Menstruation occurs in women as a result of physiological processes occurring in the reproductive organs. Normally, they are repeated at approximately equal intervals of time, last several days and almost do not bother. But in some situations (after childbirth, during menopause) with the appearance of blood secretions, there are doubts about their origin. Uterine blood loss has very dangerous consequences. You need to know how to distinguish it from menstruation, to prevent complications, to find out the cause of the pathology.
What blood secretions are normal
Uterine bleeding is divided into functional (normal) and pathological. Normal physiological secretions of blood in women include:
- Monthly. Their duration is 3-5 days, the volume of 50-80 ml. They occur regularly with a deviation of 2-3 days. The interval between them is 21-35 days. The color of the discharge is from red (at the beginning) to burgundy or dark brown (on the last day), the consistency is mucous with clots of coagulated blood.
- Minor bleeding in the middle of the cycle. They occur at the time of the rupture of the follicle.
- Implantation bleeding. Appear if conception occurs. They are caused by slight damage to the endometrium at the time of the attachment of the embryo to the wall of the uterus. A scanty discharge of this kind appears on day 7 after fertilization. If they increase, it speaks of the detachment of the ovum and the threat of miscarriage. If a woman is looking forward to the occurrence of pregnancy, then such secretions should be alerted and made urgent to go to the doctor.
- Obstetric – blood discharge during childbirth.
It is important to know how to distinguish menstrual from pathological bleeding in order to take action in time and begin treatment.
Addition: Any deviations from the norm, as well as increased morbidity of menstruation are pathologies. In rare cases, the deviations are due to the characteristics of the body and heredity. The most common cause is serious illness.
This uterine bleeding resulting from hormonal imbalance associated with disruption of the functioning of the ovaries, pituitary and adrenal glands. Depending on the nature of the manifestation, they are divided into the following types:
- Menorrhagia. So called regular long and abundant periods with a small gap between them. Blood excretion continues for more than a week. During this time, blood loss is 100-150 ml and more, which leads to anemia.
- Metrorrhagia. This is an irregular discharge of blood between menstruation. They have nothing to do with the processes of the menstrual cycle. Their duration and volume are variable.
- Manometrorragia. Irregular long periods.
- Polymenorrhea. Frequent periods with an interval of less than 21 days.
There are functional, organic and iatrogenic causes.
Functional. These include diseases of the ovaries, pituitary, thyroid, adrenal glands, which lead to disruption of hormone production. These include inflammatory diseases of the genital organs, ovarian dysfunction, hypothyroidism, and others.
Organic Associated with diseases in which not only hormone production is disturbed, but also the structure of organs (tumors, cysts, polyps, endometrial hyperplasia, endometriosis, myoma, cancer of the uterus, and liver cirrhosis, pyelonephritis, impaired blood formation).
Iatrogenic. The reasons are medical manipulations or medications (hormones, antidepressants, anticoagulants).
Types of dysfunctional bleeding
Such factors as emotional stress, physical overload, poor living conditions, and unhealthy diet contribute to the occurrence of dysfunctional bleeding. In addition, an important factor is the age and overall condition of the body, its functioning.
Video: Uterine bleeding. Types and causes
Occurs in girls during puberty, when the formation of hormonal levels. The development of reproductive organs in adolescents is influenced by living conditions, emotional and physical activities, and the nature of nutrition. The appearance of unusual uterine blood secretions contributes to malnutrition, vitamin deficiency, abnormalities in the thyroid gland, adrenal glands.
The transferred infectious diseases (measles, mumps, whooping cough, rubella), the presence of diseases of the liver and other organs also affect puberty and reproductive health. Juvenile hemorrhages are anovulatory, they can be distinguished by the fact that they occur mainly in winter and spring.
Dysfunctional bleeding of the reproductive period
They occur in women of reproductive age with endocrine disorders, heart and vascular diseases, in the presence of inflammatory diseases of the genital organs, endometriosis or tumors of the uterus, as well as as a result of stress and physical fatigue. This group includes bleeding that occurs only in women who have sex.
Ovulatory. They appear during menstruation. When this happens, ovulation occurs. Characteristic is the fluctuation of the intervals between periods. They are plentiful and long lasting. The cause is usually inflammatory diseases of the uterus and appendages, the formation of adhesions. Often, in addition to abundant menstruation, a woman also has a smearing brown discharge in front of and after them. Such secretions are associated with impaired ovarian function, leading to an imbalance of estrogen and progesterone. They are characteristic of young women.
