Why do spotting appear in the middle of the cycle? Discharge is red, but not monthly: causes Spotting for more than 10 days
22.10.2017 Smirnova Olga (gynecologist, GSMU, 2010)
The entire reproductive age of a woman is accompanied by various vaginal discharges associated with both the physiological state of the body and the presence of gynecological pathologies. Often, representatives of the weaker sex observe spotting in themselves at different periods of the menstrual cycle, but most of all they are interested in the question of what a similar symptom means in its middle. We will talk about this in this article.
Types of spotting
In order to understand the causes of the phenomenon, one should understand what kind of spotting it is in the middle of the cycle. These are called scanty mucous bloody discharge from the vagina.
The basis of such secretions contains a mucous secretion produced by the glands of the female genital organs. For various reasons, a certain amount of blood enters it, which, when released, mixes with mucus and oxygen, acquiring a certain shade. It all depends on where exactly the blood has coagulated, what is its composition, the content of the mucous secretion, and the characteristics of the body.
Such mucus is produced in moderation and has such a consistency that when it comes into contact with panty liners or underwear, it quickly spreads and absorbs, creating the effect of unevenly smeared spots. You can see their photos below.
They occur at the end of the follicular, throughout the ovulatory and early luteal phases of the menstrual cycle. It can be thick white, cream, liquid pink, dark brown, brown,. Normally, there are few of them, they are odorless and are not accompanied by unpleasant sensations.
Creamy, yellow curdled, bloody, copious, dark, watery, foul-smelling discharge, accompanied by pain in the lower abdomen, itching, weakness, and other uncomfortable symptoms, speak of the pathological etymology of such spotting.
Learn what the nature of the discharge should be by clicking on the link.
Common Physiological Causes of Spotting
Before menstruation and at the end of menstruation, the symptom has a logical explanation. But what does it mean and what are the causes of spotting in the middle of the cycle? Allocations can be physiological and pathological in nature. Consider the reasons for the first.
Ovulation
The most common cause, accounting for 80% of spotting cases, is the ovulatory period. It occurs approximately in the middle of the menstrual cycle. Its duration is up to 3 days. Ovulation itself means the release of a mature egg from the follicle by rupture, in which about 10 ml of follicular fluid comes out of it. When ruptured, small vessels are injured, which is indicated by a small amount of blood. At this time, under the influence of hormones, they come out.
Mucous discharge in the middle of the cycle is slightly sticky and viscous, like snot, bloody, transparent with a streak of blood, or in the form of a brown or pink daub. Closer to the equator of the cycle and after ovulation, smearing whitish, yellowish and even of a homogeneous consistency are considered normal, which do not overlap with discomfort, pain and do not stink. Severe vaginal leucorrhea is a sign of an infectious disease.
Fertilization
In the middle of the cycle, bloody discharge with mucus or spotting can mean a successful conception. A fertilized egg is introduced into the inner mucous layer of the uterus, the endometrium, and a violation of its integrity leads to minor blood loss. As it leaves the uterus and passes through the vagina, the blood coagulates and mixes with oxygen and the accompanying secretion, and at the exit becomes brownish in color. This explains the appearance of moderate brown discharge on the 10th day of the cycle or in its middle. At this moment, a sharp hormonal restructuring begins, under the influence of which moderate blood smearing also occurs in the first week of pregnancy.
If you notice spotting in the middle of the cycle, and then there was a delay in menstruation, then most likely a pregnancy test will show a positive result.
This symptom is acceptable only in the early stages. In the future, this is a sign of a pathology that threatens miscarriage or premature birth.
Taking hormonal drugs
The body reacts in a similar way to the intake of OK. In the first three months of using these contraceptives, dark discharge is often traced due to changes in hormonal levels. These medicines include: Duphaston, Jess, Yarina. Often, similar drugs are used in premenopause in order to restore the menstrual cycle and eliminate the anticlimacteric syndrome.
Find out how the cycle changes for yourself in our article at the link.
