the pathology of the endometrium (scraping only on this tissue) are bleeding, abundant menstruation and intermented bleeding. Thus, if you do not have this, discuss with the doctor how justified by his desire to make you scraping.
• "Chronic endometritis" - a frequent diagnosis of ultrasound and in the results of histological conclusion after scraping. We are talking about chronic inflammation of the mucous membrane of the uterus. but generally accepted criteria for setting this diagnosis on ultrasound in evidence-based medicine. Simple histology as well can not reliably confirm this diagnosis. Often, this diagnosis is placed where it is not, since they are oriented towards "leukocytes".

A reliable diagnosis is possible only when conducting a special type of study - immunohistochemistry. This study is not available in all laboratories, and the material for it can be obtained by biopsy, and not pinches. I think it is now clear what to make scraping to confirm the diagnosis of "chronic endometritis" is not necessary. In general, the diagnosis and treatment of this endometrial disease make sense only within the framework of the problem of infertility and non-pending pregnancy.

In what situations agree to scraping?

• Strong uterine bleeding: Yes, scraping is a way to stop it.
• Suspected ectopic pregnancy (difficulty in diagnosis).
• Polyp or hypeometrium hyperplasia, which have not disappeared after menstruation or medication conducted.
• The remains of the fetal shells (after abortion, miscarriage, pregnancy).
• Any bleeding after the onset of menopause.

Now, I hope you have a reliable instruction, how to avoid, perhaps excessive operations for you. Do not be afraid to ask questions to Dr. Suggest alternatives (Endometrial biopsy, medication treatment). Ask to justify the need for exactly the scraping. The answer "we have so accepted" not worth it. Of course, all this concerns only those situations in which you have no threat to life and health (abundant bleeding).

For some women, this farewell is very unpleasant. They feel negative changes in the body, fall into depression. Others do not pay attention to this, trying to quickly move the trait of menopause.

Do not notice the changes can not if uterine bleeding in the premanopausal period is manifested and after menopause. They may indicate pathologies in the body, especially the availability of formations. Tumors have both benign and malignant.

When to worry about nothing

When the climax occurs, the bleeding is not always anomalous.

Help his appearance should not at:

• manifestations of premenopause;
• artificially extended premopause;
• reception of oral contraceptives and installation of the uterine spiral to exclude the likelihood of the occurrence of pregnancy in premaneopause and menopause.

It is worth remembering that in the presence of menstruation, a woman can get pregnant. Therefore, protection during this period is mandatory. Bleeding may indicate the improper selection of the contraceptive method. It is important to visit the doctor to replace the way to more suitable.

The onset of Klimaks is noted at the age of 40 years. There should be no sudden disappearance of menstruation.

During this period, there are several stages of development:

1. Premenopause is celebrated for two to five years. At this time, menstruation is preserved, but they have an irregular, weakly expressed character. Changes are associated with hormonal imbalance, impaired work of the organs of the endocrine system.
2. In the period of menopause, monthly terminates. If they are not for the year, their final disappearance is noted. Some women trying to delay menopause, take progesterone. It allows you to return menstruation that becomes painless and inhum.
3. In the absence of menstruation during the year, postmenopause occurs. During this period, any bleeding is considered pathological. Especially dangerous are the selection with clots. Changes are no longer caused by hormonal violations. Sometimes they testify to malignant formations. It is important to visit the doctor who will celebrate possible reasons and treatment of uterine bleeding during climax.

It is worth remembering that in the period of menopause there may be various diseases accompanied by uterine bleeding. To identify a woman, it is important to regularly visit the gynecologist and treat pathologies.

Classification

Bleeding from the uterus in old age can be of various types:

• For diseases of the organs of the female reproductive system, among which the uterus, ovaries, vagina are distinguished, organic bleeding appear. They can also be associated with violation of metabolism, the work of the endocrine system, liver and blood supply.
• Yatrogenic bleeding are associated with the reception of medicines with hormones in the composition, anticoagulants and other medicines. They are also manifested when installing intrauterine spirals.
• Dysfunctional uterine bleeding in the premanopausal period is due to a cycle impairment due to hormonal imbalance.

Bleeding of dysfunctional nature may have different duration. They are considered anomalous with abundance (more than 80 ml), elongation (longest) and a cycle of less than 21 days or more than 40 days. Normally, the cycle must be from 21 to 35 days, monthly over 3-7 days with blood loss up to 80 ml.

Depending on the nature of violations of the bleeding of dysfunctional type can be divided into several types:

• regular long-term monthly abundant (more than 80 ml) of character for more than a week are called hypermoreria or menorragia;
• with a weak severity of intermenlar selection, metroralia is diagnosed;
• irregular bleeding from the uterus, the duration of which is more than a week, are considered menometroral;
• regular bleeding at intervals over 21 days are polymenores.

In menopause, bleeding disorders (duration and abundance) can be associated with the state of blood vessels or blood coagulation. Also, doctors note among the frequent causes of changes in the endometrial layer of the uterus.

Why mowan bleeding during menopause

Uterine bleeding During the period of Klimaks, they may indicate hormonal changes that are associated with the aging of the body. Also, abnormal disorders may be a consequence of pathologies, receiving contraceptives, other medicines.

The first changes in women can be celebrated upon the occurrence of 35 years of age. Early menstruations are given to the appearance of bleeding in this period, a considerable gap between birth, lactation cessation with an artificial way.

Influence of climax and dysfunctional bleeding and heredity. In addition, among frequent reasons, infectious and inflammatory processes In the organs of the reproductive system, tumors of a benign and malignant character.

Hyperplasia Endometrial

As a result of a sharp increase in estrogen levels in the body, the endometrium can be uncharacterically to grow and thicken. In the normal state, after leaving the follicle, the ripening egg should reduce the hormone indicators. During this period, progesterone increases, which does not give estrogen to increase.

After that, a woman can get pregnant. Then the embryo is attached to the mucous membrane of the uterus. If fertilization does not occur. That endometrium is brazed and comes out in the form of menstruation.

Climax is due to hormonal failure. Therefore, premenopause is characterized by abundant and long-term menstruation. If the monthly is missing for half a year, then a woman can detect a bleeding character. They have an abundant or scant expression and different duration.

Myoma

Mioma is a benign formation appearing in the uterine cavity in muscle layers. This is due to the violation of the structure of tissues and the lack of normal cutting in the uterus.

Before the onset of menopause, women often suffer from Miom. As a result of the tumor, the nature of menstrual discharge changes: their abundance and duration increases (up to 10 days).

Due to the regular appearance of bleeding, menorragia is considered. The tumor may increase in size until the period of menopause period is stopped. Subsequently, its growth stops.

Polyps

Benign tumors in the uterine cavity are polyps. They are considered the result of the growth of individual parts of the endometrium.

The polyp is an outflow consisting of endometrial cells. Education is on the leg, with the help of which it is attached to the wall of the uterus. It is permeated with blood vessels that can bleed during injury. Allocations are usually oscillation and irregular.

Polyps can be placed one or in the form of clusters. They are considered dangerous, as they can be reborn into malignant tumors.

Adenomyosis or endometriosis

If the endometrium germinates in the fallopian walls or on neighboring organs, adenomyosis or endometriosis is diagnosed.

It can cover:

In the development of the process, there may be rebirth of tissues in malignant. At the same time, endometriosis is accompanied by bleeding between menstruation and severe pain syndrome.

Malignant tumor

Cancer formations sometimes have no expression. Therefore, women do not diagnose them in a timely manner.

It is important to remember that even non-delicate bleeding can signal the presence of a malignant tumor. Sometimes bleeding is abundant or cargo sections. Especially often an oncological disease is manifested in postmenopause.

Ovarian dysfunction

With violation of the production of hormones in the body, the ovarian dysfunction may be observed. It is associated with inflammatory processes and endocrine pathologies.

This disease in premopause has been particularly often observed. A woman can distinguish it on randomly occurring menstrual bleeding of different intensity.

Other reasons

Other reasons for the appearance of bleeding in women of the older age period are distinguished:

Symptomatics

The duration of the menstrual cycle and the abundance of menstruals change already in premenopause. At this time, menstruation may be absent for several months, and then suddenly begin.

The abundance of discharge changes. They either are scooping or become too abundant. These signs are considered normal for a woman who has joined premenopause.

If a woman notes the increased abundance of the discharge, in which the gaskets change every hour, you can suspect bleeding. Also a wrapping should be permanently accompanied by the yield of bunches.

Pathological is considered bleeding between menstruation or after intimate proximity.

Anxiety should be revealed in relation to:

• long periods;
• lack of menstruation for several months;
• the start of menstrual bleeding earlier than in 21 days after the previous one.

The condition of the woman in this period may change. It depends on the degree of severity of anemia, additional pathologies (hypertension, liver failure, thyroid disease, malignant education).

Diagnostic events

To discover pathology in the uterine cavity, a woman needs to undergo a diagnostic examination.

• ultrasound examination of the organs of a small pelvis;
• biochemical blood test for identification of liver pathologies, pancreas;
• studies of the hormonal state of the body provided by the thyroid gland;
• determination of the level of genital hormones;
• hysteroscopy, as a result of which is taken to analyze a piece of tissues of the mucous meter;

How to Stop

To stop bleeding, gynecologists often spend scraping of the mucous membrane of the uterus and cervical canal. During the procedure, it is possible not only to restore the functioning of the endometrium, but also to find out the causes of bleeding. After surgical intervention, the further tactics of treatment is determined if the selection does not stop.

PHIsterectomy is required if a woman is revealed by adenocarcinoma or atypical endometrial hyperplasia. If the mucous membrane is covered with miomas, fibromes and adenomas, hysterectomy or overall removal of the uterus is carried out.

