Continuous vaginal bleeding
Introduction
Introduction Continuous vaginal bleeding that occurs in addition to normal menstruation. Vaginal bleeding refers to bleeding from any part of the genital tract. The form of bleeding can be divided into menstrual periods and prolonged menstruation. Irregular bleeding or contact bleeding, etc., the amount of bleeding can be more or less. The bleeding is called continuous vaginal bleeding. Irregular bleeding after menopause. Women of childbearing age who are more likely to have pregnancy-related diseases, such as abortion, ectopic pregnancy, hydatidiform mole, etc.; postmenopausal women have more likely to have malignant tumors.
Cause
Cause
Inflammation of the reproductive organs, pathological pregnancy, endocrine disorders, trauma, tumors, etc. The symptoms of vaginal bleeding can be roughly divided into the following types:
1. The amount of menstruation increases, the menstrual period is extended but the cycle is normal. More likely to be uterine fibroids, uterine adenomyosis, dysfunctional uterine bleeding, in addition to the upper ring can also increase the amount of menstruation.
2. Irregular vaginal bleeding during the menstrual cycle. Often for dysfunctional uterine bleeding, but should first exclude endometrial cancer.
3, long-term continuous vaginal bleeding. Mostly genital malignant tumors, such as cervical cancer, endometrial cancer.
4. Irregular bleeding after menopause. Women of childbearing age who are more likely to have pregnancy-related diseases, such as abortion, ectopic pregnancy, hydatidiform mole, etc.; postmenopausal women have more likely to have malignant tumors.
5. Bleeding after sexual intercourse. Mostly cervical erosion, cervical polyps, cervical cancer or submucosal fibroids.
6, vaginal bleeding with leucorrhea. More consideration for advanced cervical cancer, endometrial cancer with infection.
7, paroxysmal vaginal blood. There is a possibility of primary fallopian tube cancer.
8, menstrual bleeding. Occurred between two menstrual periods, lasting 3-4 days, when the amount of blood is very small, most of them are bleeding during ovulation.
9, bleeding before and after menstruation. A small amount of bloody secretions before or after menstruation, usually ovarian dysfunction, may also be endometriosis.
10, the amount of bleeding is not much, some people are only a small amount of brown secretions, usually last for half a day or 2 to 3 days, up to 7 days, may be accompanied by mild ovulation pain and backache. Western medicine is called ovulation bleeding, which is called "intermenstrual bleeding" by Chinese medicine. This is due to the transient decline in estrogen levels, which causes the endometrium to lose its hormonal support and partially shed, causing regular vaginal bleeding. If a person who is measuring basal body temperature can be found, this type of bleeding generally occurs during periods of low body temperature to high body temperature. If the symptoms are mild, it can be left untreated, but if the symptoms are obvious, it may affect the fertility and should be treated.
11, the menstrual cycle is irregular, excessive menstruation, menstrual extension or irregular bleeding. Functional uterine bleeding is referred to as dysfunctional uterine bleeding. The disease is very common in the clinic, mainly caused by abnormal neuroendocrine function regulating reproduction. The principle of treatment is rapid hemostasis. After hemostasis, the normal menstrual cycle is established to prevent recurrence. Due to long-term bleeding, some people are accompanied by Different degrees of anemia, so it is also important to correct anemia.
12, menstruation is delayed for 7 to 10 days before bleeding, do not think that this is definitely late menstruation, should pay attention to observe whether the amount, color, duration, etc. of bleeding is the same as normal menstruation, if there is more or less menstrual blood, dripping If you have abdominal pain, you should pay attention to whether there is the possibility of ectopic pregnancy or threatened abortion; if the bleeding is more than usual, the duration is long, the dysmenorrhea is obvious, and it is more common in uterine fibroids or endometriosis. Timely visits are necessary.
13. Some women may experience vaginal bleeding after taking unprotected sex life because of taking emergency contraception. The impact of emergency contraception on menstruation is mainly reflected in the menstrual cycle changes, may be early or delayed, especially repeated users may cause menstrual disorders, bleeding, dripping. Therefore, it can only be used as a remedy and cannot replace the normal method of contraception. It should also be reminded that some women may also have an impact on menstruation due to the abuse of some "health products" containing hormones, "augmented milk", "cream" and so on.
14, vaginal bleeding will stop after 3 to 7 days after the general flow or spontaneous abortion, very few people will be prolonged due to physical weakness, fatigue, etc., but this needs to be judged by the doctor. If there is no special situation, the vaginal bleeding time is prolonged. After excluding the intraoperative injury and cervical inflammation, it is likely that there is residue in the uterus. At that time, it is decided by the doctor to check whether it is medication or Qing Palace. Otherwise, after a while, the residual The membrane tissue may become chorionic epithelial cancer.
15. Women who have had hydatidiform moles have experienced repeated vaginal bleeding within two years of regular treatment. It may be an early symptom of malignant moles and should be treated immediately.
Non-menstrual bleeding is mostly pathological, and because many people cannot distinguish whether the bleeding is physiological or pathological, it is best to go to the hospital to consult a doctor for safety reasons, so as not to delay the early diagnosis and treatment.
