Metrorrhagia in premenopause. Metrorrhagia: why uterine bleeding occurs and how to stop it

A woman’s health determines her physical and psychological state and makes it possible to fulfill the main purpose of nature - to conceive, bear and give birth to a child. The entire female body functions in a genetically determined cycle. However, in cases where diseases occur, the cycle may be disrupted. Metrorrhagia is the appearance of bloody discharge not associated with menstruation. To distinguish normality from pathology, it is important to know the main symptoms of the disease.

Bloody discharge from the uterus is normal for a woman. At the same time, there are certain criteria that allow some bleeding to be classified as pathological processes. Symptoms of metrorrhagia may appear in at different ages and are always associated with serious diseases.

It is worth thinking about metrorrhagia if bleeding of varying intensity appears between menstruation or prolongs it. Anomalous are bloody issues during menopause and postmenopause, when the level of female sex hormones decreases. The discharge itself can be abundant or scanty, often accompanied by paroxysmal pain in the lower abdomen.

Laboratory blood tests in women with metrorrhagia often show a decrease in hemoglobin levels, iron deficiency, and an imbalance of sex hormones. When examining and determining the diagnosis, the doctor always pays attention to the psycho-emotional state of the patient.

In addition, metrorrhagia manifests its symptoms in other organs and systems. Thus, with acyclic uterine bleeding, dizziness, nausea, increased heart rate, and increased body temperature may appear. Many women report fatigue, drowsiness, and general malaise.

Causes of pathology

Violation menstrual cycle(nmts) can manifest itself in different ways. Any deviations from the norm should alert a woman. If metrorrhagia-type NMC occurs, this will always indicate serious diseases of the genitourinary system. Such situations cannot be ignored.

In order to prevent recurrence of bleeding, representatives of the fair sex should periodically undergo medical examinations and combat the factors that provoke the disease. It is possible to use sedatives as a preventive measure to maintain a normal psycho-emotional state. Exposure to hazardous working conditions should also be avoided.

Understanding what metrorrhagia is, it will be easy for a woman to figure out whether uterine bleeding that occurs outside the cycle really has signs of the disease. It is important to pay due attention to your health and seek timely treatment. medical care, strictly follow the doctor's instructions.

Metrorrhagia is bleeding in the uterus caused by inflammatory processes in the genitourinary system. Often women mistake them for menstrual bleeding and do not seek help from a doctor.

However, if such hemorrhages occur, you should immediately undergo a medical examination. Metrorrhagia can be caused by any infection that has penetrated the uterine cavity, but often its causative agent is the growth of the endometrium (the inner layer of the uterus).

Uterine bleeding that is not related to menstruation occurs with cervical erosion, complex forms of endometritis, sarcoma, adenomyosis, and cancer.

Symptoms

This disease is difficult. The symptoms of metrorrhagia are often confused with ordinary discomfort during the menstrual cycle, but it is still possible to distinguish metrorrhagia. It is characterized by:

• Acyclicity – interruption of normal uterine bleeding.
• Abundant or, conversely, small blood loss. They can also be unequal, that is, on the first day the hemorrhage is significant, on the next day it is small.

In addition, the disease is accompanied by symptoms of other inflammatory processes that caused uterine bleeding:

1. Headache.
2. Weakness.
3. Nausea.
4. Increased fatigue.
5. Major blood loss (dark red color).
6. Increased heart rate.
7. Temperature increase.
8. Severe pain lower abdomen.

Causes of the disease

Metrorrhagia can occur in girls and women. The source of the disease is always damage to the inner layer of the uterus. The main causes of metrorrhagia are as follows:

• ulcer;
• cervical erosion;
• stress, depression;
• uterine fibroids;
• physical stress;
• mental fatigue;
• tumor in the uterine cavity and ovaries (uterine myomatous node);
• hormonal disorders;
• long stay in negative environment(for example, increased hazards at work).

Dysfunctional metrorrhagia

This term is commonly used to refer to neuroendocrine disruptions that affect the functioning of sex hormones. With such a disorder, the nature of menstruation changes, which ultimately causes acyclic bleeding. There are 2 types of dysfunctional metrorrhagia: ovulatory and anovulatory.