If the changes are not hazardous, conservative treatment is carried out:

• To eliminate the likelihood of repetition of bleeding, hormonal pills with gestagens are prescribed in the composition. They atrophize the ferrous epithelium and stromometry. Also, drugs soften other symptoms of this period.
• In uterine bleeding, anti-estrogenous means Danazole and Gestrinone can be appointed. They not only affect endometrium, but also reduce myoma, mastopathy.
• After 50 years, androgens are prescribed to patients.

Blood-link drugs for uterine bleeding during climax are additional medicines. Weight correction and patients with metabolic disorders are also possible. It is carried out by an endocrinologist, a diabetologist and a cardiologist.

If uterine bleeding even after treatment continues, this may indicate:

• nodes (myomatous and submucose);
• polyps;
• endometriosis;
• editions on the ovaries.

In this case, additional surveys and therapy will be required.

First aid in old age

The treatment of uterine bleeding in old age is based on the causes of its occurrence. With dysfunctional discharges, hormonal agents are prescribed. They include analogues of female sexual active substances - estrogen and progesterone. Hormones regulate the menstrual cycle during perimenopause and warn the appearance of menometrormal.

Organic bleeding is treated during the elimination of the main pathology. It is often not necessary without the help of a surgeon. Oncological tumors are removed promptly and complemented. radiation therapy, chemistry.

Effects

Bleeding from the uterus can lead to various complications. One of the dangerous is postghemorrhagic anemia or hemorrhagic shock. This happens with abundant discharge.

Also often occurs infection with the body as a rising way. As a result, secondary complications are developing in the form of a purulent minerite or the formation of pus on myomatous nodes.

If myoma is not detected in a timely manner, then the woman feels a strong pain syndrome in the abdomen and placing a bloody character. Symptoms are due to rejection of the fibromatous node and its yield to the uterine cavity. Complication is dangerous and requires surgical removal.

Bleeding, which are atypical character, should alert a woman in any period of Klimaks. It is important to immediately turn to the gynecologist to prevent the development of complications.

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Uterine bleeding: signs, treatment and drugs, reasons based on age

In the practice of obstetrician-gynecologist, uterine bleeding is one of the most frequent symptoms with which patients enter the hospital or their own appeal to the doctor. Uterine bleeding can arise as a very young teenage girl and elderly womanlocated for more than 25 years in menopause.

However, the reasons that can cause this alarming symptom are absolutely different. As you know, for the effective treatment of pathological conditions, it is necessary to understand the mechanisms of development primarily. It is for this reason that the principle of "symptomatic treatment" is absolutely unacceptable for uterine bleeding, which eliminates the investigation, and not the reason. In addition, given not only such different age groups, but also certain physiological conditions (for example, pregnancy), it becomes obvious that fundamental knowledge of medicine is important in this matter, as well as an individual approach to patients.

In most cases, uterine bleeding arise due to violation of hormonal status, so they are called dysfunctional. In this regard, for the deep understanding of the true causes of bleeding, it is necessary to briefly sort out the regulation of the menstrual cycle.

Briefly about the physiology of the menstrual cycle

For a simplified understanding of this complex system, the cycle regulation can be compared with a five-storey building, where each below is obeyed by the above-mentioned, but it is quite obvious that the upper floor cannot function independently without its "subordinates". Such a comparison reflects the main principle: the existence of direct and inverse relations between all levels of regulation.

• So, on the first floor of the building, the uterus is located. It is she who is the main executive body and is influenced by all higher levels. Now it becomes clear that the uterine bleeding is a symptom that may appear when violating at any level. And this means that effective treatment It should be carried out not only by hemostatic drugs, which is essentially a struggle with a consequence. The most important thing is to find the cause.
• We rise above on the "second floor": there are ovaries here. They are iron internal secretion and produce a large number of hormones: estrogens, progesterone, androgens. Estrogens prevail in the first phase of the cycle, and progesterone - in the second. However, the ovaries are also not autonomous and obey the levels of regulation located above.
• The "third floor" is the pituitary, which produces:
  1. follicle-stimulating hormone (FSH) - responsible for ripening processes dominant follicula in the ovaries;
  2. luteinizing hormone (LH) - his peak causes ovulation (egg yield) in the ovaries.
• The "fourth floor" occupies a hypothalamus. The so-called "liberins" stimulate the pituitary gland, and "statins" - on the contrary, suppress the production of hormones. In addition, for the normal functioning of the sexual system, the cyclicality of the flow of hormones in blood is important. Numerous studies prove that the hypothalamus hormones in the norm go to the bloodstream every hour.
• Finally, the "fifth floor" rightfully occupies the bark of large hemishers, that is, the central nervous system. And this means that any stress, complex situations that happen to us - all this affects the regulation of the menstrual cycle. This explains the reason for the bleeding in women in stress.

Classification of uterine bleeding

Depending on the age factor:

1. Juvenile - arise in adolescent girls, ranging from the age of menarche (first menstruation) and up to 18 years.
2. Reproductive age - characteristic of women over 18 years and until Menopause.
3. Climacteric - arise in women in the menopausal period.

In relation to pregnancy:

• Uterine bleeding during pregnancy:
  1. in the first trimester (up to 12 weeks);
  2. in the II trimester (from 13 to 26 weeks);
  3. in the third trimester (from 27 to 40 weeks).
• Postpartum bleeding:
  1. in early postpartum period (within 2 hours after delivery);
  2. in the late postpartum period (within 42 days after childbirth).

Juvenile bleeding are a consequence of the violation of the hormonal regulation of the menstrual cycle in girls. The main problem is that the girl is rarely treated with this problem for a gynecologist for many reasons:

1. Shy to tell parents about the violations of the cycle;
2. It is mistaken to think that menstruation will be regular after some time. However, many studies were conducted on the basis of which we can conclude: in the absence of treatment of cycle disorders in the pubertal period, persistent abnormal changes in the menstrual and, most importantly, in the reproductive function of the female organism are developing.
3. Girls confuse menstruation with uterine bleeding.

How to distinguish normal menstruation from bleeding in the menstrual period?

Criteria for normal menstruation:

• The duration of the menstrual period does not exceed 7 days;
• The volume of lost blood does not exceed 80 ml;
• In menstrual blood, abundant blood clots should not be present.

At first glance, pretty simple and clear criteria, but it is not always possible to calculate blood loss in milliliters. In addition, the evaluation system of blood loss by the visual method is very subjective and pays a lot of errors. Even experienced doctors cannot always determine the volume of blood loss "on the eye", so for young girls is very difficult.

For this reason, according to statistics, about 20% of uterine bleeding is mistaken for menstruation, which means that every fifth girl from this risk group is exposed to long-term chronic blood loss (anemization).

In this regard, a fairly fair question arises: for what other signs can be distinguished by pathological blood loss from physiological?

Usually these girls have characteristic symptoms:

1. Pale skin;
2. Brittle, dry hair;
3. Dull nails;
4. Weakness is expressed, fatigue;
5. Reduced performance;
6. Configured states;
7. Heart palpitations.

Video: Dysfunctional uterine bleeding, the program "Live healthy!"

Causes and treatment of uterine bleeding among girls

The main reason for such disorders of the menstrual cycle is to change the hormonal status, namely:

• Violation of the production of hormone progesterone ovarian;
• Changes in the ratio of pituitary hormones (increase in the follicularity-free (FSH) hormone and a decrease in luteinizing hormone (LH). The insufficient level of LH also leads to the fact that no ovulation occurs;
• Excessive content of estrogen in the body;
• Pathology of the thyroid gland, adrenal glands.

Important! For the full functioning of the female sexual system, it is important not only the quantitative content of hormones (their concentration in the blood), but also the ratio of one to the other. In other words, if, according to the results of the study, the concentration of sex hormones is placed in the physiological norm, then this does not indicate full well-being. It is for this reason that only a doctor can correctly evaluate the results of laboratory research.

In addition, the causes of uterine bleeding are also:

1. Violations of blood coagulation system (thrombocytopathy, Willebrand disease, hemorrhagic vasculitis, thrombocytopenic purpura);
2. Various anomalies of the development of the uterus;
3. Adenomyosis is manifested by long-term menstrual bleeding, which is accompanied by severe pain in the lower parts of the abdomen;
4. Oncological blood diseases (leukemia);
5. Ovarian cysts;
6. Pituitary tumors;
7. Inflammatory diseases of female genital organs sometimes lead to uterine bleeding;
8. Increase endometrial thickness or polyp in the uterine cavity.

Methods for the treatment of juvenile uterine bleeding

Treatment should be primarily aimed at:

• Stopping bleeding to the rapid time limit;
• Treatment of anemia with a large blood loss;
• Elimination of the cause of bleeding in order to prevent the repeat of this situation.

Unfortunately, sometimes the treatment stops at the first two points, and until the reason for clarification, the case does not reach. But this is rooted incorrectly, as it is possible to fight solely with a consequence - this is a useless occupation. In addition, the lack of treatment itself leads not only to the risk of repeated bleeding, but also to the violations of the reproductive function in the future.

It includes the hemostatic drugs:

1. Preparations affecting a chopping system of blood. Very well established the drug "Transcamam" ("Transcamic acid"). It is especially important that it can be applied by almost all causes of bleeding. In case of severe blood loss, it is necessary to introduce the drug intravenously drip in dilution with saline. The hemostatic activity of "TRACKSAMA" is very high and persisted for 17 hours after the administration of the drug. In the future, when stopping bleeding and ongoing cargo bleeding, you can go to the tablet form. this drug. A similar action, as well as "transcons", has "aminocapronic acid". However, numerous studies have shown that the effectiveness of the Transcama is several times more.
2. Calcium chloride solution is also effective in uterine bleeding. It can be introduced intravenously (slowly!), Either in the form of drip infusion with saline. It is categorically impossible to prick intramuscularly given drug, as it can cause muscle tissue necrosis.
3. Preparations that contribute to the reduction of the uterus, for example "oxytocin". Thanks to the reduction in muscle fibers, the uterus occurs spasm blood vesselsAs a result, bleeding stops.
4. It is possible to strengthen the vascular wall in such a drug as "Ascrotin".
5. Special attention deserves such a method of stopping uterine bleeding, as the use of hormonal drugs. With abundant bleeding, the following scheme is effective: appointment on the first day 2-3 tablets of combined oral contraceptives ("Marvelon", "Regular"), in the following days 1 tablet within 21 days.
6. The introduction of freshly frozen plasma for uterine bleeding is also justified. Especially if, according to laboratory surveys, signs of violation of the blood coagulation system are revealed.

