Abnormal Uterine Bleeding
It is normal for a woman to have her menstrual period up to seven days. If the menstrual period is not regular, the bleeding period is longer than normal and if the bleeding periods vary, abnormal uterine bleeding may occur. This section will explain the causes of abnormal bleeding, how to diagnose, how to treat.
During the menstrual period, the hormone estrogen and progesterone secreted from the ovaries causes changes in the endometrium layer that covers the inner surface of the uterus. Each month, eggs are released from any of the ovaries approximately 12-14 days after the start of menstruation. This event is called ovulation. The egg enters into any of the female canals called the fallopian tube and tries to reach the place where it is fertilized with sperm. If the egg is not fertilized, pregnancy does not occur and hormone levels begin to decrease. This shedding refers to the monthly menstrual period. ** THE Tears of the Womb ... **
The menstrual period begins from the first day of the bleeding period and continues until the first day of the next menstrual period. The menstrual period lasts approximately 28 days, but may be longer and shorter. If the period is more than 35 days or less than 21 days, it should be considered abnormal. It is called amenorrhea that the menstrual period is not during 3 normal periods or for 6 months. If your period is delayed, you should consult a doctor. ** ALARM **
Abnormal uterine bleeding:
Bleeding between menstrual periods
Bleeding after intercourse
Drip-style bleeding at any time during the menstrual period
Menstrual bleeding is more than normal or longer
Abnormal bleeding can occur at any age. There are some periods in a woman's life where menstrual periods are abnormally irregular. Menstrual periods between the ages of 9-16, when menstruation begins first, are not regular. Perimenopausal period, which can start as early as 35 years and lasts up to about 50 years, is also such a process. At the same time, menstrual delay and decreased bleeding may be normal in this period. But excessive bleeding should be investigated in every way. ***ATTENTION**
Causes
There are many causes of abnormal bleeding. Your doctor will be able to determine the cause of bleeding more easily by checking the most common causes of abnormal bleeding in your age group. Some of these causes are not serious and can be easily treated. Some may be serious. All must be checked. In some women, the cause of abnormal or excessive bleeding may be hormonal. This may be related to the over or under production of certain hormones. Sometimes it may occur due to problems in the thyroid gland (goiter) or the use of certain medications.
Other Causes of Abnormal Bleeding
Pregnancy
abortions
Ectopic pregnancy
Problems related to birth control methods (birth control pill, spiral etc.)
Inflammation of the cervix or cervix
Fibroids
Coagulation disorders
polyps
Various types of cancers (uterus-uterus, cervix-uterus-vagina-hazne)
Chronic medical problems (troit, diabetes)
Diagnosis
The first thing for your doctor to make the diagnosis of abnormal bleeding is to obtain a personal and family history of the patient. For this:
Past or present diseases
Drugs used
Use of birth control pills
Body weight, eating and exercise habits, stress level are questioned.
Your doctor will also ask you about your period. For this purpose, marking the period of menstruation and bleeding on a calendar will help you. You will then have a physical. Blood counts, if there is pregnancy, blood tests will be done. Depending on your symptoms and symptoms, one or more of the tests listed below may be required.
Hormone levels
Endometrial biopsy: Evaluation of the part taken under the microscope after gently scraping the inside of the uterus with the aid of a catheter.
Ultrasound: The evaluation of pelvic organs through images generated by sound waves. This device is used through the hopper or through the abdomen.
Sonohisterography (SIS): Vaginal ultrasonic evaluation after filling the uterus with sterile fluid using a small plastic catheter.
Hysteroscopy: Direct visual examination of the uterus through the vagina and cervix with the help of a thin instrument similar to a telescope
Dilatation and curettage (D&C): The opening of the cervix is enlarged, the inside of the uterine layer is taken by scraping or vacuum samples. Subsequently, the removed part is examined under a microscope.
Hysterosalpingography - X-ray demonstration of contrast agent introduced into the uterus and fallopian tubes
Laparoscopy: Abdominal look through a thin incision in the abdomen just below the navel by inserting a thin telescope into the abdomen
Most of these tests can be performed in the doctor's office, while others can be performed in hospital conditions.
Treatment
The treatment of abnormal bleeding depends on many factors, such as the cause, the age of the patient, the severity of the bleeding, whether the child wants it. Hormone therapy or other drug therapies can be used as well as surgery. The doctor can only assess the effectiveness of his treatment after several menstrual periods. If you think you are pregnant, your doctor may need to repeat the necessary tests before starting any treatment.
Hormones
Your doctor may prescribe birth control pills to make your menstruation more regular. This approach helps to improve other complaints. Progesterone provides treatment and prevention of intrauterine thickening called endometrial hyperplasia. It takes a few months for the hormones to control the bleeding. Excessive bleeding in the first months, the following months will be less. Hormone treatment will be given according to whether you want pregnancy.
Other Drug Treatments
Nonsteroidal antiinflammatory drugs similar to ibuprofen can help us control severe bleeding. They also reduce menstrual pains. Another treatment option is medication (tranexamic acid), which acts on clotting. If there is infection, antibiotics will also be given.
Surgical
Some women may require surgery to remove abnormal structures such as fibroids or polyps that cause abnormal uterine bleeding. Endometrial ablation is also used to treat abnormal uterine bleeding. Endometrial ablation is the destruction of the uterus by any means of electricity, laser, heat, or freezing. This is preferred when permanent removal of bleeding is desired. Endometrial biopsy should be taken before treatment. After this procedure, a woman cannot become pregnant.
Hysterectomy is another procedure commonly used in the treatment of abnormal bleeding. The woman can no longer conceive. These options should be considered before deciding on treatment.
As a result;
If you notice that your period is irregular, consult a doctor. There are many causes of abnormal bleeding. Your doctor will not be able to tell you the cause of the abnormal bleeding without examining you. If the cause of bleeding is found, abnormal bleeding will be treated successfully. If treatment continues or recurs despite treatment, we recommend that your doctor see you again.
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