1. Ovulatory - with this phenomenon, ovulation occurs, but with noticeable deviations. They manifest themselves in the form of uneven periods of the menstrual cycle. If ovulation is defective, a woman cannot have a child.
2. Anovulatory is the most common form of the disease. Ovulation does not occur, but menstruation with a single-phase cycle proceeds as usual. The causes of this disease are as follows:

• Death of the egg due to follicular atresia (underdevelopment).
• Death of the egg due to the maturation of the follicle and the inability of the mature egg to be released. In this case, the follicle remains alone (persistence).

Both phenomena cause heavy bleeding and growth of the inner layer of the uterus (endometrium). Such hormonal disorders occur due to overwork, vitamin deficiency, chronic diseases of the genitourinary system, acute infections and nervous diseases.

Metrorrhagia during premenopause

Perimenopause is a period of decreased estrogen due to low ovarian activity. The process is typical for women aged 40-50 years, but can also affect earlier years. Perimenopause is a completely normal process in the female body; it ends after the ovaries stop producing eggs.

Metrorrhagia in premenopause indicates that polyps have formed in the uterine cavity. These benign tumors often cause miscarriage and premature birth.

Due to polyps, the fertilized egg cannot implant in the uterus. During such periods, menstrual bleeding is either absent altogether or lasts more than 7 days, and in profuse form. In premenopause, these phenomena can mean pathologies in the uterus and other inflammations in the reproductive system.

Uterine bleeding during menopause

Metrorrhagia during menopause occurs due to hormonal imbalance or the presence in the body cancer. The provoking factor can be various tumors or formations in the pelvic area.

Bleeding during menopause is accompanied by sharp, sharp pains in the lower abdomen. The presence of such a sign indicates serious disorders in the body, so the woman should immediately consult a doctor.

During this same period, women often experience a whole bunch of different diseases. Ovarian tumors are not uncommon in women over 50 years of age. If an ovarian cyst is detected during menopause, the doctor prescribes surgery. This is the only way to eliminate the tumor.

Any cyst during menopause is removed surgically. This is necessary to prevent the risk of developing cancer.

Metrorrhagia in postmenopause

The development of the disease during the postmenopausal period requires special attention. This is the time when hormonal function has almost died out and menstruation no longer occurs. If bleeding occurs in postmenopause, this means that there are serious diseases in the body, including cancer. The causes of metrorrhagia in postmenopause are as follows:

• polyps;
• uterine fibroids;
• adenomyosis;
• oncological processes;
• miscarriage, abortion;
• diabetes;
• cardiovascular diseases.

Treatment and prevention

Standard treatment of metrorrhagia is comprehensive. First of all, the doctor does everything possible to stop the bleeding.

If the patient comes in on time, at an early stage of the disease, the doctor prescribes restorative therapy, including eliminating anemia, restoring blood clotting, and the process of uterine contraction.

However, it is not always possible to prescribe treatment on time, since metrorrhagia is not so easy to diagnose immediately.

Diagnosis of the disease

1. To correctly determine the presence of a disease, it is necessary to focus not only on the symptoms. If you notice bloody discharge from the vagina, which should not be present at the moment, you should immediately consult a doctor. Already in the hospital additional actions will be taken:
2. Determination of hemoglobin and platelet levels in the blood.

Measuring the thickness of the endometrium and examining the size of the uterus.

• Identification of NMCs based on the type of metrorrhagia (menstrual cycle disorders) occurs at the stage of collecting anamnesis. In this case, the patient will have the following characteristics:
• the duration of menstruation is less than 3 or more than 7 days;
• scanty or heavy periods that do not appear in the menstrual cycle;

sharp pain in the lower abdomen.

NMC in the reproductive period (from 20 to 35 years) is a common and normal phenomenon. However, if the deviations are caused by metrorrhagia, the disease can cause a decrease in a woman’s ability to conceive.