Treatment of such complications of uterine bleeding as anemia:

• With severe anemia, when hemoglobin is less than 59 g / l, do not do without transfusion of the erythrocyte mass.
• Effectively increase the level of hemoglobin intravenous drugs Iron, such as "Licferr", "Wenimer", "Argiferer", "Ferisect". Infusion 1 packaging of these drugs is sufficient to increase the hemoglobin Nag / l for the rapid period of time. The only drawback is a high price.
• With anemia of an easy degree, it is enough to do with tableted drugs ("sorbifer", "Ferrum-Leka", "Ferro-Folgamma", "Feneuls", "Malto").
• In parallel with the use of iron preparations, you can take vitamins of group B. Most effective scheme of alternation in a day intramuscular injections Vitamins B6 ("pyridoxine chloride") and B12 ("Cyancobalamin").
• Do not forget about the observance of the diet: the use of meat, liver, apples, plums, carrots, beets.

Stage Third - Elimination of the cause of bleeding:

1. When the pathology is found, the blood system needs consultation of the hematologist, and if necessary, continuing treatment in the hematology department.
2. With proven hormonal disorders, you can assign combined oral contraceptives for 3 months.
3. When progesterone failure, it is necessary to take into the second phase of the menstrual cycle "Dufeston" within 3-6 months.
4. For functional disorders At the level of the hypothalamus, it is enough to adhere to the vitaminotherapy, as well as under the course of endonazal electrophoresis with vitamin B1 to correct the cycle. Also effectively appointing Glycine preparations, "Nootropyl", "Asparkamka" to normalize metabolic processes in the central nervous system.
5. If the girl had psychological injury or stress, it is advisable to consult a psychologist.
6. When confirming the diagnosis of "adenomyosis", the treatment of this pathology is necessary.

When carrying out all three stages of treatment, almost 90% of girls during the first year, a normal menstrual function is completely restored, and episodes of repeated uterine bleeding are stopped.

Uterine bleeding in women of reproductive age

According to statistical data, each third woman had uterine bleeding at least once in his life. This means that the study of this problem needs to pay due attention.

The reasons

• Violations of hormonal status. Changes at any level of regulation of the menstrual cycle may cause bleeding;
• Endometriosis, in particular - adenomyosis. This disease is the introduction of endometrium cells into the muscular wall of the uterus, which significantly reduces its contractile ability, and also causes pain syndrome. A distinctive feature This pathology is the appearance of bloody discharge after menstruation or before them;
• Defects of the coagulation system of blood;
• Endometrial pathology (hyperplasia). If the thickness of the inner shell of the uterus exceeds 14 mm, then you can talk about hyperplasia. This is one of the most frequent causes of the appearance of bleeding;
• Polyp uteria. This formation is discovered, as a rule, when conducting an ultrasound;
• Myomatous nodes (especially those that grow towards the uterine cavity are called submucosic). Currently, there is a tendency to increase the number of women with the Mioma of the uterus. Moreover, this disease "young people" means that it is no longer a rarity of the Mioma of the uterus of large sizes in a very young girl. A certain contribution to the development of this disease is an imbalance of estrogen and progesterone in the body;
• The intrauterine spiral can also cause bleeding, especially if it is incorrectly located in the uterus cavity.
• The resulting complete or incomplete spontaneous abortion;
• Ectopic pregnancy can also cause uterine bleeding.

Principles of treatment

Given the diversity of the reasons that cause bleeding in women of reproductive age, for proper treatment It is primarily necessary to spend thorough diagnosis.

1. In hormonal disorders, it is necessary to conduct a correction. With progesterone deficiency, apply substitution therapy with the help of "Dufeston".
2. With functional disorders, it is sufficient to carry out treatment with hemostatic drugs ("transcons", "aminocaproic acid", "ethanzilate"), and then take vitamins over the cycle: in the first phase (from 5 to 15 days) foliic acid 1T. 2 times a day, vitamin C is 0.5 mg 2 times a day, in the second phase of the cycle (from 16 to 28 day) Vitamin E 1 caps. 1 per day. You can add a course of physiotherapy to treatment: magnetic therapy on the region of uterus's appendages, as well as endonazal electrophoresis with thiamine (vitamin B1).
3. If the diagnosis of adenomyosis was confirmed, then after hemostatic drugs it is necessary to treat this pathology.
4. If there is an endometrial hyperplasia and a polyp in the uterine cavity, it is necessary to carry out a surgical stopping of bleeding, namely: therapeutic and diagnostic scraping of the uterine cavity. This method It is good in that it effectively stops bleeding, as well as the resulting histological preparation (scraping from the uterine) is sent to the study of cytomorphologists. Based on the data obtained, the doctor may prescribe a specific treatment.

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With submucose morning, the uterus also sometimes helps to stop bleeding the scraping of the uterine cavity. But with a large size of the node, which deforms the uterus, urgent surgery is necessary. However, contrary to many fears, this operation is not always carried out by open laparotomous access (with a cut of the abdominal wall). If the myomatous node is not very large and is located "on the leg", then this operational intervention can be carried out with a hysteroresterectoscope. This tool is an optical chamber with a cutting loop. The hysterorezectoscope is introduced into the uterine cavity with vaginal access and under control of view (the image from the camera in the uterine cavity is displayed on the big monitor) the doctor cuts off the myomatous node. This method is very effective, and most importantly, the period of recovery of the patient after the operation is very short. However, sometimes an open operation is required to remove nodes. The volume of surgical intervention is established by the attending physician. For women of reproductive age, obstetrician-gynecologists try to dispense by organ-grinding operations to leave the opportunity to give birth to a child in the future.

The main principle of treatment of uterine bleeding in women of reproductive age is the preservation of its childbearing and menstrual function.

Video: The problem of uterine bleeding in the program "Live healthy!"

Bleeding during pregnancy

Obstetric bleeding to this day are one of the main causes of maternal mortality. Despite the development of new methods for diagnosing and treatment, these bleeding is not fully avoided even in the best clinics and perinatal centers.

Causes of bleeding during pregnancy:

• Chorion delay (early) or placenta detachment;
• Antiphospholipid syndrome;
• Hellp syndrome;
• Disorders of the coagulation system of the blood of a pregnant woman;
• Threatening spontaneous abortion;
• The resulting or accomplice of the uterus.

Treatment of obstetric bleeding is a challenging task for a doctor, as many factors affect tactics: the state of the fetus, the term of pregnancy, is there a threat to the life of the mother, the volume of bleeding, etc.

Basic principles of treatment:

In the early period of pregnancy, the hormonal drug Dupaston is effective during chorion detachment. When pairing the placenta plays the volume of bleeding: with minor and moderate bloody discharges, doctors try to preserve pregnancy. For this, hemostatic drugs are introduced ("TRANSAM", "Ditinon"). With strong bleeding, signs of hypoxia of the fetus, an emergency operation is necessary. The earlier will be held cesarean sectionThe greater the chance to save two lives: mother and child.

Important! Bleeding during pregnancy - an extremely unfavorable symptom. Provide qualified assistance in such a situation only a doctor, no ways of treatment folk remedies At home should not be!

Uterine bleeding after childbirth

According to statistics, 2% of all kinds are complicated by postpartum bleeding.

• Reducing the tone of the uterus after delivery (there may be a consequence of uterine abstinement in large fruit, multi-way);
• The increment of the placenta to the inner surface of the uterus;
• Delay of the parts of the placenta in the uterine cavity;
• Cervical breaks in childbirth;
• Continuation of the cervix break to the lower segment of the uterus;
• Pathology of blood coagulation system;
• The discrepancy between the seams after the cesarean section.

The treatment of postpartum bleeding should be carried out as soon as possible, since the uterine bleeding after delivery can be very massive and lead to a serious blood loss.

1. It is necessary to immediately begin the conduct of intravenous infusion of the reducing uterus of drugs: "Oxytocin", "Methyleirgobrevin", "Pabal".
2. Introduction of hemostatic drugs "Tranxam", "Aminocaproic acid", "Ethalzila", a 10% solution of calcium chloride.
3. Replenishment of blood loss with saline solutions (saline solution, 5% glucose solution), as well as colloidal preparations (Venofundin, Stabizol, Reahles, InfoCol).
4. With a large blood loss (more than 1000 ml), it is impossible to do without erythrocyte mass and freshly frozen plasma, as it contains coagulation factors.
5. Mandatory administration of drugs - inhibitors of "Gordskors" enzymes, "Ponticale" or "Trasilol". Without these drugs, it is ineffective to introduce freshly frozen plasma, as coagulation factors will be destroyed by blood enzymes.
6. When the placenta parts are delayed in the uterine cavity, it is necessary under intravenous anesthesia to conduct manual control of the uterus in order to remove the remains of the placental fabric and the shell.
7. With cervical breaks, it is necessary to sew all torn fabrics. If the gap from the cervix moves to the lower segment of the uterus, then an emergency operation is necessary.
8. After all medical events On the lower part of the abdomen, it is necessary to put the cold cargo (weighing about 1.5 kg) for 20 minutes every 2 hours. This contributes to the reduction of the uterus.

Important! The first 24 hours after childbirth are the most dangerous to develop bleeding. Therefore, during this period there should be round-the-clock monitoring of the state of the woman.

