Bleeding from the uterus in old age. Heavy uterine bleeding

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 angioedera. 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, a substantial role is played by the reduced reactivity of the vascular tone and the 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 endometrial and ovarian pathological changes missing; 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 are absent.

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, etc., Reducing the muscular layer and sclerosis of the vessels, summing up, can cause 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. Statistics of world literature, characterizing the frequency and causes of bleeding in menopause and menopause in women collected by Hek and Garbut (Garbut) are presented in Table 9 (as a percentage).

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 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-mentioned data on menopacteric bleeding is shown how different the etiologies and pathogenesis of uterine bleeding during the period of menopause 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 climax or menopause ceased after scraping bleeding after 1-2 years or later again appears, 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 gland, as well as violations of the function of endocrine glands and other systems female organism And it's incorrectly to see the main cause of bleeding only in functional disorders of the ovaries and the mucous membrane of the uterus.

3. Rational therapy Climacteric bleeding should be a set of measures aimed at regulating the menstrual cycle.

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 sign about availability malignant tumor. Sometimes bleeding is abundant or cargo sections. Especially often oncological disease manifests itself 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, disease thyroid gland, 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 Further treatment tactics 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 strong pain syndrome In the area of \u200b\u200bbelly and isolation of a bloody nature. 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. The uterine bleeding can arise both at a very young teenage girl and in an elderly woman who is over 25 years old in menopause.

However, the reasons that can cause this alarming symptom are absolutely different. As you know, for effective treatment pathological state It is primarily necessary to figure it out in its development mechanisms. 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. This means that effective treatment 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) - is responsible for the processes of ripening of the dominant follicle 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 big Hemispheres, 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 the 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 menstrual bleeding, which accompanies strong 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 tableted form of 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 iron preparations, such as "Licferr", "Wenimer", "Argeferr", "Feriegrak". 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, vitamins of the group B. The most effective scheme of alternation is most effective in the day of intramuscular injections of vitamins B6 ("Pyridoxine chloride") and B12 ("Cyancobalamina").
• 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. With 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 for the correction of 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.

Causes

• 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 of this pathology is the appearance of bleeding 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 suffices to be treated with hemostatic drugs ("tractions", "aminocaproic acid", "ethanzilat"), and then taking vitamins over the cycle: in the first phase (from 5 to 15 days), the folic acid is 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 is good in that it effectively stops bleeding, as well as the resulting histological preparation (scraping from the uterine cavity) is sent to the study to the cytomomorphologists. 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 that deforms the uterine cavity, urgent operational intervention. 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.

With a spontaneous abortion, it is necessary to remove the residues of the fetal egg, as it is impossible to stop the bleeding without it.

With ectopic pregnancy you need to remove fruit egg (in the pipe, on the surface of the ovary or in the abdominal cavity).

If a spiral has been detected in the uteria, which has changed its position, then it is subject to urgent removal. It is also necessary to make sure that the elements of the helix did not damage the walls of the uterus. For this purpose, a hysteroscope is introduced into the uterus cavity, which is equipped with a camera. After careful inspection of all walls, the operation can be completed. Then the hemostatic drugs are prescribed.

Treatment of anemia if necessary.

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.

With violations of blood coagulation, a hemostasiologist is needed, and it is also important to take into account the status of the fetus and the volume of blood loss. If it is necessary to carry out an emergency delivery, it is important to find drugs affecting the hemostasis system: coagulation factors ("NovosEven", "Coagil-VII"), freshly frozen plasma, erythrocyte, thrombocyte mass.

The most dangerous situation is the uterus break. This can occur in women who have undergone the pregnancy of the operation in the uterus (removal of myomatous nodes, correction of various anomalies, cesarean section). Bleeding from torn uterus is so great that the account is not for a minute, but for seconds. In this situation, an emergency operation is necessary. The volume of intervention is set during the operation.

Important! Bleeding during pregnancy - an extremely unfavorable symptom. Render qualified help 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 inefficiently enter freshly frozen plasmaSince 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 therapeutic activities on low part The abdomen 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.

findings

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.

Such a type of uterine bleeding is enough to simply determine, compared with the menstrual cycle, it has very abundant, constant discharge. However, they are very often confused. Bleeding from the uterus in the elderly age is very dangerous if it is not stopped in time and not to identify the cause, you can cause huge harm to the body.

The hemorrhage is outer, since it is visible not armed with an eye. However, specialists assigned to him a separate group. The uterus is an organ with an excellent blood system, violations can entail a huge number of consequences.

Treatment and recovery is extremely difficult. In such cases, it is not necessary to delete the appeal to the doctor, since abundant can lead to anemia and entail a number of serious consequences.