Treatment

If ovarian dysfunction is detected, the functioning of the adrenal glands and cerebral cortex is adjusted. Then - nutrition, the woman is given a special diet that will replenish the body with the necessary elements.

From the uterine cavity, which are irregular in nature and not dependent on the menstrual cycle. The reason for the appearance of such discharge may be a state of severe stress, physical or mental stress, the consequences of intoxication of the body or disruption of the endocrine system.

To make a diagnosis, an examination of the vagina, cervix, urinary tract and rectum is performed. During an external examination, pathological changes are detected or excluded, such as polyps, tumors, injuries, foreign bodies. The next step is to exclude causes associated with intrauterine and ovarian pathology. Such uterine bleeding can occur when hormonal and non-hormonal drugs are prescribed or taken incorrectly.

The laboratory takes clinical and biochemical blood tests, ultrasound of the pelvic organs, and takes blood to determine hormone levels. If the presence of tumors is suspected, a tumor marker test is performed.

Metrorrhagia during postmenopause

Metrorrhagia in postmenopause can be characterized both cyclically and acyclically. The causes of such bleeding may be age-related changes in the endometrium of the vagina or more serious diseases, therefore self-medication is unacceptable.

Metrorrhagia in postmenopause is expressed by such clinical manifestations as prolonged uterine bleeding, lasting 7 days or more. They often occur after a missed period, are irregular and can cause anemia.

Metrorrhagia, causes

Before prescribing treatment, it is necessary to accurately determine the cause of uterine bleeding. For this purpose, a number of laboratory tests are carried out to help identify the disease, the consequence of which is metrorrhagia. In some cases, this may be due to an overdose of drugs with high estrogen content.

In this case, it is recommended to stop using the drug, replacing it with another, or completely abandon such therapy. Sometimes the appearance of uterine bleeding during the postmenopausal period is caused by the occurrence of cancer of the body and cervix.

If anovulation is observed, then curettage is performed from the body of the uterus for diagnostic purposes and to achieve therapeutic effect. Immediately after curettage, a hormone therapy complex is prescribed. If such treatment is not effective and bleeding occurs again, the doctor will prescribe surgical removal of the uterus.

Uterine bleeding during menopause can also be caused by the appearance of polyps, inflammation in the endometrium of the uterus, hormonally active neoplasms in the ovaries, hyperplasia, hyperthecosis, and tecomatosis.

Diagnostics

For timely diagnosis of metrorrhagia, the following is used:

• Collecting anamnesis of the patient’s lifestyle and previous diseases.
• Clinical examination on a gynecological chair.
• Blood tests for hemoglobin level, clinical, biochemistry, coagulation, hormones.
• Analysis of cervical smears and endometrial biopsy.
• Ultrasound of the pelvic organs.
• Treatment of metrorrhagia

Treatment of metrorrhagia depends on the pathology. If glandular fibrous polyps are detected, they are removed under hysteroscopy control. If after this a relapse occurs and a suspicion of cancer arises, removal of the uterus and appendages is prescribed. But on an individual basis, it may be recommended to use a course of oxyprogesterone intramuscularly for a period of up to 4 years.

Such treatment is carried out under strict control with regular scrapings. If it is not effective and relapses still occur, then the only solution to this problem is to remove the uterus and appendages.

If chronic inflammatory processes are detected, which are the cause of uterine bleeding, intrauterine administration of a mixture of dimexide, deoxyribonuclease, ribonuclease, chymotrypsin, lidase, hydrocortisone and sodium chloride is prescribed. The proportions are determined by the doctor.

What else to do

If staphylococcus joins the inflammatory process, an alcohol solution of chlorophyllipt is added to this mixture. This is a long-term therapy, the course of which lasts more than 1 thousand procedures. The prognosis of treatment depends on the nature inflammatory process. Metrorrhagia in postmenopause is treated by eliminating anovulatory dysfunction, eliminating metabolic and endocrine disorders, and using hormonal contraception.