After extracting from the maternity hospital for the prevention of bleeding, a woman needs to independently take funds cutting the uterus: a tincture of water pepper or a decoction of nettle. These tools help return the uterus to normal sizes.

Women's bleeding in menopause

Blood selection when climax is always an alarming sign. It is impossible to treat it lightly and irresponsible.

The main causes of bleeding in menopause:

Obviously, there are not so many reasons, but they are all very serious.

The main difference in medical tactics in the uterine bleeding in women in menopause is an oncological alertness.

• When identifying the ultrasound of the pathology of endometrial or polyp due to oncological alerts, among all methods of treatment, a surgical method of stopping bleeding is prevailing, namely: scraping the uterine cavity and cervical canal. This is necessary in order to send the material obtained during the operation to histological examination and exclude or confirm the oncological process on time. Important! Studies have shown that in 70% of cases, endometrial cancer appears in women in menopause and the first symptom is uterine bleeding. After scraping the uterus, hemostatic drugs are introduced.
• When identifying submucosic myoma, you can carry out a hysteroresterate with the subsequent removal of the node. With large sizes of nodes, the uterus is removed with appendages.
• If a spiral is found in the uterus, which is installed more than 5 years ago, it must be deleted. After removing the helix it is very important to make sure the integrity of the walls of the uterus. After the operation, it is necessary to further conduct anti-inflammatory therapy.
• When the level of hemoglobin decreases, iron (intravenously or in the form of tablets) should be taken depending on the level of hemoglobin.

The predominance of surgical tactics towards the uterine bleeding during Klimaks allows you to recognize a benign or malignant nature of the pathological process.

conclusions

Depending on the age of a woman, the causes that cause uterine bleeding are different. This means that therapeutic tactics with the elimination of the cause cannot be the same type and universal for all patients.

In addition, it is necessary to take into account the principle of "continuity" of pathologies. The essence of the principle is that the absence of treatment of dysfunctional uterine bleeding in the pubertal period can lead to chronic anovenation and endocrine infertility in reproductive age. And this, in turn, is a "bridgehead" for the development of benign and malignant pathological processes of endometrial in menopause. It is for this reason that the uterine bleeding should be treated seriously at any age.

At the age of menopause, the main pathology, which should attract particular attention, is the cancer of genital organs. The doctor must, however, remember how many cases of malignant lesions of the genital organs arise in the late reproductive period, before the onset of menopause. The survey of 40-year-old patients should be carried out on the full program and as carefully.

Benign vaginal diseases

Atrophic or blue vaginites are most often the cause of bleeding from the vagina in women after menopause. The lack of estrogen causes atrophic changes in the mucous membrane of the vagina, as a result of which it becomes smooth and very thin, easily ulcerated and infected.

Bleeding from the wall of the vagina is usually very scanty and are characterized by patients as drip or oscillations brownish selection. In the study of the organs of the small pelvis, symptoms of vaginite (often with signs of secondary fungal infection) and multiple petechia in the mucous membrane of the vagina can be detected. In patients living with sex life, sometimes small abrasions can occur.

Treatment is to suppress infection and the purpose of estrogen inward or locally in the form of vaginal ointments. Preparations used locally are well absorbed and have a system-wide action, comparable to those obtained when taken inward. Therefore, patients who are conducting local treatment must also be carefully observed, as well as a system-wide treatment with estrogens about other diseases.

Malignant tumors

Most of them are the result of the invasion of endometrial cancer or cervix. From the primary cancer tumors of the vagina most often occurs at the age of the plane carcury cancer, which was the cause of postmenopausal bleeding in 0.7% of women from a large group of patients.

The average age of patients is 65 years old, and two thirds of them are over 50 years old. Characteristic sign The disease is bleeding from the vagina, observed in 50.0-83.7% patients with vaginal cancer. Bleeding can be postcoital or spontaneous. However, many of these patients with symptoms are absent, which makes it necessary to conduct regular prophylactic inspections with the taking of smears for cytological research Even in the absence of uterus.

The diagnosis in patients coming with bleeding from the vagina can be delivered after inspecting its walls with mirrors. The most characteristic location of lesions is the top one third of the vagina. Treatment (surgical or radial) depends on the stage of the disease and age of the patient; on the early stages Diseases may address the question of saving the function of the vagina.

Cervical and body disease

The cause of bleeding in most patients after menopause cannot be determined only on the basis of an objective examination. In several works, the difference in the occurrence of bleeding during malignant lesions is given.

The frequency of the occurrence of cervical cancer reaches its peak in the age group of 40-60 years. Endometrium adenocarcinoma is a typical malignant disease causeing bleeding in postmenopausal period. It affects 20 women out of every 100,000 and most often occurred at the age of 60. The frequency of the occurrence of adenocarcinoma endometrial has increased, and at present the uterus body cancer is also observed as often as its cervical cancer. This happens mainly due to an increase in the average life expectancy of women. Diagnostic embodiment of endometrial is a painful procedure and gives only 28-86% of the correct answers. We prefer to use vacuum-aspiration biopsy in these cases.

Obesity, lack of birth and oligoovulation (history), elevated arterial pressure And diabetes suggests the high risk of adenocarcinoma. Treatment with estrogen patients after menopause is also a risk factor. Patients taking exogenous estrogens should be regularly and thoroughly examined and warn about this risk. In some groups, almost 50% of patients with bleeding after menopause could be identified with various forms of treatment with estrogen. Bleeding is the main and usually the only sign of endometrial carcinoma. Sometimes the tumor applies to the cervix, causing the obturation of the cervical canal, which causes the occurrence of a pio-or hematometry. In these cases, with a bimanual study, an increased and painful uterus can be detected.

The most accurate diagnostic method is a fractional scraping of the walls of the uterus. Depending on the state of the patient and the desire for the surgeon, anesthesia may be local (paracervical) or common. General anesthesia Provides the ability to conduct a better study of the organs of a small pelvis. Only an experienced doctor can produce scraping the walls of the uterus in the clinical conditions.

The endometrium carcinoma forecast depends on the degree of differentiation of the tumor, the size of the uterus, the degree of invasion into the myometrium and the propagation of it on the cervix. The nature of treatment should be due to the set of all these factors.

Other (more rare) malignant uterine lesions - sarcoma and mixed mesodermal tumors are also accompanied by bleeding from sex tract. Together they constitute less than 1% of malignant lesions of the genital organs. Leiomiosarcoma is usually diagnosed in the study of a remote tumor under a microscope. Mixed mesodermal tumors or carcinosarks may be accompanied by strong bleeding and pain at the bottom of the abdomen. Research using mirrors sometimes reveals a gaping cervical canal, in which there are tumor masses.

The carcinoma of the uterine tubes is not characteristic of this age group and is rarely accompanied by bleeding. The classical manifestations of the disease are intermittent watery slabs in the absence of infectious chrocery and tumor formations in the area of \u200b\u200buterine appendages in the vagina. Carcinoma of the uterine pipe should always be borne in mind when the bleeding in patients after menopause, when the study of the small pelvis organs and the diagnostic scraping of the water cavity walls do not allow to identify any other causes of bleeding.

Benign processes

Of benign diseases, accompanied by post-menopausal bleeding from sex tract, most often (in addition to atrophic vaginites) are found polyps, atrophy and endometrial hyperplasia.

Why bleeding occurs in patients with endometrial atrophy not very clear. The cause can be arteriosclerotic changes in myiometry, leading to increased vessel fragments and the rupture of atrophic endometrial cysts. These patients also often observe the omission of the uterus, possibly associated with venous stagnation. Endometrial polyps After the diagnostic scraping of the uterine cavity walls do not require further treatment. Observations for patients with hypeclastic changes of endometrial in the pre- and postmenopausal period should be regular. The use of hormonal therapy is a fully adequate event in order to cause regress of the disease in most cases. The absence of an appropriate effect after the administration of progestogenic drugs or recurrences of bleeding serve as an indication to hysterectomy.

Studies have shown that the forecast for bleeding of benign etiologies arising after menopause is quite good: in 92% of cases malignant diseases do not develop, but, however, it is necessary to ensure careful dispensary observation For these patients with the purpose of early detection of their signs of malignization.

J.P.BaalmAtse

"Bleeding after menopause" and other articles from the section

For some women, this farewell is very unpleasant. They feel negative changes in the body, fall into depression. Others do not pay attention to this, trying to quickly move the trait of menopause.

Do not notice the changes can not if uterine bleeding in the premanopausal period is manifested and after menopause. They may indicate pathologies in the body, especially the availability of formations. Tumors have both benign and malignant.

When to worry about nothing

When the climax occurs, the bleeding is not always anomalous.

Help his appearance should not at:

• manifestations of premenopause;
• artificially extended premopause;
• reception of oral contraceptives and installation of the uterine spiral to exclude the likelihood of the occurrence of pregnancy in premaneopause and menopause.

It is worth remembering that in the presence of menstruation, a woman can get pregnant. Therefore, protection during this period is mandatory. Bleeding may indicate the improper selection of the contraceptive method. It is important to visit the doctor to replace the way to more suitable.

The onset of Klimaks is noted at the age of 40 years. There should be no sudden disappearance of menstruation.

During this period, there are several stages of development:

1. Premenopause is celebrated for two to five years. At this time, menstruation is preserved, but they have an irregular, weakly expressed character. Changes are associated with hormonal imbalance, impaired work of the organs of the endocrine system.
2. In the period of menopause, monthly terminates. If they are not for the year, their final disappearance is noted. Some women trying to delay menopause, take progesterone. It allows you to return menstruation that becomes painless and inhum.
3. In the absence of menstruation during the year, postmenopause occurs. During this period, any bleeding is considered pathological. Especially dangerous are the selection with clots. Changes are no longer caused by hormonal violations. Sometimes they testify to malignant formations. It is important to visit the doctor who will notice possible causes and treatment of uterine bleeding during menopause.