Causes

Almost every woman may encounter such a problem, regardless of age. Bleeding from the uterus in the girl can have an organic or functional character. In case of violation of the structure of endometrial, appendages, it is believed that bleeding is organic peculiarity, and if a violation is observed, then functional.

Woman bleeding can be divided into two groups:

• Organic.
• Functional.

The reasons for organic bloodstures include the following:

• Oncological diseases.
• Tarve the cervix or vagina.
• (Spiral).
• Pregnancy ectopic.
• Miscarriage.

Intrauterine spiral - one of the reasons for bleeding from the uterus

Functional bleeding include:

• Follicular ovarian cysts.
• Stressful situations.

Symptoms

Each woman has different, which are kinda bleeding, so bleeding from the uterus is not a clear phenomenon. Everyone has its own characteristics, for example, in one half of the female population of the selection have an average number and are not prolonged, the other half has sufficiently strong and continuous allocations. But the most important indicator is constant.

Violation of such a process can be considered bleeding. If they appear, from the vagina you can safely talk about the presence of violations, if such factors occur, it is necessary to immediately consult a doctor. The causes of bleeding from the uterus are of different character.

The signs of bleeding from the uterus include the following:

• Mozhoving bleeding from the vagina.
• Big blood loss during the menstrual cycle.
• Selection in the middle of the cycle.
• Active highlights of bright color, sometimes.

Each of the listed features has its origin, it is very important to correctly establish it and assign the necessary treatment that will help stop the bleeding and cope with its consequences.

Every woman should know how severe bleeding is manifested which symptoms and signs it has. This type of selection carries a serious threat to health and life, it is very important to recognize them on time and contact a specialist:

• Big blood loss in a short time.
• Dizziness and weakness.
• Pale skin.
• Drowsiness.

Any manifestation of such symptoms is an urgent reason to appeal to the medical institution. If you do not apply to the doctor in time, followed by a woman's death.

Than dangerous

The uterine hemorrhages are very dangerous, how much they have the ability to quickly increase, leak to a long time, and also sufficiently difficult to stop.

The following may occur:

• Blood loss leading to.
• Massive bleeding uterus, which is very difficult to stop, and specialists use the operational method in such situations, followed by the removal of the uterus.
• Minor blood loss that do not bring any threat to the patient's life, they are a consequence of the development of the disease caused by which they are.
• Intensive bleeding allocations in women in position or women after childbirth, such bleeding is heavy, in such a situation the uterus is poorly reduced and not able to stop him independently. Such a situation obliges specialists to resort to surgical intervention.

Today for emergency stop The uterine bleeding is actively practiced.

Bleeding during pregnancy or after childbirth

As a rule, such blood discharge in pregnant women most often arise in late terms, the reason for which is:

• Do not properly dispose of.
• The formation of scars on the uterus.
• There was a previously separated by the placenta.
• Various pathology of the uterus.

Postpartum blood loss can be due to the following factors:

• The uterus is poorly reduced.
• Getting injuries of tributes.
• Pathological changes endometrial.
• Oncological tumors.
• Various kinds of nodes.

The uterine bleeding of this nature is dangerous for a woman, and during pregnancy also for a child. There are situations in which there is an emergency to carry out childbirth with the use of Cesarean. In a similar condition, they begin suddenly and acquire a strong course.

There are the following reasons for bloodstures during pregnancy:

• Pathology of cervix.
• Disposal of the placenta.
• Incorrect placenta location.

Bleeding occurs in cases of turning the cervix, the nature of the selection is not abundant, it may occur in the presence of a bacterial,.

The disclosure of the placenta implies its low finding. This state is subject to women who have undergone Caesarean, having bad habits, or women in labor for 35 years.

The hemorrhage that occurred during the detachment of the placenta is of a serious danger to the fetus, as well as for the mother. This situation implies emergency delivery.

• To lay a woman.
• Ensure constant control of the above and pulse.
• With the help of cold heating or ice to provide constant cooling of the abdomen.
• It is necessary to deliver the patient to the hospital.

Help in hospital

In the medical institution of a special gynecological department, the patient must have the following set of events:

• Provide therapy for the restoration of blood supply, special preparations.
• or plasma, to restore the blood volume lost during bleeding.
• The use of medicines contributing to the rapid stop of blood loss.
• If the blood loss in the patient has a functional nature, it requires a high dose of hormones, such as estrogenic, but with organic bleeding, this method will not bring the result.
• Operational intervention at which the scraping of contents from the uterus is carried out. This method is very effective with strongest bleeding. The material of the damaged endometrial layer is also carried out, the study of which will help to establish the true cause of bleeding from the uterus. When scrolling and removing the damaged layer of endometrial, the uterus begins to quickly shrink, which stops bleeding.
• If the listed activities do not make effectiveness, then in such cases, clipping of the uterine artery is used, which contributes to stopping bleeding.
• Surgical intervention with subsequent removal of the uterus is used in emergency casesWhen all the above treatments do not give results. This option can be considered in any bleeding.