In addition to treating the cause of uterine bleeding, the patient is prescribed complete rest, bed rest, cold is applied to the lower abdomen, preferably an elevated position of the pelvis 25-30 cm above the level of the body position. Thus, you can alleviate the condition and reduce blood loss.

Uterine bleeding during menopause can be significantly reduced by using herbal remedies that can reduce or stop bleeding, but it should be remembered that these are only auxiliary methods of control and cannot be used as the main treatment. Improvement in the condition after herbal medicine is observed after 2-3 weeks. Before use, you must carefully study the composition, contraindications and side effects.

Physiology and pathology of the postmenopausal period

Postmenopause is the period of a woman’s life after the cessation of menstruation. The status of menopause can be diagnosed based on tests of estradiol levels (less than 30 pg/l) and an increase in FSH of more than 40 IU/l in the blood serum. The average age of menopause is 51 years. Due to the decrease in estrogen levels, this age period accounts for the largest number of cancers of the genital organs.

Changes in the functioning of the ovaries and adrenal glands begin even before menopause. A decrease in the level of progesterone, estrogen and estrone leads to many disorders in the body. On the one hand, this is a normal physiological process, and on the other, it can cause significant damage to a woman’s health. About 70% of women are susceptible to such diseases associated with disruption of normal ovarian activity.

Menopause symptoms and their treatment

Elderly women are more often susceptible to urogenital disorders 2-5 years from the beginning of the postmenopausal period. Under the influence of a decrease in estrogen levels, symptoms of diseases such as atrophic vaginitis, dyspareunia, decreased lubrication function and pistourethritis, pollakiuria, and urinary incontinence occur. During this period, genital prolapse may also appear.

Due to the occurrence of estrogen deficiency, the number of cardiovascular diseases caused by atherosclerosis increases. Preventative measures such as exercise and a healthy, nutritious diet can help combat such symptoms. Diseases of this nature are treated as prescribed and under the close supervision of a doctor.

Older women face problems with unwanted facial hair. The solution may be depilation and hormone replacement therapy.

Loss of skin elasticity leads to sagging breasts, facial contours and body contours. Massage courses, sports, healthy eating, skin care products and hormone therapy courses.

Another of the most serious consequences of postmenopause is osteoporosis, which makes bones brittle and thins the skeletal structure. In addition to hormone replacement therapy, a diet high in calcium and magnesium, sunbathing and exercise are prescribed.

The walls of the vagina atrophy, become thinner, and itching appears. This problem must be combated with the help of estrogen creams and the use of artificial lubricants. A good measure would be to continue sexual activity.

The increased risk of arthritis is reduced by regular exercise, taking mild painkillers, and using severe pain only under the supervision of a specialist.

Postmenopause is often accompanied by infectious diseases of the urinary tract and enuresis. Infections are “killed” by antibiotics. Enuresis is treated with hormonal therapy in combination with strengthening the pelvic muscles and a diet high in dietary fiber.

Discharge

Vaginal discharge during postmenopause does not change its consistency, color or smell - this is the norm. Postmenopause does not affect these indicators. The only exception is the quantity, which is significantly reduced. But if the discharge has changed after menopause, this may be the first symptom of the development of pathologies. The cause may be either an infection or a hormonal imbalance.

During menopause, urogenital disorders may develop. Depending on the rate of progression of hormonal deficiency, complaints of vaginal dryness, itching, burning sensation and extreme discomfort appear. Against the background of such symptoms, a secondary infection may occur. The discharge acquires an unpleasant, specific odor, changes color, and increases in volume.

Against the background of all the changes that characterize postmenopause, discharge is one of the first sources of information for a woman that a malfunction has occurred in the body that requires immediate treatment.

The hormonal imbalance that occurs during this period can also lead to bloody discharge, which should be the reason for an urgent visit to the gynecologist. Problems of this nature can be solved using both medical and surgical methods.

Postmenopausal pain syndromes

Most women experience pain during menopause. The nature and locations of localization may vary.

Chest pain occurs due to the replacement of glandular tissue with fibrous and fatty tissue. If diseases of the mammary glands are not detected, the cause of such pain may be severe psycho-emotional stress.