It is worth remembering that in the period of menopause there may be various diseases accompanied by uterine bleeding. To identify a woman, it is important to regularly visit the gynecologist and treat pathologies.

Classification

Bleeding from the uterus in old age can be of various types:

• For diseases of the organs of the female reproductive system, among which the uterus, ovaries, vagina are distinguished, organic bleeding appear. They can also be associated with violation of metabolism, the work of the endocrine system, liver and blood supply.
• Yatrogenic bleeding are associated with the reception of medicines with hormones in the composition, anticoagulants and other medicines. They are also manifested when installing intrauterine spirals.
• Dysfunctional uterine bleeding in the premanopausal period is due to a cycle impairment due to hormonal imbalance.

Bleeding of dysfunctional nature may have different duration. They are considered anomalous with abundance (more than 80 ml), elongation (longest) and a cycle of less than 21 days or more than 40 days. Normally, the cycle must be from 21 to 35 days, monthly over 3-7 days with blood loss up to 80 ml.

Depending on the nature of violations of the bleeding of dysfunctional type can be divided into several types:

• regular long-term monthly abundant (more than 80 ml) of character for more than a week are called hypermoreria or menorragia;
• with a weak severity of intermenlar selection, metroralia is diagnosed;
• irregular bleeding from the uterus, the duration of which is more than a week, are considered menometroral;
• regular bleeding at intervals over 21 days are polymenores.

In menopause, bleeding disorders (duration and abundance) can be associated with the state of blood vessels or blood coagulation. Also, doctors note among the frequent causes of changes in the endometrial layer of the uterus.

Why mowan bleeding during menopause

The uterine bleeding during the period of Klimaks may indicate hormonal changes that are associated with the aging of the body. Also, abnormal disorders may be a consequence of pathologies, receiving contraceptives, other medicines.

The first changes in women can be celebrated upon the occurrence of 35 years of age. Early menstruations are given to the appearance of bleeding in this period, a considerable gap between birth, lactation cessation with an artificial way.

Influence of climax and dysfunctional bleeding and heredity. In addition, among the frequent causes, infectious and inflammatory processes in the reproductive system organs, tumors of a benign and malignant character are distinguished.

Hyperplasia Endometrial

As a result of a sharp increase in estrogen levels in the body, the endometrium can be uncharacterically to grow and thicken. In the normal state, after leaving the follicle, the ripening egg should reduce the hormone indicators. During this period, progesterone increases, which does not give estrogen to increase.

After that, a woman can get pregnant. Then the embryo is attached to the mucous membrane of the uterus. If fertilization does not occur. That endometrium is brazed and comes out in the form of menstruation.

Climax is due to hormonal failure. Therefore, premenopause is characterized by abundant and long-term menstruation. If the monthly is missing for half a year, then a woman can detect a bleeding character. They have an abundant or scant expression and different duration.

Myoma

Mioma is a benign formation appearing in the uterine cavity in muscle layers. This is due to the violation of the structure of tissues and the lack of normal cutting in the uterus.

Before the onset of menopause, women often suffer from Miom. As a result of the tumor, the nature of menstrual discharge changes: their abundance and duration increases (up to 10 days).

Due to the regular appearance of bleeding, menorragia is considered. The tumor may increase in size until the period of menopause period is stopped. Subsequently, its growth stops.

Polyps

Benign tumors in the uterine cavity are polyps. They are considered the result of the growth of individual parts of the endometrium.

The polyp is an outflow consisting of endometrial cells. Education is on the leg, with the help of which it is attached to the wall of the uterus. It is permeated with blood vessels that can bleed during injury. Allocations are usually oscillation and irregular.

Polyps can be placed one or in the form of clusters. They are considered dangerous, as they can be reborn into malignant tumors.

Adenomyosis or endometriosis

If the endometrium germinates in the fallopian walls or on neighboring organs, adenomyosis or endometriosis is diagnosed.

It can cover:

In the development of the process, there may be rebirth of tissues in malignant. At the same time, endometriosis is accompanied by bleeding between menstruation and severe pain syndrome.

Malignant tumor

Cancer formations sometimes have no expression. Therefore, women do not diagnose them in a timely manner.

It is important to remember that even non-delicate bleeding can signal the presence of a malignant tumor. Sometimes bleeding is abundant or cargo sections. Especially often an oncological disease is manifested in postmenopause.

Ovarian dysfunction

With violation of the production of hormones in the body, the ovarian dysfunction may be observed. It is associated with inflammatory processes and endocrine pathologies.

This disease in premopause has been particularly often observed. A woman can distinguish it on randomly occurring menstrual bleeding of different intensity.

Other reasons

Other reasons for the appearance of bleeding in women of the older age period are distinguished:

Symptomatics

The duration of the menstrual cycle and the abundance of menstruals change already in premenopause. At this time, menstruation may be absent for several months, and then suddenly begin.

The abundance of discharge changes. They either are scooping or become too abundant. These signs are considered normal for a woman who has joined premenopause.

If a woman notes the increased abundance of the discharge, in which the gaskets change every hour, you can suspect bleeding. Also a wrapping should be permanently accompanied by the yield of bunches.

Pathological is considered bleeding between menstruation or after intimate proximity.

Anxiety should be revealed in relation to:

• long periods;
• lack of menstruation for several months;
• the start of menstrual bleeding earlier than in 21 days after the previous one.

The condition of the woman in this period may change. It depends on the degree of severity of anemia, additional pathologies (hypertension, liver failure, thyroid disease, malignant education).

Diagnostic events

To discover pathology in the uterine cavity, a woman needs to undergo a diagnostic examination.

• ultrasound examination of the organs of a small pelvis;
• biochemical blood test for identification of liver pathologies, pancreas;
• studies of the hormonal state of the body provided by the thyroid gland;
• determination of the level of genital hormones;
• hysteroscopy, as a result of which is taken to analyze a piece of tissues of the mucous meter;

How to Stop

To stop bleeding, gynecologists often spend scraping of the mucous membrane of the uterus and cervical canal. During the procedure, it is possible not only to restore the functioning of the endometrium, but also to find out the causes of bleeding. After surgical intervention, the further tactics of treatment is determined if the selection does not stop.

PHIsterectomy is required if a woman is revealed by adenocarcinoma or atypical endometrial hyperplasia. If the mucous membrane is covered with miomas, fibromes and adenomas, hysterectomy or overall removal of the uterus is carried out.

If the changes are not hazardous, conservative treatment is carried out:

• To eliminate the likelihood of repetition of bleeding, hormonal pills with gestagens are prescribed in the composition. They atrophize the ferrous epithelium and stromometry. Also, drugs soften other symptoms of this period.
• In uterine bleeding, anti-estrogenous means Danazole and Gestrinone can be appointed. They not only affect endometrium, but also reduce myoma, mastopathy.
• After 50 years, androgens are prescribed to patients.

Blood-link drugs for uterine bleeding during climax are additional medicines. Weight correction and patients with metabolic disorders are also possible. It is carried out by an endocrinologist, a diabetologist and a cardiologist.

If uterine bleeding even after treatment continues, this may indicate:

• nodes (myomatous and submucose);
• polyps;
• endometriosis;
• editions on the ovaries.

In this case, additional surveys and therapy will be required.

First aid in old age

The treatment of uterine bleeding in old age is based on the causes of its occurrence. With dysfunctional discharges, hormonal agents are prescribed. They include analogues of female sexual active substances - estrogen and progesterone. Hormones regulate the menstrual cycle during perimenopause and warn the appearance of menometrormal.

Organic bleeding is treated during the elimination of the main pathology. It is often not necessary without the help of a surgeon. Oncological tumors are removed operational and complemented by radiation therapy, chemistry.

Effects

Bleeding from the uterus can lead to various complications. One of the dangerous is posthemorrhagic anemia or hemorrhagic shock. This happens with abundant discharge.

Also often occurs infection with the body as a rising way. As a result, secondary complications are developing in the form of a purulent minerite or the formation of pus on myomatous nodes.

If myoma is not detected in a timely manner, then the woman feels a strong pain syndrome in the abdomen and placing a bloody character. Symptoms are due to rejection of the fibromatous node and its yield to the uterine cavity. Complication is dangerous and requires surgical removal.

Bleeding, which are atypical character, should alert a woman in any period of Klimaks. It is important to immediately turn to the gynecologist to prevent the development of complications.

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Highlights from vagina in senior women

Most frequent cause - Atrophic vaginitis and unsatisfactory hygiene of external genital organs.

Frequency

It occurs infrequently, but any abundant allocations in women of old age should be considered as pathology.

Women annoy these symptoms, and they often themselves, without consulting a doctor, use various drugs To save the vagina.

Etiology

1. Atrophic vaginitis and unsatisfactory genital hygiene.
2. Infection or formation of ulcers on the mucosa as a result of using vaginal rings (pessaris).
3. Malignant process.

Symptoms

Often, women hide the symptoms, hoping that they will disappear independently.

1. The appearance of spots on underwear.
2. Unpleasant smell from the vagina.
3. Non-permanent bleeding and frequent urges on urination and defecation.

Blood allotments in older women causes

Blood selection after menopause are a reason for the mandatory visit of the doctor, although this may not be a serious danger. Minor disorders in women's reproductive functions during periods of menopause can be easily treated and disappeared without a trace. However, sometimes bleeding after menopause is able to indicate serious diseases developing in endometrials of the uterus, up to the formation of tumors.

