Author: Yu Qi (Peking Union Medical College Hospital)
Regarding menstrual abnormalities, we have heard many names, such as blood, uterine bleeding, menorrhagia, menstrual abnormalities, etc. In order to facilitate communication and facilitate standardized treatment, the concept of "abnormal uterine bleeding" is currently uniformly used internationally.
What does abnormal uterine bleeding mean? When it comes to "abnormalities", we must first know what "normal menstruation" looks like.
1. Normal menstruation needs to meet the following four basic characteristics
Period: 21 to 35 days. That is, the time between the first day of menstruation and the first day of the next menstruation. The doctor asks about the "first few days of menstruation?" It refers to the first few days of menstruation, or the first few days of seeing blood.
Menstruation: 2 to 7 days. That is, the number of days that menstrual blood persists.
Menstruation: 5 to 80 ml. This is the total amount of blood lost during a menstrual period.
Menstrual regularity: two consecutive menstrual cycles change within 7 days and there is no bleeding during the non-intermenstrual period.
What we usually call "menstrual irregularities" refers to the loss of regularity of menstruation, with two consecutive menstrual cycles changing for more than 7 days.
Image source: Stand Cool Helo
2. So what is abnormal uterine bleeding?
Abnormal uterine bleeding is considered if a non-pregnant woman of childbearing age (excluding pre-adolescent and postmenopausal bleeding) does not meet any of the four basic elements of normal menstruation and blood is flowing out of the uterus. include:
Abnormal cycles: frequent menstruation < 21 days; rare menstruation > 35 days;
Abnormal menstruation: > 7 days of prolonged menstruation; shortened period of < 2 days;
Menstrual abnormalities: 80 ml more menorrhagia >; <5 ml less menorrhagia.
If you have repeated abnormal menstruation, you need to seek the help of a doctor, and abnormal menstrual flow is very difficult to judge. The international definition of menstrual volume >5 milliliters is normal menstrual volume, which means that in most cases there is no need to worry too much about low menstrual flow. As for whether the amount of menstruation is too much, usually the patient "says what he says", that is, if he feels that it is too much, it affects his work life, that is more. The main concern for abnormal uterine bleeding is the high amount of menstruation and frequent menstruation.
3. What are the causes of abnormal uterine bleeding?
Doctors often refer to intermenstrual bleeding, breakthrough bleeding, bleeding, drip bleeding, what does it mean?
Intermenstrual bleeding: there is a normal menstrual cycle (21 to 35 days) with bleeding that occurs randomly or at fixed times during the menstrual cycle.
Breakthrough bleeding: Such as the use of estrogen, progesterone, compound short-acting oral contraceptives and other sex hormone medication process, the doctor will choose the time to stop the drug according to the patient's situation, after stopping the drug will appear within two weeks of withdrawal bleeding. And the blood that does not stop the drug during the medication is called breakthrough bleeding.
Bleeding: The amount of bleeding has reached the point where a sanitary napkin is required.
Drip bleeding: the amount of bleeding does not yet require a sanitary napkin, only the extent of the pads, described as drip bleeding.
Co-author: Dr. Lin Lin, Gynecology Department, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital Hospital
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