DMK - is dysfunctional uterine bleeding, occurring outside the menstrual cycle is not related to changes in the structure of the genital organs and is a complication of inflammatory processes. State is accompanied by copious blood loss, it causes dysfunction of the ovaries, may be the cause of iron deficiency anemia and negatively affect the quality of life.
Causes
Externally, the menstrual cycle is as follows: egg matures, the follicle releases its way down the fallopian tube to meet with the sperm. At the same time begins the maturation of the endometrium lining the uterus wall. If conception does not occur, the endometrium is rejected and the separation of blood begins.
For cyclical corresponds to the cerebral cortex, which transmits a signal to release gonadotropic hormones (follicle, LH and prolactin stimulating progesterone synthesis) in the hypothalamus, which in turn transmits the pulse in pituitary. Feedback through the thyroid gland - the more active work ovaries, the less stimulating hormone is released.
DMK can cause disturbances in the brain, thyroid and reproductive system. Factors adversely affecting the function of these organs:
- Infectious-inflammatory diseases of a general nature and pelvic organs, intoxication caused by external influences - for example, related to the professional necessity.
- Emotional and physical stress.
- Tumors in the brain and the endocrine system, regardless of etiology.
- Social conditions: poor nutrition, jet lag and climate.
- Hormonal changes - at puberty and the transition to pre-menopausal women. Climacteric DMC constitute 30% of the identified pathologies.
- Hereditary factors: the tendency to genetic diseases.
- Complications from abortion, gynecological curettage and pregnancy.
All these factors violate rejection and recovery process of the endometrium. Uterine capacity is increased in the walls of blood vessels are damaged, the bleeding starts.
Classification
The following types of bleeding between menstrual cycles appear:
- Without disturbing the periodicity. Polimenoreya - menstruation duration increases, and hypermenorrhoea - copious blood compartment during menstruation.
- Metrorrhagia - rejection of the endometrium occurs outside of the loop.
- Menometrorrhagias, also called a breakthrough. Associated with abnormal gynecological organs.
Classification by age: juvenile - in adolescents, to restore the menstrual cycle; reproductive - to reduce hormonal function; climacteric - the transition to menopause.
Another type of classification - etiology (whether by reason of appearance) occurring when insufficient or excessive production of LH (luteinizing hormone):
- shortening of the follicular phase - cycle time is 14-21 days;
- atresia or luteal insufficiency - heavy menstruation and bleeding prior to and after the loop;
- persistence of corpus luteum - a long cycle with a large blood loss.
In addition, allocate anovulatory and ovulatory status. In the first case, the follicle matures, but most do not ovulate. missed period can last up to six months, and the amount allocated to the blood increases several times. The cycle is called a single-phase. When the two-phase state ovulatory cycle - the follicle matures, and the pathology caused by dysfunction of the ovaries - a violation of the synthesis of sex hormones, estrogen and progesterone.
symptoms
Dysfunctional uterine bleeding symptoms are as follows; general:
- weakness, malaise;
- frequent dizziness;
- lowering blood pressure;
- appetite loss;
- thirst.
Specific symptoms suggestive of abnormal gynecological organs:
- pain in the lower abdomen and lower back;
- an increase in blood volume;
- irregular menstrual cycles;
- appearance clots and plasma volume compartment (liquid bright blood).
anovulatory cycles
Signs state for gynecological: uterus becomes denser, increases in size, the cervix softens. The woman noted an increase in pain and increase in blood separation, increased cycle time.
ovulatory cycles
The woman may complain of delay regular menses which flows already described symptoms and mezhtsiklicheskie selection. On examination revealed violations of the secretory function and connective tissue of the endometrium. Occur 10-12 days after the end of the next month; basal temperature rises.
Diagnostics
During the inspection it is necessary to put in the doctor notified of changes associated with the passage of menstrual period, the appearance of pain, tell us about associated diseases. Estimated diagnosis is established after inspection. To confirm prescribe blood tests - hemoglobin, and to determine the clotting (coagulation).
Methods of diagnostic procedures are selected based on the clinical picture. Most often spend colposcopy, ultrasound gynecological organs and the adrenal gland to exclude tumors and brain MRI for differentiating tumors. In order to identify infections examine a smear from the cervix and cervical canal, conduct laboratory tests of hormone levels of the reproductive system and thyroid gland. It may require diagnostic curettage or hysteroscopy.
Treatment
Therapeutic activities include to stop the bleeding, restoration menstrual cyclicity and eliminate recurrences.
Non-hormonal drugs can be used long courses. Tranexam used, Dicynonum, Etamsylate, aminocaproic acid, calcium gluconate. For pain relief is used antispasmodics, such as no-silos or spazgan, means the group of NSAIDs. But these drugs have only an auxiliary effect.
Treatment of dysfunctional uterine bleeding is performed using hormonal drugs. Application reduces blood loss, suppresses endometrial development, reduces the probability of formation of tumors or appearance of malignancies of the reproductive organs.
To restore the state used iron preparations, for example, Totem, vitamins, sedatives; may require tranquilizers.
gynecological curettage may be done to stop acute bleeding. Surgery is recommended for detection of endometrial polyps or cervical canal.
complications
The most common complication of MQM is iron deficiency anemia. There is a weakness, shortness of breath, tachycardia. Reduced working capacity, deteriorating quality of life. Hormonal imbalance leads to infertility. Thickened ovarian capsule, ovulation ceases. The most dangerous complication - haemorrhagic shock due to heavy blood loss and the development of multiple organ failure. If medical care is not provided, possibly fatal.
prevention
even from an early age is recommended to reduce the risk of MQM to pay attention to the reproductive organs, to dress for the weather girl, wash away properly. This will help prevent the development of inflammatory processes. Since adolescence is necessary to undergo regular gynecological check-ups, to control their weight, active lifestyle. Prevention of abortion and correction of endocrine changes prevents the occurrence of uterine dysfunction.