Causes of bleeding after menopause

The bleeding allocations in postmenopausus in theory are obliged to completely stop due to the fact that this period is considered to be completed by all female reproductive functions. At this time, blood loss with menstruation completely stops, endometrial mucosa in the uterus is thinned, the ovaries decrease in size, the follicles are not formed and the pregnancy becomes impossible. It would seem that the female competes in the female body, and it is possible not to be worried about the state of childbearing bodies. But this is not the case, very often it is during the menopause there are problems forcing women to worry, and refer to specialists for help. The released selection in postmenopausal with blood content is almost always caused pathological reasons. The most common of them leading to the manifestation of bleeding in postmenopausage include the following:

• treatment with hormonal means;
• infectious processes;
• chronic diseases in reproductive organs;
• endometrium mucosa injuries;
• polypa formation;
• endometrial hyperplasia;
• myoma;
• malignant neoplasms.

The appearance of blood in the composition of the mucus in women of reproductive age is a natural and occurring phenomenon with menstruation. This happens because of the separation of the mucous layer in the endometrium when the conception has not occurred and the body is cleared of unnecessary tissues. Returning endometrial, as a rule, occurs with injury to small blood vessels, which leads to the appearance of blood in the uterine discharge. Since during the postmenopause, these processes are not performed, the endometrium layer, intended for the development of pregnancy, is no longer increasing and is not separated. Sex hormones, actively participating in cyclic processes, are also no longer produced by the body, which is the reason for the occurrence of Klimaks.

The mucous membralls during menopause become single and dryness in the vagina, accompanying changes in the body during this period, is considered normal.

Due to the changes committed in the reproductive system, the blood loss during the menopause should not be. And not only abundant, manifesting in the form of menstruation, even streaks of blood in the composition of mucus secretions in this age period Should alert and serve as a reason for the survey.

The character of the selection when climax

Not always bleeding after menopause is considered an indicator of pathologies occurring in the reproductive system. Some blood is able to stand out from the urethra urinary tract or from the intestines. With postmanopausal, hormonal imbalance with an insufficient level of necessary hormones is able to cause the development of pathological processes and in these bodies. To make sure that there is a gynecological problem in the presence of a tampon, placing it in the vagina. If after a certain period of time it remains clean, the cause of pathological manifestations must be determined by contacting other specialists.

What can suggest the character of postmanopause

1. Despite the fact that most women at the time of Klimaks are most worried about dry in the vagina, which gives it some inconvenience, the cervix in a small amount still continues to produce mucus. If it is natural color and the usual consistency, does not cause excessive discomfort, then its appearance is still considered the norm. But if blood appears in them, then most often it serves as a signal of pathological processes that have developed in the body.
2. Blood bodies can be caused by hormonal medicinal preparations used to treat any diseases or with severe syndromes accompanying climax. In these cases, to facilitate menopausal syndrome, doctors are often used hormones. Despite similar situations, drugs with hormone content can affect the organism in different ways. Suspension by estrogen can provoke the growth of the endometrium and cause a minor blood release. Cancellation of the drug is able to quickly get rid of the problem situation.
3. The brown selection color may be a consequence of oxidative reactions, since the cervical canal during menopause it becomes already, then the selection from the uterus cannot be output rather quickly and oxidized. A doctor in such cases will successfully select the necessary drugs to adjust the body's hormonal background.
4. During the postmenopause during the washed, it is sometimes noticed that the vagina is a little blood, which serves as a sign of mechanical damage to the mucous membrane. With the cessation of highlighting the hormones necessary to maintain childbearing functions, the mucosa becomes more thin and vary, which leads to damage to it during hygienic procedures. The same uncharacteristic allocations in postmenopausal are possible after contacting sex or during the gynecological examination of the doctor. It can not be left without proper treatment, as the traumatic damage to the cervix, is able to very quickly take a malignant character. Much worse if the blood streaks in mucus appear due to the development of the erosion of the cervix. This pathology may occur even before postmenopause and remain undetected, and can develop after the end of the reproductive age. These ailments should also be eliminated, since otherwise the manifestation of the disease with such releases in postmenopausus can lead to undesirable consequences.

Diseases that can affect menopause

Diseases caused by various infections that appear during the postmenopause period are not always dependent on the intimate life, which may simply be. The cause of their occurrence in the violation of the vaginal microflora, in which, due to the decline in local immunity, protective forces are not able to protect the body from attacking numerous microorganisms. Most often on the mucous vagina with the appearance of unusual sequencies, it is possible to detect bacteria causing chlamydia, gonoronia, trichomoniasis, bacterial vaginitis. For example, the same ordinary thrush or vaginite, in addition to curly white discharges, are able to show themselves with the discharge of blood mucus.

One of the reasons for such a discharge may be a polyp in the cervix or on the endometrium mucosa. Hormonal imbalancecaused by the extinction of the ovarian functions causes the growth of the mucous membrane or the development of elevations in its cavity, which leads to the occurrence of polyps. Mucous membranes with blood streaks are capable of occurring at intensive exercise Or when separated from the mucosa under its own weight.

The cause of bloody discharge in women can serve as the resulting Mioma, which is a benign tumor. Despite the fact that the period of menopause causes its decrease, sometimes at this age it is able to show its activity in the form of unusual disclaimers. Especially provokes their manifestation of hormonal agents intended to eliminate climacteric syndrome or the use of plant hormones.

Quite often, in postmenopausal, there is an arrangement of cells in the uterine cavity - hyperplasia. This increase in cells can be a benign nature, but can and move into malignant state. But almost always, such situations cause abundant uterine bleeding, in which blood clots and particles of fabrics from the uterine epithelium can be observed. If this disease was broadcast before the occurrence of menopause, then when it occurs, the disease most often subsides and does not show a sharp nature. But the changes committed in the body in this period can serve as one of the reasons for increasing activity and cause aggravation.

What can be taken in the occurrence of bleeding

The first thing to be done in a similar situation is to determine the source that caused bleeding and the cause that caused the manifestation data. From the timely and correctly conducted diagnosis of the created pathology, it depends on how successfully it will be possible to get rid of it. In the treatment of gynecologists, it most often uses scraping, a method that is used with a diagnostic purpose. There is a chance that after the scraping, the disturbing of the woman is distinguished by a mucus disappears forever, since such techniques are capable of rendering the therapeutic treatment. Women who have reached the fiftieth anniversary can help use medical preparations Based on androgens capable of suppressing sexual functions. To eliminate common menopausal syndrome, ordinary sedatives are used.

In addition to the treatment, conducted against the underlying disease, a gynecologist must also be paid to the methods aimed at improving the body. To do this, resort to changing the diet with increasing the shares of vegetables, fruits and equal milk products, especially cottage cheese. To avoid the unpleasant impact of menopause and related changes in the bones, it is necessary to use medical gymnastics, engage in accumulating sports with the calculated loads. Active lifestyle and positive attitudes are able to extend the feeling of youth and deserved to live a period of menopause.

What if you have Mioma?

• You are worried about sudden stomach pain.
• And long and painful monthly periods are already tired.
• And for some reason the recommended medicines are not effective in your case.
• In addition, constant weakness and ailments have already firmly entered your life.
• Now you are ready to take advantage of any opportunity.

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The age change in the hormonal background leads to the fact that with the onset of CLIMAKS, women appear specific fewems associated with violation of the work of various organs. In particular, the size of the uterus and ovaries decreases, reduces the production of mucus in the cervix. Due to this, the volume of normal discharge during menopause is reduced. But due to the dryness of the vagina, the risk of inflammatory diseases, the formation of tumors increases. Possible pathological discharge. To change their character during menopause, you must pay special attention.

Normal discharge

Vaginal allocations in a woman of any age are an indicator of reproductive health. The fir-bit function of the body is reflected on the formulation of mucus in the cervix. It continues to fulfill its protective role, preventing the infection in the cornelists. However, its volume decreases up to the point that during this period women appears dryness of the vagina.

It is believed that when climax, mucous allocations are normal if their volume does not exceed 2 ml per day, they are transparent (may have a weak yellowish tint due to oxidation of mucus in air). In addition, they should not have a sharp smell. The discretion includes not only mucus, but also plasma and lymph, therefore, they resemble rice decoction by consistency.

Normal damage during menopause do not cause a woman of unpleasant sensations, irritation of genitals.

Types of pathological discharge

Depending on the nature of the pathology, the release of the following type may appear:

• mucous membranes (if they are too scarce or too abundant, have foam consistency, smell badly);
• purulent (thick, have a grayish-green shade, sharp smell);
• curl (white, with lumps, have a sour smell);
• blood (color from bright red to brown, appear in the form of sucrovitsa, masses or bleeding).

Blood discharge is most dangerous, especially in postmenopausal period. When they are impossible to confuse with menstruation.

Blood selection during premanopause

Approximately the woman has menstruation, but the regularity of their arrival is disturbed due to the instability of hormonal processes in the body. The volume and duration of bleeding fluctuates. They may be a selling brown duration less than 2 days, and next time - abundant burgundy red, go, not stopping, within 2 weeks. In addition to irregular menstruation, when climax may be the appearance of blood discharge, if a woman takes drugs of substitution hormone therapy for weakening tides and other ailments of this period.

During premenopause women, endocrine diseases reinforcing hormonal shift appear more often. The incorrect metabolism arising due to poor work of the digestive organs, lack of vitamins leads to violation of hormones. All this becomes the cause of irregular bleeding.

Origin of bleeding during postmenopause

With the cessation of menstruation and hormonal restructuring, the woman disappears physiological factors that could lead to the appearance of bleeding. Now they become only a symptom of pathology (diseases of the uterus or appendages).

WARNING: When traces of blood in the discharge in women during the postmenopause period, it is especially risky with a visit to the doctor. The most terrible cause of such discharge can be uterine cancer. Singing a visit to the gynecologist, trying to somehow eliminate the problem independently, the woman loses the precious time for timely detection and removal of the tumor.

Characteristic signs of pathological discharge

In case of uterus diseases, damage to the mucous membranes occurs, possibly the destruction of tissues and blood vessels. There are foci of purulent inflammation. Therefore, pathological discharges appear the following signs:

• water consistency;
• the presence of foam, mucus clots, greenish pus or blood;
• unpleasant odor;
• cause irritation of external genital organs, redness and itching of the skin in the crotch area;
• there is burning and itching in the vagina.

