What Is a Vaginal Hemorrhage?

Vaginal bleeding refers to bleeding in the reproductive system other than normal menstruation. It is one of the more common symptoms in gynecological diseases. Bleeding can occur in the vagina, cervix, uterine body, and fallopian tubes, but uterine bleeding is the most common.

Basic Information

English name: Vaginal Bleeding
Visiting department: Gynecology
Common locations: Vagina, cervix, uterine body, fallopian tubes

Common causes: Ovarian endocrine disorders, genital tumors, ectopic pregnancy, threatened abortion, abortion, genital inflammation, thrombocytopenic purpura, aplastic anemia, etc.
Common symptoms: Reproductive system bleeding beyond normal menstruation

Causes of vaginal bleeding

1. Ovarian endocrine dysfunction can cause uterine bleeding. In addition, temporary reduction of estrogen levels caused by ruptured follicles during menstruation can also cause uterine bleeding.

2. Genital tumors, such as uterine fibroids, cervical cancer and endometrial cancer, can cause vaginal bleeding.

3. Pregnancy-related uterine bleeding, such as ectopic pregnancy, threatened abortion, abortion, etc.

4. Genital inflammation and trauma can cause vaginal bleeding;

5. Systemic diseases, such as abnormal platelet quantity and quality, coagulopathy including thrombocytopenic purpura, aplastic anemia, liver function damage, etc. can cause vaginal bleeding.

6. Exogenous hormones, such as estrogen and progesterone drugs, can cause "breakthrough bleeding" or "withdrawal bleeding".

Common diseases of vaginal bleeding

Vaginal bleeding in childhood

The possibility of precocious puberty or reproductive tract malignancy should be considered.

2. Adolescent vaginal bleeding with pain

Pain in the vagina and vulva and the amount of blood flowing out may be caused by trauma.

3.Vaginal bleeding in women during childbirth during two periods

There may be vaginal bleeding during ovulation, which is normal.

4. Vaginal bleeding after menopause

Women with ectopic pregnancy also often experience vaginal bleeding after menopause, and are often accompanied by dull lower abdominal pain and bleeding for a long time. Therefore, they cannot simply be considered ovulation bleeding without confirming pregnancy. Abortion also has vaginal bleeding.

5. Birth control pills cause bleeding

Bleeding after taking birth control pills is called breakthrough bleeding.

6. Postmenopausal vaginal bleeding

Vaginal bleeding after 2 years of menopause. Should pay attention to exclude malignant lesions, such as cervical cancer, endometrial cancer, etc., and then consider inflammation, polyps, and endocrine factors.

7. Uterine insufficiency and puerperal infection

Incomplete restoration of the uterine placenta attachment surface can cause the thrombus to fall off and the sinus to reopen, resulting in uterine bleeding. Infant puerperal infections are more common in endometritis, which can cause poor restoration of the uterine placenta attachment surface and poor uterine contraction, and incomplete closure of the sinus sinus leads to uterine bleeding.

8. Endometritis, uterine myositis, salpingitis, pelvic cellulitis, etc. cause uterine bleeding

9. Genital tumors

Uterine fibroids, cervical and endometrial cancer, ovarian cancer, etc.

Vaginal bleeding check

Gynecological examination

Vulva, vagina, cervix, uterus, accessories, etc.

2. Auxiliary inspection

(1) Laboratory examination: routine blood and urine examination. Patients of childbearing age often need urine or blood HCG tests to rule out pregnancy or pregnancy-related diseases. Depending on the situation, thyroid function, liver function, kidney function, blood coagulation function, and sex hormones are still required.

(2) Cervical cytology examination and HPV examination: those who have sexual intercourse bleeding or cervical inflammation, polyps, and blood contact need this examination to help diagnose early cervical cancer.

(3) Ultrasound examination: B-ultrasound (abdominal or transvaginal): Those with uterine bleeding often need to undergo pelvic B-ultrasound to understand the uterine size, shape, endometrial thickness, and abnormal echo of the uterine cavity. The characteristics of the mass and the mass, the presence or absence of peritoneal effusion, etc.

(4) Biopsy: Lesions of the vulva, vagina, and cervix can be directly taken for biopsy to confirm the diagnosis. Biopsy should not be used for patients with choriocarcinoma, because it can cause major bleeding that is difficult to control. For uterine bleeding, in order to make a clear diagnosis or hemostasis, a diagnostic curettage (usually limited to married patients) is often required. Pathological examination must be performed on the scraped tissue. Patients with suspected endometrial cancer undergo segmental diagnosis and curettage. That is, the cervical canal is scraped first, then the depth of the uterine cavity and the endometrial tissue are scraped, and then the source of the specimen is marked and sent for pathological examination to help diagnose endometrial cancer.

(5) Endoscopy: Hysteroscopy: Hysteroscopy is required when the B-ultrasound shows abnormal uterine echo, or when the diagnosis of dysfunction has been ineffective for a long time. To determine whether there are lesions in the uterine cavity, such as submucosal fibroids, endometrial polyps, and cancer. Laparoscopy: If a pelvic mass or endometriosis is found during gynecological examination or B-ultrasound, laparoscopy can be used to confirm the diagnosis.

Differential diagnosis of vaginal bleeding

Identify the vaginal bleeding or urethral bleeding, vaginal examination can identify the bleeding site, routine urine examination can determine whether the urinary tract problem.

Vaginal bleeding treatment principles

1. Etiology treatment, treatment for specific etiology.

2. Symptomatic treatment, mainly hemostatic treatment.

3. If there is a large amount of bleeding, the patient appears pale, sweating, palpitation, dry mouth, etc., should be sent to the hospital for treatment as soon as possible. Before arriving at the hospital, if the patient has nausea or vomiting, his face should be tilted to one side to prevent suffocation.