1ST CITY CLINICAL HOSPITAL

Abnormal uterine bleeding is bleeding that differs from normal menstruation in duration, amount of blood loss and/or frequency. A normal menstrual cycle is considered to be a cycle lasting 24-38 days with menstrual bleeding from 4.0 to 8 days and total blood loss of 5-80 ml.

However, many women experience heavy bleeding during and between periods, which disrupts daily activities, interrupts sleep, and can lead to anemia, causing fatigue, shortness of breath, and palpitations.

Causes of abnormal uterine bleeding may include:

1. Endometrial polyps are growths of the inner lining of the uterus (endometrium).
2. Adenomyosis is a disease characterized by the growth of the internal functional layer of the uterus (endometrium) into the muscular layer of the uterus (myometrium).
3. Uterine fibroids are usually benign growths of smooth muscle and connective tissue of the uterus.
4. Malignant neoplasms of the female genital organs.
5. Blood clotting disorders.
6. Ovulatory dysfunction, which can lead to an imbalance in the hormones that control the menstrual cycle. In a normal menstrual cycle, the balance between hormones regulates the growth of the uterine lining (endometrium), which is shed during menstruation. When hormonal imbalance occurs, the endometrium develops in excess and is eventually lost through heavy menstrual bleeding.
7. Intrauterine devices (IUDs): Uterine bleeding can be a side effect of using an intrauterine device.
8. Some medications (anti-inflammatory drugs, hormonal drugs, anticoagulants) may contribute to heavy or prolonged menstrual bleeding.
9. Other medical conditions, including pelvic inflammatory disease, thyroid problems, adrenal, liver, or kidney disease.

You can suspect abnormal uterine bleeding if:

1. Bleeding so much that it soaks the pad or tampon every hour for hours on end.
2. Bleeding that requires the use of a pad and tampon at the same time.
3. Nighttime bleeding that requires you to get up and change your pad and/or tampon.
4. Bleeding lasting more than 8 days.
5. The appearance of large blood clots.
6. Limitation of daily activities due to heavy menstrual bleeding.
7. Fatigue.
8. Rapid breathing, shortness of breath.

Diagnosis begins with a thorough examination by the doctor of the history of the disease, and a general physical and special gynecological examination is performed.

To clarify the diagnosis, the doctor may additionally prescribe a blood test (complete blood count, coagulogram, determination of von Willebrand factor antigen, factor VIII, determination of the level of thyroid-stimulating hormone, ferritin, iron in serum, hormone levels, tumor markers, etc.), urine, vaginal smears and cervix, PAP test, etc. To visualize the existing pathology of the pelvic organs, ultrasound and hysteroscopy can be used.

Treatment

The principles of treatment depend on many factors: on the general state of health, on the causes and severity of bleeding, on age and plans for future childbearing. Treatment can be conservative (use of medications - hormonal, hemostatic, uterine contraction, antianemic, etc.) and surgical (separate diagnostic curettage of the cervical canal and uterine cavity, hysteroscopy, ablation or resection of the endometrium, removal of the uterus).

You should seek medical help if:

1. The bleeding is so severe that it soaks through at least one pad or tampon within two hours.
2. Bleeding lasting more than 8 days.
3. Bleeding between periods or irregular vaginal bleeding.
4. Any vaginal bleeding after menopause.