Typically, such symptoms are accompanied by the discharges such as difficulty urination, accompanied by a throat bladder bubble. In addition, pains in abdomen and lower back can appear, and in some cases there is an increase in body temperature.

WARNING: It is urgent to a doctor, if during the postmenopause in the discharge in the woman's discharge, blood appears, and at the same time it did not take TGT drugs to weaken the symptoms of Klimaks. For the presence of a tumor in the uterus may indicate the appearance of constipation and urination delay.

Causes of the appearance of pathological discharges

The reasons for the appearance of anomalous discharge in women after the occurrence of Klimaks are pathologies associated with hormonal disorders, chronic diseases genital organs, infectious damage to the lower pelvis, deviations of an endocrine character.

Diseases associated with hormonal disorders

Endometriosis. During the entire reproductive period, a woman during menstruation occurred regularly updating the uterus mucosa. It was due to high levels Female sex hormones. During Klimaks, when the level of estrogen in the body decreases sharply, the endometrium decreases in the amount, its growing ceases. Therefore, often with the onset of menopause, the disease retreats, even if a woman suffered from his manifestations for many years.

But in some cases, a hormonal failure (insufficient developing of progesterone in the body), on the contrary, leads to endometriosis. One of the provoking factors is the metabolic disorder. Estrogens are produced in adipose tissue, so obesity often leads to endometriosis. Contributes to the unlimited growth of endometrials also diabetes, hypertension.

Endometriosis can occur in women who have undergone operations to remove uterus and appendages, forms on the site of scars. Infectious diseasesThe weakening of immunity also provoke the appearance of endometriosis.

When climax, this disease causes the appearance of bleeding gas seals, and more often - abundant bleeding, which leads to anemia. At this age, endometriosis is a harbinger of cancer.

Myoma uterus. A benign tumor in the form of knots in the muscle tissue of the uterus. With its increasing, the woman grows the belly, pain in its lower part appears, digestion and urination is disturbed. A characteristic symptom Mioma is the appearance of abundant bloody discharges.

Erosion and cervical dysplasia. Erosion is associated with the destruction of the surface layers of the cervix epithelium, and the dysplasia is damage to all layers of the mucous membrane. With these diseases, white discharge becomes abundant, the smell does not have, blood impurities appear in them.

Polyps in the uterus. Education can contribute to the growth of endometrial, scraping and damage to the uterus in a younger age. In the presence of polyps, a woman in the period of menopause notices white discharge without smelling with streaks of blood.

Video: How polyps endometrial is formed

Oncological diseases

Cervical cancer. In the early stages of the manifestation of the disease. When climax, bloody isolations are characteristic and most often the only symptom for which it can be detected. Other symptoms (pain at the bottom of the abdomen and the sacrum) appear later.

Uterine cancer (endometrial). Options first white watery, then blood appears in them. Bleeding is enhanced, they have purulent bunches.

Video: Factors provoking the occurrence of cervical cancer

Infectious and inflammatory diseases of the genitals

Vulvovaginitis. Inflammatory process in the vagina. During the climax period, the mucous membrane of the vagina becomes more subtle. Due to lack of lubrication on the surface there are cracks that are easily inflated. Dysbacteriosis of the vagina develops, in which the useful microflora dies. At the same time, sticky mucous membranes appear with an admixture of pus, with the smell of fish. The color of frothy seals is gray, pus gives them yellow-green shade. A woman is experiencing burning, itching and all the other symptoms of irritation of the vaginal surface.

Cervicitis - inflammation of the mucous membranes of the cervix. Immunity in older women weakens significantly, the infection quickly spreads from the vagina to the cervix. If the disease is launched, the endometrium (endometritis) and appendages of the uterus will occur. The characteristic feature of Cervicitis is intense yellow purulent discharges in which there are blood clots. Other symptoms, besides the selection, when menopause may not be.

Thrush (candidiasis). It arises due to the weakening of immunity and the violation of the composition of the vaginal microflora. Development of fungus Candida can contribute to hypothermia, taking drugs and other factors. Isolation resemble a curly mass, have a characteristic sour smell.

Sexually transmitted infections

As in the youth, the woman of menopausal age can be infected with trichomoniasis, gonorrhea, chlamydia and other infections transmitted during intercourse. With reduced organism resistance, inflammatory processes quickly spread out of the exterior genital organs in the uterus and appendages, affect the urinary organs.

With such diseases, the following sections are possible:

1. Trichomoniasis - watery, foaming, white with a yellowish-green tint. There is a sharp unpleasant smell.
2. Gonorrhea - purulent gray-green dense allocations. There are permanent urge to urination, itching and burning in the vagina.
3. Chlamydia. Selection can be transparent or white mucous membranes. The damage to the urinary tract leads to the fact that the urine becomes muddy, there are fristed during urination.

Diagnosis and prevention of genital diseases during climax

Since many diseases have similar symptoms, they understand the reason for pathological discharge, the more getting rid of them, the woman will not be able to. Important measure of prevention of transition of diseases in chronic form Is visiting a doctor and passing a survey 2 times a year.

Uzi will show the presence of any pathological neoplasms. You can inspect the neck and the uterine cavity using a colposcope - an optical device that illuminates and increasing the image of the surface under study. According to blood tests, the nature of inflammation and infectious damage is determined, the availability of oncology is found.

Diseases of genital organs

A significant percentage of bleeding in the menopacteric period depends on the diseases of the genital organs of a woman. Here in the first place should be put in tumors, benign and malignant, as well as inflammatory processes.

From the neoplasms most often found fibromyomes of the uterus. According to A. I. Petchenko and V. V. Slonitsky, who studied the features of the flow of royaltic bleeding between the ages of 46 to 57 years old, in women suffering from the fibromomists of the uterus, women with the Miser of the uterus menstruct longer - menopause comes from them 5-10 years later than in healthy women. Histological studies of the scrapings of the uterus preferably showed atrophy of the mucosa with stagnation in endometrials and only in some cases a cystic hyperplasia of endometrial and polyposis was observed. According to. authors, climacteric uterine bleeding in the presence of fibromomy of the uterus are largely associated with the disorder of the function of the central nervous system and with the phenomena of the general angioederaosis. The reduced contractile ability of the uterus, stretched with nodes, and also often an increased surface of hypertrophically or atrophically altered mucosa determine the bleeding during the uterine fibromome. A. A. Lebedev and employees also believe that the pathogenesis of the uterine bleeding in the fibromyoma of the uterus is similar to the pathogenesis of functional uterine bleeding. In both cases, reduced reactivity play a significant role. vascular tone and failure of the liver function.

According to the observations of A. A. Lebedev and employees, all patients suffering from fibromic, according to the histological picture, in comparison with the excretion of sex hormones, it is possible to divide into three groups: a) patients with asymptomatic fibromy of the uterus with a normal menstrual cycle; In the histological picture of endometrials and ovaries, pathological changes are absent; b) patients too with normal menstrual cyclebut with the prevalence of the follicular phase (hyperpolymenorrhea); In the histological picture of the endometrial, the majority (in 94%) detects iron hyperplasia, sometimes atrophy, in the ovaries is observed (in 72%) cystic expansion of follicles and yellow bodies; c) patients with "annevulatory" cycle (hemorrhagic metropathy); Histologically, iron hyperplasia (57%), endometrial atrophy (10%), in the ovaries - cystic expansion of follicles, hemorrhage foci, blood sclerosis; yellow spots No missing.

According to our data, menopacteric bleeding is particularly often combined with the so-called uterine fibromatosis - an increased, dense consistency with the uterus, which is due to the development of scar connective tissue and sclerotic changes in the muscles of the uterus.

The cause of the uterine bleeding of transitional women is often the tumors of ovarian - benign, hormonallyactive. The latter, having a hormonal effect on the mucous membrane of the uterus, cause bleeding. Such tumors include granolascellular blastomas and tekablastoma; Having producing estrogen hormone, they cause endometrial excessive hyperplasia, uterine bleeding and necrosis.

Finberg (R. Fiettberg) described 6 women aged 60-75 years, in which sudden bleeding occurred during menopause. With histological examination of the ovaries of these patients in 6 cases, granolasive-leakyllular tumors were found, in one - a tekamatous tumor. In all cases there was a hyperplasia of the mucous membrane with mitosami.

Climacteric bleeding is often combined with inflammatory diseases of the genitals, mainly with inflammatory tumors of appendages and with different incorrect positions (displacements) of the uterus. In the latter case, fixed retrodiations, as well as omitting and falling out of the uterus have a particularly important impact. With incorrect positions of the bleeding of bleeding, it may be caused by both venous stagnation (in the presence of a pelvic pillar) due to the inflection of the uterine bundles with the vessels passing in them and (which happens especially often) the insufficiency of the muscles of the uterus. When the ulcers of the source, bleeding can be the sizes of the type, which develop on the surface of the vaginal part of the uterus.

During the period of menopause, sclerotic changes are made in the occurrence of uterine bleeding, for which the excessive development of the connective tissue is characterized, almost complete disappearance of muscle tissue and pronounced changes in the vessels (atheromatosis and endarterate phenomena). According to Yashka, Pankov (R. Jaschke, O. Pankow), S. S. Kholmogorova and others. Reducing the muscular layer and sclerosis of the vessels, summing up, can be the cause of profuse uterine bleeding.

The neoplasms are malignant (cancer and sarcoma) are one of the frequent causes of uterine bleeding in the transitional years of a woman. Statistical data of world literature, characterizing the frequency and causes of bleeding in menopauca and menopause in women collected by Hek and Garbut (Garbut) are presented in Table. 9 (in percent).