Hormone therapy is also prescribed for endocrinological diseases, during menopause, as emergency contraception. Menstrual, Escapela or Ginepristone is undergoing changes - a pink, bloody daub accompanies the use of these drugs.
Cancellation of hormonal pills in most situations is manifested by spotting, up to the beginning of the next menstruation.
Installation of an intrauterine device
Spotting is often observed after the introduction of this contraceptive. So the first time the reproductive system reacts to the presence of a foreign body.
Mucosal injury
Spotting after sex makes itself felt at any moment of the cycle, but since the concentration of estrogen reaches a maximum in its middle, the walls of the vagina are especially sensitive, which increases the risk of injury to small blood vessels, and the amount of secretion increases. Therefore, mechanical damage is indicated by a pink daub without itching, burning and unpleasant odor. This is acceptable if bleeding for a short time.
Often indicated poorly, sports training, physical activity and even stress.
Allergic reaction
The manifestation of allergies to medications, intimate hygiene products, lubricants, contraceptives, synthetic underwear is sometimes accompanied by moderate bleeding. Sometimes there is itching and burning, which is similar in symptoms to an infectious disease. The difference from it will be the absence of an unpleasant smell of rotten meat, fish, onions, cottage cheese, and the symptoms will disappear after the irritant is eliminated.
After childbirth
The occurrence of such secretions is permissible during the year if a woman is breastfeeding a child. Thus, the gradual formation of the menstrual cycle is indicated, which is a variant of the norm.
Spotting discharge in pathology
Pathological daub in the middle of the cycle is accompanied by certain symptoms. It can be yellow with a heterogeneous consistency, liquid leucorrhoea, spotting, which develops into heavy bleeding. They are supplemented by: a specific smell, burning and vaginal itching, pain in the lower abdomen, radiating to the lower back in the side, fever, nausea, and in advanced cases, vomiting. Such discharges can be conditionally divided into two groups depending on the reason for their appearance.
The first group - caused by pathology of the uterus
- Erosion of the uterine neck is an inflammatory process of tissues, the main symptom of which is periodic bleeding, from spotting to heavy. They are often indicated after sexual contact and between periods. Many pathologies are asymptomatic. Erosive tissue destruction increases the risk of infection. The therapy uses medicines, laser, radio waves, cryodestruction, diathermocoagulation, chemical coagulation, electroexcision. Small affected areas are most often left untreated, periodically monitoring them.
- Endometriosis is a pathological benign process of tissue growth outside the uterine mucosa. It is manifested by both spotting and heavy bleeding, prolonged critical days at the beginning, middle, end of the cycle, pain in the lower abdomen, shifts in menstruation, painful intercourse. Eliminated by electrotherapy, laser, ultrasound, surgical curettage, combined treatment with the use of medications.
- Endometritis is an inflammation of the surface layer of the endometrium. Smearing brown, pink, including in the middle of the cycle, is the main designation of pathology. She is characterized by fever, pulling pain in the lower part of the peritoneum, radiating to the side, painful sexual contact. For treatment, anti-inflammatory and antibacterial tablets, or broad-spectrum antibiotics are prescribed.
- Polyps, neoplasms of various etymologies are characterized (in the first half of the cycle). Like any pathological changes in the uterine tissues, they lead to periodic severe bleeding. These symptoms are accompanied by pain, general weakness, nausea. Treatment occurs depending on the etymology and stage of the disease.
- During pregnancy, brown spotting, along with pain and spasms, indicate fetal fading, a threatened miscarriage, and an ectopic pregnancy. If a sign is detected, you should immediately consult a doctor to remove a dead embryo in order to avoid infection of adjacent tissues. Sometimes the fetus can be saved with blood leakage. An ectopic pregnancy must be removed urgently, as it threatens to rupture the fallopian tube.
The second group - provoked by inflammatory processes, urological and infectious diseases
Inflammatory processes in the genitourinary system occur for a number of reasons: complication after suffering colds, hypothermia, weakened immunity, infection, overgrowth of opportunistic bacteria, and improper hygiene.
