It is normal for a woman to have menstrual bleeding for up to seven days. If the menstrual period is not regular, the bleeding time is longer than normal, and the bleeding periods vary, abnormal uterine bleeding may occur. This section will explain the causes of abnormal bleeding, how to diagnose, and how to treat.
Estrogen and progesterone hormones secreted from the ovaries during the menstrual period cause changes in the layer that covers the inner surface of the uterus, called endometrium. Each month, an egg is released from either of the ovaries approximately 12-14 days after the start of menstruation. This event is called ovulation. The egg tries to reach the place where it will be fertilized by sperm by entering any of the female channels called the fallopian tube. If the egg is not fertilized, pregnancy will not occur and hormone levels begin to decrease. When this decrease continues, the tissue developing in the uterus will shed. This shedding represents the monthly menstrual bleeding period.
The menstrual period starts 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 can be longer or shorter than that. If the period is more than 35 days or less than 21 days, it should be considered abnormal. The absence of a menstrual period for 3 normal periods or for 6 months is called amenorrhea. There may be various reasons for this abnormal situation. If your menstrual period is delayed, you should consult a doctor.
Abnormal uterine bleeding:
Bleeding between menstrual periods
After intercourse. bleeding
Drip-like bleeding that occurs at any time during the menstrual period
Menstrual bleeding that is more or longer than normal
Abnormal bleeding can occur at any age. There are some periods in a woman's life when her menstrual cycles are so irregular that they can be considered abnormal. Menstrual periods between the ages of 9 and 16, when the menstrual period first begins, are like this and are not regular. The perimenopausal period, which can start as early as the age of 35 and continue until the age of 50, is also such a process. It is normal for each menstrual period to gradually shorten during this period. At the same time, it may be normal for menstruation to be delayed and bleeding to decrease during this period. However, excessive bleeding should be investigated in every way. is.
Causes
There are many causes of abnormal bleeding. Your doctor can more easily detect the cause of bleeding 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 of them should definitely be checked. The cause of abnormal or excessive bleeding in some women may be hormonal. This condition may be related to the over or under production of certain hormones by the body. Sometimes it may occur due to problems in the thyroid gland (goiter) or the use of certain medications.
Other Causes of Abnormal Bleeding
Pregnancy
Miscarriages
Ectopic pregnancy
Problems related to birth control methods (birth control pill, spiral, etc.)
Uterus or womb Inflammations of the mouth
Myomas
Coagulation disorders
Polyps
Various types of cancers (Uterus, cervix, vagina -chamber )
Chronic medical problems (thyroidism, diabetes)
Diagnosis
The first thing to do for your doctor to diagnose abnormal bleeding is taking the patient's personal and family health history. For this:
Past or current illnesses
Medications used
Use of birth control pills
Body weight , eating and exercise habits, and stress level are questioned.
Your doctor will also ask about your menstrual cycle. For this, marking the menstrual onset and bleeding times on a calendar will help you. Following this, you will have a physical examination. A blood count and, if there is a pregnancy, blood tests will be performed to show these. Depending on your complaints and findings, one or more of the tests listed below may be needed.
Hormone levels
Endometrial biopsy: Taken after gentle scraping of the inside of the uterus with the help of a catheter. Evaluation of the part under the microscope.
Ultrasound: Evaluation of the pelvic organs through images created by sound waves. This device is used through the chamber or over the abdomen.
Sonohysterography (SIS): A small plastic catheter Ultrasonic evaluation performed vaginally after filling the uterus with sterile fluid by using
Hysteroscopy: Direct visual examination of the uterus by passing through the vagina and cervix with the help of a thin instrument similar to a telescope
Dilatation and curettage (D&C) ): It is the process of widening the opening in the cervix and taking a sample from the layer lining the uterus by scraping or vacuuming. Following this, the taken piece is examined under a microscope.
Hysterosalpingography - X-ray demonstration of the contrast material administered into the uterus and fallopian tubes
Laparoscopy: A thin incision is made into the abdomen through a thin incision just below the navel. looking inside the abdomen by inserting a telescope
While most of these tests can be done in the doctor's office, some may be performed in hospital conditions.
Treatment
Abnormal bleeding Treatment depends on many factors, such as the cause, the age of the patient, the severity of bleeding, and whether or not they want to have children. Hormone therapy or other drug treatments can be used, as well as surgery. The doctor can only evaluate the effectiveness of the treatment he prescribed after several menstrual periods. If you think you are pregnant, your doctor may need to repeat the necessary tests before starting any treatment.
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