uterine bleedingNot related to the menstrual cycle, often mistaken for a normal menstrual period, making it difficult to diagnose hormonal failure, endometriosis and other disorders. In new mothers postpartum month easily confused with postpartum or implant secretions.
To distinguish from the monthly bleeding, you need to pay attention to the nature, quantity and associated symptoms secretions and consult a physician-gynecologist at the first suspicion of pathology.
How to recognize monthly
The normal length of the menstrual cycle is 21-35 days. It is divided into several stages:
- follicular phase (egg maturation);
- ovulation;
- luteal phase (the corpus luteum formation, which maintains a high concentration of sex hormones);
- menstruation.
In the absence of pathologies of endocrine glands unfertilized egg is output together with the endometrium for 3-7 days, after which a new cycle begins.
To discern with any secretions faced woman (abnormal bleeding or heavy menstruation), can be based on several criteria:
- the intensity of blood loss;
- duration of bleeding with the rise and decay of intensity;
- character and color selections;
- associated symptoms.
Per day of menstruation appears about 40-50 ml of blood. Normally, the more plentiful monthly allocation (to 90 mL) could be observed only in the most active day: the majority of patients, this is the second day after the start of menstrual bleeding.
Recognize monthly possible and character selections. One day prior to or on the first day of menstruation is not underwear or sanitary napkin observed spotting brown. On the second day of bleeding increases sharply, but does not exceed the maximum safety standards (80-90 ml per day), and then gradually on the wane. On the last day marked not intensive smearing dark discharge.
In a small amount of menstrual blood clots there is a lot of, the occurrence of which is due to detachment of the uterine lining.
Associated symptoms are monthly aching or cramping in the lower abdomen, lower back pain, bloating, swelling, fatigue, and others. Before the onset of menstruation can be observed premenstrual syndrome, caused by violation of the ratio of estrogen and progesterone. It can manifest severe weakness, swelling, blood pressure fluctuations, headaches, mood and sleep disorders, depressive state, and others.
The loss of iron along with regular normal secretions may not provoke a significant decrease in the concentration hemoglobin, so the symptoms of anemia can be observed only in pathological processes in the uterus, but not monthly.
signs of bleeding
In addition to the monthly selections, which are observed at all healthy women, there are other physiological and pathological bleeding from the genitals. They are divided into two main groups: physiological and pathological.
Distinguish uterine bleeding postpartum or reproductive system dysfunction of menstruation is not always possible without laboratory and instrumental diagnostics. Despite the presence of characteristic signs, clinical pathology can be lubricated and inaccurate.
Many patients, to understand, to understand that menstruation is treated less long or abundant, but by this time already feeling the symptoms of bleeding or other complications.
After childbirth
After giving birth, women are required to restore the body and hormonal changes, aimed at restoring the normal menstrual cycle. The duration of the recovery period of at least 6-8 weeks. During this period, distinguished by monthly bleeding after childbirth simply because even early recovery cycle is not observed before 6-7 weeks.
Breastfeeding and applying of the baby to the breast of the mother's body in the request produces the hormone prolactin, which blocks ovulation and the onset of menstruation. However, when a mixed or artificial feeding prolactin level decreases rapidly and the cycle is reversed.
Stabilization of the duration and heavy menstruation occurs within 2-3 cycles. Irregular, too long and the amount of bleeding can indicate a myoma, endometriosis, cancer, tumors, inflammation of the pelvic organs and other diseases.
Spotting during the postpartum period (lochia) should be distinguished with menstrual. The mechanism of occurrence of lochia is based on the formation of the wound at the site of attachment of the placenta. Due to the large area of bleeding surface in the first week of selection have a bright red color. They can be observed mucous inclusions, blood clots, small pieces of placenta and other seals. Also lochia different characteristic odor, which is very different from the smell of menstrual blood.
In the first 2-3 days lochia allocated abundantly: their volume is several times greater than the maximum blood loss during menstruation.
As the wound heals lochia color becomes darker, and consistency - more viscous, without clots. If the intensity and consistency of discharge does not change, you should consult a gynecologist and to find out if they are not the first symptom of a dangerous disease.
pathological postpartum hemorrhage characterized by the following features:
- the presence of large blood clots and dark;
- bright red shade selections beyond the first days after birth;
- massive blood loss (the need to change the maximum absorbency of hygienic means every 1-2 hours);
- sharp or severe aching pain in the abdomen;
- fever;
- severe weakness.
implantation bleeding
implantation bleeding may occur if the attachment of a fertilized female sex cells to the uterine wall. Trophoblast, which develops around the egg, often damages the uterine vessels and stimulates physiologic bleeding from the genitals.