The appearance of abundant whites, gray, purulent discharge with itching in the vagina, the unpleasant smell of rotten meat, fish, onions and other stench characterizes bacterial vaginosis. The disease refers to inflammation and is transmitted both sexually and develops against the background of the growth of opportunistic bacteria living in the microflora. Similar symptoms, supplemented by a curdled composition of whites and a sour-milk smell, indicate candidiasis. Such diseases are mainly amenable to local treatment with suppositories and douches.
Infectious diseases, in particular, sexually transmitted ones, are indicated by secretions of yellow, green, purulent nature, they stink and appear at any time both in a smearing manner and in abundant mucus secretion. They can be liquid, stretch like snot,. With such ailments, the vagina itches, there is a burning sensation and pain during urination, and the external genital organs become inflamed. Such diseases are treated with antibiotics in combination with anti-inflammatory and other drugs.
Briefly about the main
Our little research has shown that the topic of mid-cycle spotting is discussed quite frequently in forum and blog reviews.
The scanty spotting described by women, which has a smearing character, without foreign smell and accompanying symptoms, is normal. But there are also pathological signs that require medical attention.
There is no need to be afraid of visiting a doctor, since statistics show that in 68% of cases the symptom described has a physiological etymology, 40% of them are associated with hormonal changes, and 32% of the total number of women who applied fall for signs of a pathological nature. Therefore, it can be argued that with a higher probability, the symptom you found is not caused by the disease. A slightly higher percentage of the likelihood of a hormonal shift, but if you are approaching the age of 45, this process is natural due to the approaching menopause. At a young age, such a violation is extremely rare.
Blood discharge that came after menstruation - is this the norm or a reason to think about the presence of pathology? Often women are faced with the problem of a variety of secretions, including blood. What can blood "smearing" tell about a woman's health?
The main thing in the article
What does bleeding after menstruation mean?
Most women at least once, but saw bloody secretion on linen after menstruation. Reactions to this fact vary. Some start to panic, others accept it as normal. But it should be noted that the secretions can be different and to determine whether they appeared due to a pathological process or just the body gave a slight failure, the woman herself can, having studied the secreted secretion.
- Its pink color, accompanied by an unnatural rotten smell, indicates chronic endometritis or chronic endocervicitis.
- Scarlet discharge indicates mild pelvic dysfunction and are considered normal, but subject to the lack of regularity of their occurrence.
- Brown spotting secretion — this is a clear sign of a pathological process in the uterine cavity.
Despite the color, with constantly present abundant discharge in the postmenstrual period, a trip to the doctor is necessary. Because you may be bleeding.
The main causes of bleeding after menstruation
Bleeding of varying intensity can begin due to a number of specific reasons. Consider the external and internal factors that cause unnatural secretion after the end of menstruation.
TO external relate:
- Injuries. They can be obtained both mechanically upon impact, and naturally during sexual contact.
- Stress and bad habits. Overwork and stressful situations can cause discharge. Regular alcohol consumption quite often leads to disorder and instability of hormone production.
Internal factors causing bleeding, much more and these include:
- . In medicine, it is called poiomenorrhea. Under such circumstances, the next menstruation is observed after 14-18 days. The culprit for such a short break is an insufficient amount of estrogen produced.
- endometriosis- an inflammatory pathology that has "in its arsenal" such a symptom as the release of bloody secretion.
- venereal sexual infections can progress in a latent form, manifesting itself only with secretions that appear six months to a year after infection.
- hyperplasia of the endometrium. One of the pathologies in which postmenstrual bleeding develops. Such a violation provokes copious discharge, accompanied by the release of blood clots.
- Myoma- accompanied by cramping pain in the lower abdomen, while there are discharges with blood after menstruation has passed.
- In a certain percentage of women, scant bleeding during ovulation is considered a feature of the body. This is due to hormonal imbalance, but after the ovulation period, this secretion disappears.
Blood discharge can also be observed if there is a spiral or a woman takes
What to do if there is bleeding after menstruation?
