What Is Uterine Bleeding?

Abnormal uterine bleeding not associated with menstruation can occur at any age from menarche to before and after menopause. Refers to bleeding from the cervix or from the uterine cavity.

Abnormal uterine bleeding not associated with menstruation can occur at any age from menarche to before and after menopause. Refers to bleeding from the cervix or from the uterine cavity.

Common locations

Uterine bleeding

Common causes

Endocrine factors, pregnancy complications

Uterine bleeding I. Causes and common diseases:

Uterine bleeding can occur for a variety of reasons:

1. Endocrine factors:

Anovulatory uterine bleeding, ovulatory uterine bleeding, ovulatory bleeding, sex hormones, and inappropriate use of contraceptives.

2, pregnancy complications:

Abortion, ectopic pregnancy, hydatidiform mole, chorionic carcinoma, late pregnancy with painless uterine bleeding during placenta previa, late pregnancy uterine bleeding with abdomen, contractions, weakness, placental retention, and incomplete uterine involution.

3. Uterine bleeding caused by tumor:

Uterine fibroids, cervical cancer, uterine body cancer, uterine sarcoma, cervical thyroid sarcoma, ovarian granulosa cell tumor.

4. Inflammatory bleeding.

5. Traumatic uterine bleeding.

6. Uterine bleeding caused by systemic diseases, such as aplastic anemia, thrombocytopenic purpura, and leukemia.

Uterine bleeding 2. Differential diagnosis:

Menstruation loses its normal and regular cycle, and is replaced by excessive menstrual flow with different frequencies, prolonged menstrual period, or manifested as irregular uterine bleeding, which stops and flows, and the blood volume is sometimes longer. Anovulatory blood supply is generally painless, and anemia is often associated with excessive blood loss.

Main clinical manifestations:

1. Ovulation bleeding: Due to the low level of estrogen before ovulation, a small amount of vaginal bleeding can be seen during ovulation.

2. Pre-menstrual bleeding: A small amount of vaginal bleeding a few days before menstrual cramps, followed by normal menstruation. This type of bleeding is caused by luteal insufficiency and insufficient estrogen and progesterone secretion.

3. Postmenstrual bleeding: The beginning of menstruation is normal, but the duration of a small amount of bleeding is extended to the later period. This type of bleeding is incomplete endometrial exfoliation, and the histological feature is that the exudative endometrium is mixed with the initial proliferative endometrium. This is mainly due to slow luteal degeneration and continuous progesterone secretion.

4, bleeding caused by endometrial proliferative disease: is a typical anovulatory bleeding. Because the follicles persist and secrete a certain amount of estrogen, the endometrium proliferates abnormally, and the endometrium is mostly glandular hyperplasia.

5. Bleeding caused by endometrial insufficiency: It is a kind of abnormal bleeding that is common in the luteal phase. Endometrial proliferation and luteal phase changes can coexist. It is caused by imbalance of estrogen and progesterone secretion.

Uterine bleeding III. Examination:

(A) color Doppler ultrasound (TVCDS) examination:

TVCDS is a non-invasive diagnostic method. It is easy to operate and can objectively and clearly show the condition of the endometrium and its bilateral accessories. It provides powerful and reliable information for clinical diagnosis and can be repeated. It continuously and dynamically observes the endometrium and grasps its changes. It is of great significance in the diagnosis of endometrial lesions.

(2) Hysteroscopy (HS):

HS can look directly into the structure of the uterine cavity and use the magnifying effect of the mirror to accurately distinguish the lesions in the uterine cavity, especially the location of the biopsy and the identification of small or focal endometrial lesions can not be compared with pure diagnostic curettage.

(Three) diagnostic curettage:

For married women, you can understand the size and shape of the uterine cavity, whether the uterine wall is smooth, whether the hardness is consistent, and the nature and amount of the scrape. Scraping the tissue and sending it for pathological examination can confirm the diagnosis.

(D) Basal body temperature measurement:

The anovulation pattern is a single-phase curve; the ovulation pattern is a biphasic curve.

(5) Crystallization examination of cervical mucus:

The appearance of fern-like crystals before menstruation indicates anovulation.

Uterine bleeding IV. Treatment principles:

(A) treatment of anovulatory dysfunction:

Adolescence focuses on hemostasis, adjusting the cycle and restoring ovulation. Menopause focuses on hemostasis, prevents recurrence, and smoothly passes through menopause.

(Two) treatment with ovulation and blood:

Hemostasis, luteinizing function, and cycle regulation.