Implantation occurs after 1.5-2 weeks after conception, so the occurrence of bleeding period often does not differ from the expected date of menstruation. Distinguish from monthly bleeding during pregnancy can be on other grounds: the highlight color, the intensity of bleeding and associated symptoms.
Uterine vascular damage during implantation slightly, so that the intensity and duration of bleeding is small. Spin extend from 1-2 hours to 2 days. They are pinkish (when mixing the blood with the mucus of the cervical canal) or brown (for blood coagulation).
Attaching the sexual cells can be accompanied by mild pain caused by uterine mucosa adaptation to the new conditions. However, intense cramping and aching pain not typical for him.
The main distinction of pathological and menstruation blood loss from the uterine bleeding during implantation is the appearance of other pregnancy symptoms: breast swelling, nausea, sensitivity to smells, frequent urination, decrease in performance and etc.
Dysfunction
Dysfunctional uterine bleeding (DCM) - is spotting that appear due to decreased function of the gonads (ovaries). DCM is classified on the juvenile, reproductive and climacteric.
Juvenile dysfunctional bleeding develops in 12-18 years of age due to the inferiority due hypothalamic-pituitary, ovary and uterus. Risk factors for juvenile DCM are childhood diseases (measles, chicken pox, mumps, etc.), Chronic infections, vitamin deficiencies, stress, disease during pregnancy, the girls mother and others.
Bleeding in the reproductive age (18-45 years) can be triggered by sexually transmitted diseases, abortion, fatigue, hazardous working conditions, intoxication, taking medicines that affect the hypothalamic-pituitary system, change climate, etc..
When menopause interferes with the normal development of pituitary hormones (gonadotropins) which control the synthesis of estrogen and progesterone. Progesterone deficiency leads to the growth of the endometrium, responsive to the cyclic hormonal fluctuations and increase the proportion of estrogens which trigger prolonged bleeding.
During premenopause it can be difficult to distinguish dysfunctional uterine bleeding, or monthly, as menstruation become irregular and often occur in the form of metrorrhagia (heavy fallopian bleeding).
DMK accompanied by sustained release of blood from the vagina, prolonged menstruation, drowsiness and symptoms of anemia (weakness, pallor of the skin and mucous membranes, hypotension, headache).
The causes of abnormal bleeding can be a uterine injury, the presence of an intrauterine device, endometriosis, obesity, malignant and benign neoplasms, spontaneous abortion, ectopic pregnancy and others.
Understand the causes of emissions and to understand that it is bleeding, you can use the pelvic exam and hardware studies of the reproductive system.
How to distinguish
Distinguish between bleeding from menstruation can on the following grounds:
- Bright red and liquid spotting. Menstrual blood has a dark color and contains clots endometrium. Copious red blood evidence of massive blood loss, which is not typical for the month.
- The need to frequently change hygiene. Changing pads, menstrual cups or tampons with high absorbency often times 1.5-2 hours is dangerous sign. When combined with the symptoms of acute anemia, immediately consult a doctor.
- Increasing the bleeding intensity and duration of selections more than 7 days. Menses different regularity, small duration and intensity of the recession characteristic discharge for 3-4 day cycle. If the intensity increases blood loss and duration of their symptoms was more than a week, this is evidence of pathology.
- Growing pain. Sharp pain and severe cramps may be a symptom of a pipe rupture at an ectopic pregnancy or early miscarriage. These pathologies are accompanied by heavy bleeding and fainting. Prolonged aching abdominal pain are also symptoms of diseases of the reproductive system.
- Anemia. The occurrence of anemia is one of the main differences from monthly bleeding. Massive blood loss causes a decrease in hemoglobin concentration or a decrease in the total blood volume. This leads to cerebral hypoxia, which is manifested by weakness, sweating, tachycardia, sudden pressure reduction, skin pallor, dizziness and nausea. For small develop chronic blood loss anemia, which are signs of chronic fatigue, decreased performance, nail fragility, dryness of hair and others.
Distinguish heavy monthly bleeding by helping the various diagnostic methods. These include:
- complete blood count and coagulation;
- diagnostic uterine curettage with histological analysis of tissues obtained;
- a blood test for ovarian hormones (estrogen, progesterone), thyroid, pituitary and adrenal glands;
- Pelvic ultrasound;
- CT and MRI of the reproductive system and brain;
- endoscopic study of the uterus.
Pinpoint monthly bleeding or the patient can only gynecologist. The primary diagnosis is made after anamnesis and inspection on the gynecological chair.
