Any vaginal bleeding not related to a menstrual cycle is considered a pathology. Signs of a uterine bleeding: a bleeding from the genital tract during a menstrual cycle or long periods or hypermenorrhea causing anemia. The medical aid includes as follows: bleeding control, iron replacement therapy, a check-up in order to determine the causes and to prescribe the relevant treatment.
Abnormal uterine bleeding (AUB) - diagnosis by exclusion. This diagnosis is made when all the other bleeding causes (injuries, tumors, inflammatory diseases included) are not confirmed after a complete examination of a patient. Usually this condition is associated with hormonal disorders, more specifically, with the reduction in progesterone level.
Dysfunctional uterine bleedings may happen in fertile age, menopause period, at puberty. Some sources affirm that the term “dysfunctional” implies the hormonal mechanism of the pathology.
Depending on whether ovulation occurs or not, DUB can be classified as ovulatory and anovulatory. Usually, DUB is a menstrual disorder, however, an abnormal bleeding can happen in the middle of the menstrual cycle.
The most common cause (of about 90% of cases) of dysfunctional bleedings is the anovulation. When there is no ovulation, a yellow body is not formed, so, no progesterone is produced. In the result of it, estrogen is produced continuously provoking the overgrowth of the uterine mucosa. There are 10% of DUBs in ovulatory bleedings.
How to distinguish abnormal uterine bleeding of women? The assessment of an anovulatory bleeding should always begin with the examination of the medical history and a check-up of a patient. Then, a laboratory tests for the levels of hemoglobin, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, thyroid stimulating hormone (TSH), androgenic profile should be run. A pregnancy test (β-HCG) is also compulsory. An ultrasound examination of small pelvic organs as well as endometrium scraping may be required.
Sometimes an anovulatory DUB is provoked by the developmental delay of the reproductive system of adolescents. However, the pathological mechanism is unknown.
Symptoms of the juvenile uterine bleeding:
- excessive blood-tinged discharge from the genital tract is observed after a delay of menstruation from 0.5 to 6 months;
- a uterine bleeding with clots is possible;
- weakness, dizziness;
- anemia;
- possible coagulation disorder, DIC syndrome type.
Such menstrual disorders usually appear within two years after a menarche (the first menstruation). It can be caused by psychological stress, obesity, anorexia, strenuous physical activity, endocrinopathy, neoformations, drug abuse.
Hemostatic drugs are not very effective in case of uterine bleedings, and they are usually prescribed together with other medications. The treatment of a DUB depends on the cause that has provoked the pathology, so, you have to visit a gynecologist in case of any irregularity. A doctor will prescribe the relevant therapy after examination and diagnosing. If the bleeding is caused by an infectious process, you need an antibacterial therapy. A bleeding during pregnancy requires an urgent examination.
Use of pills for the treatment of uterine bleedings of the anovulatory type is possible only after a determination of the hormonal state. Oral contraceptives are usually taken in small doses. Progesterone medications in the form of injections in case of uterine bleedings are prescribed according to the special scheme. Intrauterine devices (IUDs) are also used, they release progestins.
Dysfunctional bleedings during the menopause period happen due to endocrine changes in a female body. Besides, vaginal walls are NOT lubricated, that also may provoke a bleeding during or after a sexual intercourse. A uterine bleeding control during menopause is performed taking into account the cause of a DUB. If the causes are polyps or other benign neoformations, they are removed surgically.
How to stop a uterine bleeding, if it cannot be stopped with medications and threatens the life of a patient? A gynecological curettage of the uterine cavity is performed, in emergency cases a hysterectomy is possible. The emergency assistance in case of a severe uterine bleeding is provided at hospitals only.
Article author: Olga Tymofeeva
Publication date: 10.12.2020
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