For any prolonged unnatural discharge, you should immediately seek help from a doctor.
You need to be wary if, in addition to an unpleasantly smelling bloody secretion, a woman feels severe pain. Self-medication is inappropriate here as it may worsen the patient's condition. Therefore, refuse to use traditional medicine, undergo the necessary examination and, after the appointment, follow all the doctor's instructions.
Therapy of bleeding after menstruation directly depends on the root cause that provokes the appearance of bloody secretion.
- In the presence of infectious pathology prescribe antibiotics, both local and systemic. Anti-inflammatory drugs are also used as adjuvants.
- In addition to eliminating the root cause, hemostatic medications are prescribed and restorative therapy.
- At diagnosis endometriosis, fibroids or polyps resort to surgical treatment.
- A endocrine abnormalities amenable to hormonal therapy.
Why is there bleeding for a week after menstruation?
A common problem in which there is pain and spotting is endometriosis. Their volume and frequency directly depend on the severity of the development and localization of the pathology. For example, if the focus of endometriosis is located on the cervix, then the discharge is insignificant. And with adenomyosis, dark spotting can disturb a woman 5-7 days after menstruation, either appearing or disappearing. Also, the secretion may have a mucous structure with bloody streaks.
Bleeding one day after period
All representatives of the beautiful half of humanity from the time of their first menstruation are well aware of their menstrual cycle. But it so happens that with a duration of monthly discharge of 4 days, bloody secretion appears on the 6th day. There are several explanations for this fact:
- The uterus continues to clear from menstruation. In this case, one-time discharge is no different from menstrual secretion. They appear 2-5 times for 12-14 annual menstrual cycles and are the norm.
- Taking hormonal birth control may provoke blood spotting in the postmenstrual period in the first 3-6 months of taking them.
Bleeding after menstruation 2-3 days later
If bloody secretion is not accompanied by physical malaise or pain, then a possible cause of such disorders:
- hormonal disbalance;
- a decrease in blood clotting, which leads to a longer cleansing of the uterus from the endometrium.
If the bloody secretion disappears after 2-3 days, then there is nothing to worry about. For longer visits, a trip to the doctor is essential.
Quite often, the cause of bloody secretion, when menstruation has already passed, becomes ectopic pregnancy. If it is present, the intensity and volume of menstrual flow decreases, and after they stop with a break of 3–7 days, blood secretion occurs, sometimes blood clots are present in it. If this symptom is present along with pain in the lower abdomen, then you need to visit the hospital.
Bleeding after menstruation in a week
The egg matures 7–10 days after menstruation (ovulation) and is released by rupture of the follicle walls to move into the uterus. Accompanied by the release of minor discomfort and pain. The remains of the tissues of the follicle come out along with other mucous secretions.
Erosion and endocervicitis can provoke discharge with blood after menstruation for 7-10 days. In cases where the secretion is very dark and is stable, then we can talk about bleeding. In such situations, medical attention is urgently needed.
Bleeding 2 weeks after period
Depending on the individual duration of the menstrual cycle, a certain percentage of women experience pain of varying intensity in the lower abdomen, accompanied by blood secretion, on the 12-16th day after menstruation. This may indicate the presence ovulation. Distinguishing such discharge from bleeding is quite simple. They are pink in color because scanty drops of blood come out with other clear vaginal secretions. The discharge caused by ovulation ends on the same day, occasionally the next.
If blood secretion occurs after 14–18 days, then this may be due to fertilization of the egg. In medicine, there is a term for such secretion - implantation bleeding. This happens due to the fact that a fertilized egg (fetal egg) is attached to one of the walls of the uterus, damaging its upper layer.
Bloody discharge after menstruation after sex
Become The cause of bleeding after sex can be:
- cyst rupture;
- previous injury;
- violent sex;
- cervicitis;
- vaginitis;
- polyps.
Another common problem of spotting after sex is the presence of ectopia. This pathology is characterized by the presence of bloody secretion after any contact with the vagina.