The uterine bleeding among girls may cause the development of any disease that must be diagnosed and immediately begin treatment. Doctors conduct a comprehensive examination to establish the nature of blood loss. There are cases when the strongest bleeding end the removal of the uterus, which is the lack of pregnancy.

At the age of menopause, the main pathology that should attract special attentionis cancer cancer. 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 spend local treatmentIt is also necessary to carefully observe, 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. A characteristic feature of the disease is bleeding from the vagina, observed in 50.0-83.7% of patients with vaginal cancer. Bleeding can be postcoital or spontaneous. However, many of these patients with symptoms are absent, which makes it necessary to carry out regular preventive 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; In the early stages of the disease, the question of maintaining the function of the vagina can be considered.

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 oligo-olation (in history), increased blood pressure and diabetes involve 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 possibility of holding 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 are not developed, but, however, it is necessary to ensure a thorough dispensary monitoring of these patients with the aim of early detection of their signs of malignancy.

J.P.BaalmAtse

"Bleeding after menopause" and other articles from the section

Bleeding or spottedness after menopause is a common cause of treating patients to the gynecologist. Options after menopause are abnormal and, as a rule, caused by benign lesions of the genital tract. Therefore, it is important to inform the doctor about bleeding during the climax, the reasons for this phenomenon will be able to determine only a specialist after complete diagnosis.

Causes of bleeding after menopause

Approach the last menstruation in the life of a woman is 50 years old. If 12 months after the cessation of menstruation there was no bleeding, this means that the woman entered postmenopause. Bleeding and bleeding, which occur a year after the last menstruation is an abnormal state.

• Hormonal replacement therapy - Its use significantly increases the likelihood of bleeding
• The ovarian cyst - together with bleeding, abdominal pain may occur (may be in the spine), nausea and vomiting.
• Mioma - in this case, bleeding can be accompanied by severe pain.
• Polyps of the uterus: spotting and bleeding can appear.
• Atrophic vaginal process - after menopause, due to a decrease in estrogen levels, it can lead to a decrease in the thickness of the walls of the epithelial walls of the vagina. There is a feeling of dryness in the vagina, burning, itching of external genital organs and vagina, and even bleeding.

Any vaginal bleeding, which occurs a year after the last menstruation, requires consultation with the gynecologist. Even if there was little selection.

• Atrophic endometrium (mucous membrane of the uterus) - after menopause, due to the reduction of estrogen levels, the endometrium becomes very thin, and under it very fragile capillaries. They can give a gap, causing bleeding or bleeding
• Damage to the uterus and vagina can lead to bleeding

• Cancer vagina, cervix. In the event of an endometrial cancer, painless bleeding occurs in the early stages of the development of the disease. It often occurs in women suffering from obesity, hypertension and diabetes. In the event of cervical cancer, bleeding is sometimes the main and only sign. In turn, the vaginal cancer is a rare form, and can manifest itself as vaginal bleeding and discharge from the blood vagina.
• Blood diseases, including pathological changes in blood, for example, hemophilia or disease Villebrand.
• Use some drugs, such as anticoagulants.

Sometimes vaginal bleeding can be confused with bleeding from the urethra (which indicates the disease of the urinary tract) or bleeding from rear Passage (which can cause hemorrhoids or polyps, tumors).

Diagnosis of bleeding in women after 50-60 years

In the case of bleeding or bleeding after menopause, you should inform the gynecologist about it. You need to go to the doctor during the selection, without waiting for their completion.

The following studies will be needed for installing accurate dignosis:

1. endoscopy of the cervix;
2. transvaginal ultrasound;
3. MRI of the bodies of a small pelvis (performed with an ultrasound);
4. hysteroscopy is a study in order to estimate the state of the inner wall of the uterus;
5. biopsy mucous membrane of the uterus (endometrium);
6. histopathological examination of collected fragments of endometrial.

Communicable analyzes will be the collection of urine and blood.

How to treat bleeding?

Treatment of post-glimacteric bleeding depends on the cause of its occurrence. For example, in the case of atrophic vaginite, replacement hormone therapy is used to fill the estrogen deficiency.

For small atrophic changes in the vagina, humidifiers and lubricants are suitable.

If the cause of bleeding during menopause is momas - analgesics and anti-inflammatory, justified hormonal drugs are prescribed. It can also be removed surgically.