Classification of causes:
Vaginal bleeding refers to bleeding from any part of the genital tract. The form of bleeding can be divided into menstrual periods and prolonged menstruation. Irregular bleeding or contact bleeding, etc., the amount of bleeding can be more or less. For different reasons, vaginal bleeding can be divided into the following categories:
Endocrine-related bleeding:
Neonatal vaginal bleeding, bleeding associated with birth control pills, dysfunctional uterine bleeding, intermenstrual bleeding, postmenopausal uterine bleeding.
Pregnancy-related bleeding:
Threatened abortion, incomplete abortion, ectopic pregnancy, placenta previa, placental abruption, hydatidiform mole, choriocarcinoma, etc.
Bleeding associated with inflammation:
1. Vulvar bleeding: seen in vulvar ulcers, urethra meat and so on.
2. vaginal bleeding: seen in vaginal ulcers, vaginitis, especially senile vaginitis, trichomonas vaginitis.
3. Cervical hemorrhage: seen in acute and chronic cervicitis, cervical erosion, cervical ulcer, cervical polyps and so on.
4. Uterine bleeding: seen in acute and chronic endometritis, chronic uterine myositis, acute and chronic pelvic inflammatory disease.
Tumor associated with tumors:
1. Irregular vaginal bleeding in young girls: seen in grape sarcoma.
2. Women with vaginal bleeding in middle-aged or older: more common in uterine fibroids.
3. Middle-age or postmenopausal women with contact or irregular bleeding in cervical cancer, endometrial cancer, functional tumors of the ovary.
Trauma associated with trauma:
1. The first sexual intercourse or sexual intercourse is too fast and too fierce, so that the vaginal wall is not fully expanded, and it is easy to cause the vaginal wall to tear. This situation is more common in girls who steal the forbidden fruit. In general, women's vagina is elastic, with many vertical and horizontal wrinkles, easy to expand, and will not tear. The vaginal development of the girl is still not perfect. The initial sexual intercourse is too tight, the muscles contract, and the force is more prone to tearing.
2. Older women have vaginal atrophy, reduced vaginal secretions, and tears during sexual intercourse.
3. Masturbation: Some women put their hands or other harder foreign objects into the vagina, causing the vagina to rupture.
4. Injury: During childbirth, the fetal head declines with the contraction of the uterus. If the labor process progresses too fast, the birth canal is not fully expanded, and the fetus is larger, and the vaginal wall tear is prone to occur.
5. Bleeding caused by trauma:
Because the vaginal wall is rich in blood vessels, bleeding can not only cause serious complications, but even life-threatening.
Bleeding associated with systemic diseases:
Found in liver disease, aplastic anemia, thrombocytopenic purpura leukemia and gynecological diseases with diffuse intravascular coagulation.
Vaginal bleeding during menstruation:
The amount of menstruation increased significantly, more than double or even more than usual, accompanied by large blood clots. When suddenly standing up, a large amount of menstrual blood poured out, and severe symptoms such as dizziness, vertigo, and weakness were observed.
Possible causes: bleeding from the birth control ring, uterine adenomyosis, ovulatory dysfunctional uterine bleeding.
Childbearing age vaginal bleeding:
Women of childbearing age vaginal bleeding during pregnancy.
Possible causes: abortion, ectopic pregnancy, hydatidiform mole.
Vaginal bleeding at the time of menopause:
Possible causes: anovulatory dysfunctional uterine bleeding, malignant tumors.
Drip bleeding before and after menstruation:
It lasts for a few days, causing the entire menstrual period to last for ten days or more.
Possible cause: Side effects of placing the birth control ring.
Examine
an examination
Related inspection
Vaginal secretions examination vaginal cytology examination electronic colposcopy
Continuous diagnosis of vaginal bleeding:
Pay attention to the general condition, whether there is anemia, bleeding tendency, lymphadenopathy and thyroid enlargement, etc. should carefully peep into the vagina and cervix, pay attention to the source of bleeding; double complication and triple repair check the size of the uterus, hardness is smooth, There is no cervix pain, no lumps and tenderness on both sides of the uterus for unmarried patients, generally only for anal examination, but highly suspected tumors should also be vaginal examination.
Diagnosis
Differential diagnosis
Symptoms of persistent vaginal bleeding that are confusing:
First, bleeding related to endocrine:
1. Neonatal vaginal bleeding.
2. Bleeding associated with contraceptives.
3. dysfunctional uterine bleeding.
4. Intermenstrual bleeding.
5. Postmenopausal uterine bleeding.
Second, pregnancy-related bleeding:
1. Abortion.
2. Ectopic pregnancy.
3. Hydatidiform mole.
Third, bleeding related to inflammation:
1. Childhood vaginitis.
2. Chronic cervicitis.
Fourth, tumor-related bleeding:
1. Grape sarcoma.
2. Endometrial cancer.
3. Cervical cancer.
4. Ovarian granulosa cell tumor and follicular cell tumor.
5. Uterine fibroids.
6. Choriocarcinoma.
V. Trauma associated with trauma:
1. Trauma.
2. Sexual bleeding.
Sixth, bleeding related to systemic diseases: pay attention to the general condition of anemia, bleeding tendency, lymphadenopathy and thyroid enlargement and other gynecological examination should carefully peep into the vagina and cervix, pay attention to the source of bleeding; double and triple repair Pay attention to the size and hardness of the uterus, whether there is pain in the cervix, whether there are any masses on both sides of the uterus and tenderness. For unmarried patients, generally only do anal examination, but it is highly suspected that a tumor may also be vaginally examined.