Table 9. Causes of bleeding

The "Other" group includes endometriosis, traumatic and other damage.

From table. 9 It can be seen that in both periods of transitional years, women in the first place are the cancerous diseases of the genital organs; Reliable hyperplasia causes more than a quarter of all bleeding; Polyps and erosion are approximately 1/5 of all bleeding. Moma and ovarian tumors also play a significant role in the occurrence of bleeding of a climacteric period. The same should be said about inflammatory diseases.

The above data on menopacteric bleeding shows how different the etiologies and pathogenesis of uterine bleeding during the period of climacterium and menopause. The presence of a large number of reasons resulting in the uterine bleeding of this period dictate the need for a thorough and comprehensive examination of women suffering from this pathology. In addition to two-handed research, inspection with mirrors, cytological studies of stalls from the vagina and from the uterine cavity (aspiration), diagnostic scraping or biopsy, with subsequent histological examination of Soskob and in addition to hormonal research, the study of blood, liver, cardiovascular and other systems is shown. . Differential diagnosis The uterine bleeding of a transition period of a woman is of great importance for choosing proper individualized treatment.

The basic principles of the doctor's tactics in menopausal bleeding will be the following:

1. In the presence of bleeding, first of all, it is necessary to eliminate the malignant neoplasm, based on the data of the histological examination of the ospill of the mucous membrane. The scraping of the uterus in menopausal bleeding is not only a diagnostic, but also a therapeutic event that has a hemostatic effect. It is explained by the fact that after removing the hyperplazed bleeding obscured mucous membrane, the uterus begins to be vigorously reduced. If after scraping bleeding soon (after 2-3 months) resumes, it is, with the appropriate clinical picture and in the presence of certain studies, indicates its functional nature. If during the climetterium or menopause ceased after scraping bleeding after 1-2 years or later again appears again, the scraping should be repeated, since in such cases the reason for the bleeding can be starting the neoplasm.

Diagnose the uterine body cancer along the cytological picture of the smear is much more difficult than cervical cancer. This is explained by the fact that cell polymorphism and their nuclei, which is one of the main criteria in cytodiagnostics, is expressed in the body cancer of the uterus, significantly less [Papanicolau (G. Papanicolau), V. A. Mandelstam, etc.].

2. In the complex pathogenesis of menopacteric bleeding, it is necessary to take into account age violations of the highest departments of the central nervous system, mainly hypothalamus and pituitary glands, as well as violations of the function of endocrine glands and other systems of the female organism and incorrectly see the main cause of bleeding only in the functional disorders of the ovaries and the mucous membrane .

3. The rational therapy of climacteric bleeding should be a set of measures aimed at regulating the menstrual cycle.

Sometimes women turn to the gynecologist due to bleeding from the uterus. Such a deviation may occur at any age, both during pregnancy, and without it. The reasons for this pathology may be somewhat, and talk about them.

Turn

Types and causes of appearance

Blood selection are several species. It:

1. Negative or extragnenital.
2. Genital, which are associated with pregnancy.
3. Genital, which are not related to pregnancy.
4. Dysfunctional uterine bleeding (DMK).

Also should know the following division of bleeding:

1. Juvenile character. It occurs during puberty of girls. It can contribute to strong mental overload, frequent incidence, poor nutrition and so on.
2. Profuses. Not accompanied by pain. Consequence of abortion or vaginal infection, side effect contraceptives and others.
3. Acyclic. It occurs between the monthly. It happens such bleeding in erosion, endometriosis, moma or cyst.
4. Hypotonic. The cause of its appearance is the low tone of myometrium (after the delivery or abortion).
5. Anguulatory. Developed in adolescence and in women in the menopacteric period. If you do nothing, you can develop malignant neoplasm.

Ugrant bleeding

Arise due to infection by some diseases.

Cause bleeding can diseases in the form:

• measles;
• typha;
• Influenza;
• sepsis;
• liver cirrhosis;
• hemophilia;
• hemorrhagic vasculitis;
• atherosclerosis.

Sometimes the reason lies in an increased blood pressure or improper work of the thyroid.

Genital bleeding (during pregnancy)

If women have bleeding are associated with genital organs, then they are genital.

At the beginning of pregnancy, blood loss is due to:

• ectopic pregnancy;
• diseases of the fruit egg (bubble drift or presence of malignant neoplasm).

If the root of the cervix during pregnancy at a later date, then this may be a sign:

• placental preview;
• availability on the scarmers;
• early pairing placenta.

During the root separation of bleeding related to:

• low location of the placenta, its presence or premature detachment;
• tear of the uterus;
• violation of the integrity of the generic paths.

After the delivery, it happens because of:

• endometritis;
• moma;
• trauma during the generic process;
• chorionepithelomes;
• reduced uterine tone.

Genital (without pregnancy)

If the lady is not pregnant, bleeding can also be placed between menstruation. The reason lies in:

• the presence of tumors in the uterus, ovaries or phallopy tubes;
• ovarian breakdown or cystic education On him;
• injury organ after sexual contact or others;
• inflammation or infectious damage to the organ (under cervicitis, endometritis, vaginites, erosions, etc.).

Blood lodges happens with various dysfunctional disorders. About this in more detail.

Dysfunctional uterine bleeding

If a woman has blood loss in the form of menstruation in the laid time, while it is lost about 50-60 ml of blood - this is the norm. If there is a long bleeding after menstruation and more than 70 ml are more - this is a sign of dysfunction, that is, DMK.

If bleeding is long and strong - this is called menorgia. If it occurs between monthly - metrragia.

Often, such dysfunction is available at the ladies after 30 years. Hormonal bursts, incorrect operation of the thyroid and adrenal glands leads to a violation of ovulation.

Also may arise due to:

• nervous overvoltage, stressful situations;
• overwork, both physical and mental;
• harmful production;
• complex genera and abortion;
• inflammatory processes occurring in the organs of a small pelvis.

In the age category from 13 to 20 years, this kind of deviation is also possible. This is the result of mental injuries, heavy physical labor, lack of vitamins in the body, the presence of various pathologies, both chronic and acute character.

Bleeding from the uterus in old age is connected with:

• nervous overvoltage;
• chronic diseases;
• hormonal perestroika.

Other reasons

Sometimes the root of the cervix during inspection, if the gynecologist was neakupaten and injured the organ. The same confusion may occur with rough genital contacts.

If a woman has any vices of genitals from birth, they also have blood loss, often with clots. In this case, you will have to be fully examined and resort to radical methods of treatment.

Bleeding in old age?

In the elderly women, bloody sections from sex paths can be associated with:

• diseases of reproductive organs (diseases of ovarian, uterus, vagina);
• improper metabolism;
• impairment of the liver and endocrine system;
• blood supply problems;
• receiving certain drugs;
• hormonal failure;
• by changing the endometrial layer of the uterus.

Also, the presence of tumors, inflammation and infections is also not necessary.

Symptoms and signs

The main sign of the uterine bleeding is the bloody selection of genital tract. When bleeding, but not menstruation, there are additional symptoms:

• the volume of liquid is more than 80 ml (it is possible to understand this if the gaskets are changing more often than 1 time in two hours);
• the duration of blood loss is over 6 days and more often than once a month;
• if the interval between monthly less than 21 or more than 35 days;
• blood cervical after sex;
• blood on the underwear is present in postmenopausal period.

If a woman will regularly lose a large amount of blood, then she will have anemia. There will be dizziness, weakness and skin will become pale. If the erosion of the cervix is \u200b\u200bbleeding, it is impossible to slow, as there are serious consequences in the future.

First aid for uterine bleeding

When bleeding, the lady should be able to provide itself first aid. It is impossible to allow mass bloodstream, as this can lead to loss of consciousness, anemia and other consequences.

It is impossible to put anything hot on the stomach, take the baths, soar legs, use the products containing vitamin.

To improve well-being needed:

• to accept horizontal position and put legs on the hill;
• to the area of \u200b\u200bthe belly put ice or a bottle of cold water;
• constantly drink fluid.

When should you consult a doctor?

If bleeding does not stop for a week, there are clots and soreness. A woman needs to contact a specialist who examines it and prescribe appropriate treatment. Self-medication in this case is inappropriate, since the patient does not know the causes of pathology.

How to get rid of uterine bleeding?

What to do when bleeding? In such cases, it is impossible to slow, you need to seek medical help. It is important to identify the cause of pathology in a timely manner and begin its treatment.

If such dysfunction arose in adolescence, then the doctor will write down medication toolsProper to reduce the uterus, also blood-and-standing drugs and those that strengthen the vessels. An important consumption of vitamins, a cooking course of phytotherapy. In some cases, shown hormonal treatment. It will give the opportunity to establish a menstrual cycle.

The ladies who are in reproductive age are assigned to the reception of hormonal funds. If the reason in the fibromy, the presence of cysts or other formations is possible radical treatment. If the bleed erosion of the cervix, then remove the bleeding will help the cavity.

How to stop bleeding in old age? Here, almost always the reason lies in oncology, so you can get rid of pathology only with the help of surgical intervention. Delete will have the entire affected organ.

In order not to start the disease and cure it with a conservative way. You should seek the specialist in a timely manner and not engage in self-medication. The bloodstand means will not get rid of the underlying disease, and only for a while they will eliminate symptoms.

Prevention

For the prevention of this pathology follows:

• fully feed and eat more vitamins;
• less nervous;
• have one partner;
• timely treat all diseases associated with germ;
• do not make rapid abortion;
• to visit the gynecologist regularly;
• if any deviations occur, immediately contact the hospital.

Output

Why does the root of the cervix and whether to bleed the body without pathologies? Such questions ask themselves women who have long bleeding from sex tract. Replies may be mass. But it is important to know that the presence of blood on the underwear between menstruation is not the norm. Blood selection, the remaining more than a week should also be alated. To prevent serious complications, you should contact the gynecologist in a timely manner.