Uterine bleeding after menstruation
Uterine bleeding- one of the unsafe conditions in which medical attention is needed. But it should be noted that after 17 days of the menstrual cycle, slight scanty bleeding can be explained by pregnancy, since the fertilized egg (corpus luteum) is attached to the uterus.
Recently, dysfunctional uterine bleeding has been increasingly diagnosed in individuals from 40 to 50 years old. They are painless, and appear due to jumps in estrogen levels in an aging body. Many factors can provoke such disorders (nervous strain, taking certain drugs, strong physical exertion, etc.).
Heavy bleeding after menstruation
Copious discharge- this is when the pad can fill up completely within an hour, provided that the period of menstruation has already passed. Accompanied by profuse bleeding:
- general weakness;
- fast fatigue;
- dizziness;
- pallor of the skin;
- decrease in pressure and body temperature.
Regardless of the reasons that caused heavy bleeding, a trip to the doctor should not be postponed, since even a slight delay can provoke a violation of normal hemodynamics and lead to complications.
Small bleeding after period
Fluctuation and instability of hormonal background can provoke a small discharge with blood. They often appear when ovulation. They also pass quickly enough and usually do not disturb a woman for more than 72 hours. If a slight bleeding "delayed" and lasts more than 3-4 days, then you should see a doctor.
Bloody discharge in clots after menstruation
Blood clots appear in the secretions due to the fact that there is a kind of septum in the uterus, which narrows the lumen of the cervix and prevents the complete exit of blood, accumulating its remnants inside. If such accumulations (clots) do not come out completely, then there is a risk of developing a genital infection.
Often, such partitions appear as a result of abortions or are an innate feature of a woman. It can also provoke the appearance of clots during the release of blood secretion. spiral, which acts as such an artificial partition.
Spotting bleeding after menstruation
Hormonal imbalance very often causes spotting secretion after menstruation. But if, in addition to bloody daub, the following deviations appear:
- aching and pulling pains;
- temperature;
- itching and burning in the perineal area;
- feeling uncomfortable during sex;
- have pain when urinating
here we should talk about the presence of pathology. Which? The diagnosis will be made by the doctor after reviewing the tests, since spotting bleeding may well be the result of both a sexual infection, cystitis, and be a symptom of gynecological pathology.
Mucous discharge with blood streaks after menstruation
Mucus secretion is more abundantly produced if there are cysts or present. In inflammatory processes or exacerbations of the disease, blood streaks can be detected in the mucus.
They have the same symptoms polyps of the cervical canal and ectopia. If they are present, sex, physical activity, laying a tampon, treatment with candles can provoke the presence of blood in the mucous secretion. In other words, the presence of blood is explained microtraumatization of growths .
Brown spotting after period
Blood clotting after menstruation increases, so there may be a thicker discharge of a dark, almost brown color. If they are not too abundant and they do not have an unpleasant odor, then they can be considered a physiological norm. If an odor is detected or if there are a large number of them, the woman should take a swab for the presence of:
- cytomegalovirus;
- chlamydia;
- herpes;
- gardnerell;
- mycoplasmosis.
With the progression of endometriosis, adenomyosis can develop, in which endometrial damage affects all layers of the uterus. Therefore, it is so important, having found brown discharge not for the first time, to consult a gynecologist.
Bleeding after missed period
If there is a fact of a delay in a regular cycle, and blood secretion appears regularly, then this is a reason to visit a doctor. Since it is likely the presence of an ectopic or missed pregnancy. Such facts cannot be left to chance, because:
- ectopic pregnancy can lead to rupture of the fallopian tube, which will provoke severe blood loss and even death;
- frozen pregnancy, with it, an inflammatory-purulent process develops in the uterine cavity, which can lead to irreversible consequences.
How to distinguish bleeding from menstruation after childbirth?
After childbirth, the female body recovers for a rather long period. The first months, and for some up to a year, there are no periods. Therefore, the first spotting can alert a young mother. Consider the difference between menstruation and possible bleeding.