Painful sensations in the abdominal area indicate the presence of problems in the genitourinary system or intestines, the cause of which may be a decrease in estrogen levels.

Headaches are constant companions of menopause. They are a normal reaction of the body to stress and depression. Treatment will be to eliminate the causes and take analgesics.

Pain in the back, lower back, and joints should not simply be stopped as they are a manifestation of existing diseases, such as arthritis and arthrosis, osteoporosis. Comprehensive treatment under the supervision of specialists is necessary.

If during menopause or strange discharge appears, this may be a symptom of serious diseases, such as: ductal papilloma, mastopathy, mastitis, galactorrhea, ductal ectasia of the mammary gland, cancer. A consultation and examination by a mammologist is simply necessary.

Chest pain during menopause is often confused with pain in the heart. Cardialgia is one of the companions of the menopause. Manifested by the appearance of chills and increased sweating. These symptoms intensify at night. The appearance of such signs should be a reason to visit a cardiologist and rheumatologist.

Herbal medicine for postmenopause

Herbal medicine for the treatment of postmenopausal symptoms has a very effective effect on general state patients. However, it cannot be a substitute for hormonal therapy prescribed by the attending physician.

In nature, there are plants that are organic substitutes for estrogen. These include:

• St. John's wort. Used to treat climatic neuroses, reduces the frequency and severity of hot flashes.
• Ginseng. Reduces fatigue and reduces stress levels.
• Licorice. Causes estrogenic activity in the body, improves the condition of bone tissue.
• Angelica Sinensis. Improves sleep quality, relieves anxiety and irritability
• Sage. Significantly reduces sweating and is also used for insomnia, nervous exhaustion, and rapid heartbeat. Jujube and astragalus have the same properties.

Lifestyle during postmenopause

The well-known “three pillars” of a healthy life will help to significantly alleviate the symptoms of postmenopause.

• Change your diet to be healthier. It is absolutely necessary to switch to proper nutrition, taking into account the age-related needs of the body for vitamins and microelements.
• Playing sports and physical activity does not harm anyone, and during the postmenopausal period it will also help reduce the risk of joint diseases and also give you energy.
• Stressful and depressive conditions can be overcome by proper, healthy sleep and consultations with a psychologist.
• Absolutely need to give up bad habits such as smoking and overeating. Excess weight leads to a decrease in the production of estrogen, which is already insufficient at this time. Therefore, getting rid of these habits will help the body feel better.

Conclusion

It is impossible to prevent the onset of postmenopause, as well as menopause itself, but every woman has the power to improve her condition and quality of life during this difficult period. And the clinic women's health and its specialists will help in this difficult test.

All women who are of childbearing age experience bleeding from the vagina every month - menstruation.

The first menstrual bleeding - scientifically known as menarche - occurs in girls aged 12 to 15 years. Over the course of one and a half years, the cycle is established, and menstruation appears at certain intervals (from 21 to 35 days) and lasts from 3 to 6 days. This is the norm.

Well, of course, provided that the egg has not been fertilized and pregnancy has not occurred. But that's a different story.

But the appearance of bleeding in the intervals between menstruation cannot be called the norm. Why do they sometimes arise?

What is metrorrhagia?

The appearance of uterine bleeding in the intermenstrual period is called dysfunctional uterine bleeding or metrorrhagia. Uterine bleeding is not uncommon; it is one of the main reasons why women visit a gynecologist.

Today, metrorrhagia does not pose a threat to a woman’s life - of course, provided that she consults a doctor in time. However, this dysfunction can cause a whole bunch of troubles:

• iron deficiency anemia;
• problems in sexual life;
• feeling unwell.

What is the menstrual cycle?

Before understanding why dysfunctional uterine bleeding occurs, it is necessary to understand what changes occur in a woman’s body during a normal menstrual cycle.

The menstrual cycle normally has two phases. The first phase begins with the onset of menstrual bleeding. During this period, hormones are formed in the woman’s body that promote the maturation of eggs and the growth of the inner mucous membrane of the uterus.

