Bleeding that occurs outside the normal menstrual cycle and affects the patient's quality of life. These bleedings are seen in non-pregnant patients in the form of menstrual bleeding longer than 7 days, irregular intermittent bleeding or bleeding during intercourse. In order to determine the treatment and follow-up method, we must first confirm whether the patient has a pregnancy status.
Normal menstruation:From this menarche (first menstruation) to menopause (last menstruation), women should have regular, certain It is a cycle that he sees at intervals. And it does not affect women's quality of life.
Symptoms of abnormal uterine bleeding :
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menstruation will change one or more pads, tampons every hour
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Heavy menstrual bleeding that affects normal daily life quality
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Lasts longer than seven days menstrual bleeding
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Menstrual bleeding contains blood clots larger than 3-4 cm
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Continuous pain or severe contraction in the lower abdomen during menstruation
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Being less than 21 days or longer than 35 days between two menstrual periods
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Interim bleeding between regular menstrual periods
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Fatigue, exhaustion or shortness of breath
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Inguinal pain and bleeding during intercourse
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Staining, vaginal bleeding seen in menopausal women
The causes of abnormal uterine bleeding are various and it must be determined. Because treatment options are applied for the cause in the treatment of patients.
Organic causes:
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Myoma
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Polyp
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Adenomyotic uterus
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Malignant diseases of the uterus
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Pathologies in genital organs other than uterus
Non-organic causes:
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Systemic diseases
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Patient's coagulation – that is, clot formation disorders
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The drug therapy used
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horm onal disorders
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Infections
Assessment and diagnosis:
Evaluation of abnormal uterine bleeding is made according to each patient's age, symptoms, marital status and child request;
Blood tests - pregnancy test, complete blood count, ferritin, thyroid function tests, prolactin, testosterone
Clinical evaluations – visual speculum examination, pap smear test, endometrial biopsy, pelvic ultrasound, saline infusion sonohysterography:, office hysteroscopy
Treatment :
The treatment modalities in abnormal uterine bleeding also vary according to the patient. First of all, if the patient is suitable, medical treatment is started. If necessary, hormonal intrauterine devices or subcutaneous implants can be preferred. Endometrial ablation techniques can also be applied in patients who do not respond to treatment.
If there is no improvement despite all treatments, or if the patient is not suitable for medical treatment from the beginning of the disease, surgery is decided. Surgery can also be performed with uterine protection or removal of the uterus in accordance with the patient. Open or closed (laparoscopic) surgical techniques are chosen according to the patient. At the same time, anomalies in the uterus can be corrected with hysteroscopy. If these bleedings are moderate and mild, drug treatment may be preferred.
Bleeding during premenopause and menopause can sometimes be a sign of cancer. Many times the first sign of cancer is abnormal uterine bleeding. Women over the age of 40 who encounter this situation should definitely consult a specialist.
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