Anovulatory. Cycles without ovulation occur with insufficient progesterone levels and an excess of estrogens. This leads to the pathological growth of the endometrium (hyperplasia, endometriosis), the appearance of benign and cancerous tumors. Such bleeding is characteristic of menopause, and also occurs in adolescents. In this case, the monthly come with a delay. The intensity of blood loss may be too large, and the duration of menstruation exceeds 7 days. This is reflected in the well-being of women, as there is anemia.
Breakthrough bleeding. It occurs as a result of taking hormonal oral contraceptives. Usually spotting occurs in the first months after the start of taking the pills due to the adaptation of the organism to the changed hormonal background. They are scarce. Their volume may increase with a sharp cessation of the drug. When the patient complains of breakthrough bleeding, the doctor changes the dose or recommends another contraceptive.
Profuse bleeding. This is the most dangerous type of internal or external heavy bleeding. It can occur both during menstruation, and between them. It leads to anemia, hemorrhagic shock (acute blood loss). Occurs with injuries of the genital organs (for example, when scraping, removing fibroids). Often, to eliminate such bleeding is possible only with the help of surgery.
Video: How dysfunctional bleeding occurs
Features of bleeding during pregnancy
Normally, with the onset of pregnancy, a woman’s period should not be until the very birth. The only exception is scant implant bleeding.
In rare cases, on normal menstruation days, pregnant women in the first few months may have a brown spotting that must be distinguished from menstruation. Their cause is a reduced level of progesterone. Gradually, the state is normalized.
Blood excretions during pregnancy may appear as a result of various pathologies.
Miscarriage. Accompanied by heavy bleeding and spasmodic pains in the lower abdomen. Miscarriage is considered spontaneous abortion up to 22 weeks inclusive.
Ectopic pregnancy. There are copious dark discharge with clots. The woman has sharp pains on one side of the abdomen, nausea and vomiting. In case of rupture of the fallopian tubes urgent operation is necessary.
Contact damage to small vessels. May occur during cervical pseudo-erosion, sexual contact, gynecological examination, due to vaginal ultrasound.
Placenta previa. Bleeding occurs in 2 or 3 trimester due to too low location of the fetus and placenta, with the result that the growing fetus is not held in the uterine cavity. Exfoliation may occur, which is accompanied by abundant blood loss. There is a threat of death of the child.
Uterine rupture. Occurs in 2 or 3 trimester of pregnancy due to abdominal trauma, increased uterine tone or fetal activity.
A warning: In any case, when bleeding occurs, a pregnant woman should immediately consult a doctor in order to eliminate dangerous blood loss and, possibly, to preserve the pregnancy.
Video: How to find out that a miscarriage occurred early in pregnancy
Bleeding after childbirth
Approximately within 8 weeks after delivery, the uterus is restored in size, cleared of blood and placenta residues. At this moment a woman has so-called lochia, red discharge. After 4-10 days they brighten, become less abundant, slimy. Total blood loss in the first days is approximately 500 ml, with caesarean section – about 1000 ml. The time of occurrence of the usual monthly depends on how long a woman breastfeeds a baby.
After 40 years, women experience a gradual decrease in the level of sex hormones. Hormonal disorders increase the risk of the formation of tumors and other pathologies in the uterus. It is important for women to know exactly how to distinguish menstruation from bleeding during this period.
Any discharge of blood that occurs after the month is absent for 1 year, can not be menstruation, since the functioning of the ovaries has ceased. Spotting now act only as a sign of the disease. The sooner a woman goes to the doctor, the greater the chance of avoiding serious complications.
Video: Features of blood excretion during menopause
How to distinguish menstrual from pathological blood loss
There are signs that indicate how to distinguish menstruation from bleeding of a pathological nature:
- bleeding is indicated by discharge of blood that does not stop for more than a week;
- intensity of discharge is such that the gasket has to be changed every 1-2 hours;
- the blood contains many clots;
- symptoms of anemia appear (nausea, weakness, headache, heart palpitations);
- there are pains in the lower abdomen, having a permanent or cramping character;
- discharge of blood appears after intercourse;
- increased bleeding appears after a long delay or much earlier than usual, possibly between menstruation;
- spotting begins a few days before menstruation and continues for another 3-4 days after the cessation of menstrual bleeding;
- bleeding may cause an odor in the discharge.
The nature of the discharge helps to distinguish bleeding from menstruation after childbirth. When, after the termination of lochia, several weeks have already passed and bright red copious excretions have reappeared (while the woman is breastfeeding), these are not menstrual periods.
How to act in case of heavy bleeding or suspicion of it
If there are signs of blood loss, the woman should consult a doctor without fail, and in case of severe bleeding, call an ambulance.
Before arrival of the doctor it is necessary to lie down, remove the pillow from under the head. Feet should be above the head. Ice should be put on the lower abdomen. You can drink a decoction of nettle or yarrow, which have a hemostatic effect.