Women experience about 400 menstrual periods in their lifetime and are accustomed to vaginal bleeding. However, if you encounter abnormal vaginal bleeding, you must be careful and see a doctor in time without delay. Because abnormal vaginal bleeding is most likely a signal light for gynecological diseases.
What are the conditions of abnormal bleeding
In fact, there are many cases of abnormal bleeding, such as bleeding during sexual intercourse, bleeding during ovulation, bleeding after taking birth control pills, bleeding during pregnancy, and bleeding after menopause. In addition, what we often call menstrual irregularities is probably "irregular vaginal bleeding".
brown discharge in leucorrhoea;
Before the time of menstruation, vaginal bleeding was found;
Sudden menstrual bleeding becomes abnormally heavy or unusually light;
The menstrual cycle is suddenly elongated and intermittent;
Bleeding just after menstruation and a few days later;
……
Some of these situations are easy to spot, while others are easy for us to ignore. For example, there is a brown discharge in the vaginal discharge, which is actually a sign of vaginal bleeding. Because the amount of bleeding is relatively small, it will appear brown after staying in the vagina for a long time.
Therefore, whether it is spotting or heavy bleeding, whether it is bright red blood or abnormal discharge, it is necessary to consult a doctor in time. Evaluated by a professional doctor and given appropriate treatment recommendations, you can avoid a minor illness from becoming a major illness.
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N possibilities of abnormal vaginal bleeding
1. Endocrine-related bleeding
Normal menstruation is regulated by sex hormones secreted by the ovaries. Once the ovarian endocrine function is dysfunctional, or the use of exogenous hormones may cause hormone levels in the body to fluctuate, resulting in irregular bleeding. For example, dysfunctional uterine bleeding in adolescent and perimenopausal women, endocrine disorder bleeding, ovulatory bleeding due to follicular rupture between menstrual periods, and vaginal bleeding can sometimes be caused by taking birth control pills or wearing a contraceptive ring.
2. Pregnancy-related bleeding
Various types of miscarriage, such as threatened miscarriage, unavoidable miscarriage, incomplete miscarriage, residual miscarriage, and habitual miscarriage. Prenatal placenta previa, placental abruption, incomplete delivery of the placenta during normal delivery, or residual placental tissue after miscarriage, and incomplete uterine replacement. Ectopic pregnancy, molar pregnancy, malignant molar pregnancy, and chorioepithelial carcinoma may cause irregular vaginal bleeding.
3. Bleeding related to inflammation
(1) Vulvar hemorrhage is seen in vulvar ulcers, urethral mons, etc.
(2) Vaginal bleeding is seen in vaginal ulcers and vaginitis, especially senile vaginitis, trichomoniasis vaginitis, etc.
(3) Cervical bleeding is seen in acute and chronic cervicitis, cervical ulcers, cervical polyps, etc.
(4) Uterine bleeding is seen in acute and chronic endometritis, chronic myositis, acute and chronic pelvic inflammatory disease, etc.
4. Tumor-related hemorrhage
Cervical polyps, early cervical cancer, etc. can cause vaginal bleeding after intercourse, uterine submucosal fibroids vaginal bleeding will become irregular, menstrual flow will be increased or inexhaustible, if necrosis infection, it will be accompanied by purulent vaginal discharge, endometriosis, uterine myadenosis may also bleed. Malignant tumors such as endometrial cancer, cervical cancer, and uterine sarcoma often cause postmenopausal vaginal bleeding, and some ovarian tumors with endocrine function often cause irregular vaginal bleeding.
5. Bleeding related to contraception
Mechanical compression of the IUD can cause local injury, necrosis, and superficial ulceration of the endometrium, leading to bleeding. Irregular bleeding can also occur due to dislocation of the contraceptive ring and incorrect administration of contraceptive pills.
6. Trauma-related bleeding
Bleeding can be caused by straddle injury, hymen or vaginal wall or posterior fornix injury caused by intercourse, and insertion of a foreign body in the vagina.
7. Bleeding related to systemic diseases
Irregular vaginal bleeding can occur in liver disease, aplastic anemia, thrombocytopenic purpura, leukemia and obstetric and gynecological diseases.
8. Miscellaneous
Genital tract malformations: vaginal oblique septum, etc. Premenstrual bleeding in girls and young girls: Minor vaginal bleeding in female infants, due to a sudden drop in estrogen provided by the mother, due to endometrial shedding, and bleeding in young girls, precocious puberty or malignancy of the genital tract.
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What to do about abnormal bleeding?
Pregnancy is ruled out first, followed by a gynaecological examination and, if necessary, imaging to evaluate for endometrial polyps, scar defects from cesarean section, and structural abnormalities of the uterus. Patients with irregular bleeding often have abnormal ovulation, and it is also necessary to know whether thyroid function, prolactin, and ovarian function are abnormal.
Intimal sampling is indicated in nonpregnant patients who are obese or have other risk factors for endometrial disease, and even if there are no risk factors, recurrent abnormal bleeding or postmenopausal bleeding. If it is contact bleeding, such as bleeding after intercourse or gynecological examination, it is necessary to be alert to cervical lesions and seek medical attention as soon as possible.
For acute massive bleeding, adolescent girls mainly use hormones to stop bleeding, and for menopausal women, endometrial diagnosis and scraping are generally preferred to stop bleeding, and intimal sampling can be collected at the same time to rule out endometrial lesions. Long-term follow-up is followed to monitor for the potential risk and sequelae of anovulatory bleeding.
There can be many types of abnormal vaginal bleeding, both physiological and pathological, and the problem can be large or small. However, all sisters should be aware of the changes in their bodies and seek medical attention in time if necessary.
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