When the egg matures, a special luteinizing hormone is released, which causes ovulation - the release of the egg from the ovarian follicle. From this moment on, the second phase of the menstrual cycle begins.

The egg is captured by the villi of the uterine (fallopian) tube and begins to move along it into the uterine cavity. At the site of the ruptured follicle in the ovary, a so-called corpus luteum. It secretes the hormone progesterone, which prepares the woman’s body for a possible pregnancy.

If fertilization of the egg does not occur, it dies. The woman's brain does not receive the attachment signal ovum. As a result, the corpus luteum ceases its activity. This leads to rejection of the internal mucous uterine layer, that is, to the occurrence of menstrual bleeding.

Causes of metrorrhagia

The development of intermenstrual bleeding can be very different reasons. The most common are:

• stress and psychogenic factors;
• physical and mental fatigue;
• specifics of the profession. For example, hazardous production;
• inflammatory diseases of the genital organs;
• neoplasms (tumors) of the uterus and/or ovaries;
• endocrine (hormonal) disorders.

Metrorrhagia - symptoms

Unlike menstrual bleeding, which occurs at clearly defined intervals, metrorrhagia can occur at any time and in women of any age. If it occurs suddenly, “out of the blue,” they speak of “acute” metrorrhagia.

But, much more often, intermenstrual bleeding is prolonged and even disrupts the cyclicity of menstruation. In these cases they talk about chronic metrorrhagia.

Anovulatory metrorrhagia

This type of dysfunctional uterine bleeding occurs quite often. Most often they are observed in teenage girls and menopausal women. In addition, adult women may also experience 1–2 anovulatory menstrual cycles during the year.

During such cycles, ovulation does not occur and the corpus luteum does not form. It turns out that the menstrual cycle becomes single-phase - only the hormones of the first phase act in it, leading to the growth of the uterine mucosa - the endometrium.

When hormone levels decrease, mucosal rejection occurs and anovulatory metrorrhagia occurs. In 80% of women with an anovulatory cycle, uterine bleeding occurs due to delayed menstruation. In other cases, it begins on time, but unlike menstruation it continues long time- more than 7 days.

Metrorrhagia in postmenopause

As women age, ovarian function gradually declines. Menstruation becomes irregular and then stops altogether. After menstruation stops completely, postmenopause occurs.

Metrorrhagia during this period is most often a symptom of dangerous diseases - cancer of the body or cervix, malignant ovarian tumors, etc. Therefore, if menstruation was absent for a year, and then uterine bleeding suddenly occurred, then it is necessary to consult a doctor as soon as possible and undergo a full examination .

Diagnosis of the disease

A doctor can make a diagnosis of “metrorrhagia” based on characteristic complaints of an irregular menstrual cycle, as well as based on gynecological and general examination data.

For dysfunctional uterine bleeding, diagnostic curettage of the uterine body cavity is often performed. The resulting pieces of the mucous membrane are sent for histological examination. By the way, in addition, curettage of the uterine cavity leads to stopping bleeding.

Metrorrhagia - treatment

The method of treating uterine bleeding depends, first of all, on the reasons that caused it.

Treatment has three main goals:

1. Hemostasis is stopping bleeding. For this, women are prescribed hemostatic drugs and uterine contractions. Your doctor may also prescribe hormonal hemostasis. In this case, the woman is prescribed medications containing a high dose of female sex hormones. In case of severe bleeding, surgical intervention can be performed - curettage of the uterine body, removal of the uterus.
2. Prevention occurrence of repeated bleeding. To do this, normalize menstrual function should be achieved.
3. Restoration of the body. Metrorrhagia can lead to significant blood loss and the development of secondary iron deficiency anemia in a woman. For its treatment, iron-containing drugs and vitamins are prescribed.

Uterine bleeding in itself rarely poses a danger to a woman’s life. However, it may be the first sign of tumors of the uterus or ovaries, as well as various hormonal disorders. Therefore, if symptoms of metrorrhagia appear, you should immediately seek medical help without wasting time.

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