For monthly characteristic is: 
As for bleeding, then there are other symptoms: 
Now, after analyzing her condition, the young mother will be able to determine whether menstruation has come, or spotting - this is a reason to see a doctor.
Bloody discharge in the middle of the cycle is the reason for contacting a gynecologist. Since in the intermenstrual period only mild mucous discharge from the vagina is allowed, protecting the internal genital organs from the penetration of pathogenic microorganisms.
Having studied more than one medical forum, we noticed that most women face this problem. Therefore, in this topic, we want to tell you why there are bleeding in the middle of the cycle, when they are considered normal, and when they are an alarm and should not be ignored.
Intermenstrual spotting: norm or pathology
Scanty brown or dark red spotting in the intermenstrual phase can appear in practically healthy women. When does it happen? Let's consider situations.
- 3-4 days before the onset of menstruation, a woman may experience spotting spotting, which is a sign of approaching menstruation.
- The first 1-2 days after the critical days, small bloody discharge may also be present, as the uterus gets rid of the remaining menstrual blood.
- In women taking oral hormonal contraceptives, on the 14th-15th day of the cycle, slight brown discharge may occur.
- After sex, if a woman has not had an intimate relationship for a long time and the Bartholin glands have not secreted enough mucus, a little blood may be released due to microtraumas of the mucous epithelium of the vagina.
- After the first sexual intercourse, with a rupture of the hymen, the girl may have spotting for some time after intimacy.
In all other cases, the appearance of blood between menstruation is considered a pathology. A symptom of the disease may be a combination of spotting with pain in the lower abdomen, fever, itching in the vagina, soreness during and after sex.
You should also visit a specialist if you are constantly bothered by brown, dark or bloody discharge after sex.
In premenopause, liquid brown spotting bothers women due to hormonal imbalances, which is a natural aging process in the female body. Such bleeding most often occurs against the background of a failure in the timing of ovulation, as a result of which the cycle changes. Most often, bleeding occurs in women after a long delay in menstruation, and can be repeated for several weeks.
In addition to the above, brown or bloody discharge in women who have been in menopause for more than a year may indicate pathology.
The appearance of intermenstrual metrorrhagia (bleeding) is due to both physiological and pathological causes.
The norm is light spotting between periods, without inflammatory symptoms (unpleasant smell, itching, pain in the abdomen, lower back).
Physiological factors include the following:
- an increase in the level of lutein-stimulating hormone (LH) and estrogen, which are responsible for the release of the egg from the ovary. Therefore, discharge of a bloody nature may be a sign of the readiness of the egg for "reproduction";
- too active sexual pleasures, inappropriate posture during intercourse, or too large sexual organ of the partner, as a result of which the cervix and vaginal mucosa are injured. If such discharge is constantly observed after sex, it is necessary to consult a gynecologist, since sometimes this is the first and only manifestation of such pathologies as cervical cancer, vaginal neoplasms, and;
- brown or spotting in the middle of the cycle is a sign of pregnancy. During the attachment of a fertilized egg to the endometrium, some women release a small amount of bloody fluid. Metrorrhagia at other gestation periods is an alarming signal and requires immediate medical attention, as it can be the first sign of miscarriage, premature birth, placental abruption, etc.
Normally, such secretions become noticeable only during washing or other hygiene procedures, that is, they should not smear underwear.
If there is too much intermenstrual discharge of any nature, it is necessary to consult a gynecologist for a comprehensive examination of the body, as this may be the first sign of many diseases of the genitals and not only organs.
Also, the appearance of discharge in the intermenstrual period often indicates the presence of diseases. Let's consider them.
- Inflammation of the endometrium. This pathology is characterized by inflammation of the inner layer of the uterus, which develops due to the penetration of pathogenic microorganisms into the uterus. Infection of the endometrium can occur during medical manipulations on the uterus (curettage, vacuum extraction of the ovum, probing of the uterine cavity, etc.), if they were performed without observing sanitary and epidemiological standards. In addition, endometritis may appear after childbirth. The discharge can be both bloody and purulent in nature with a fetid odor or be with mucus. Also, the patient is concerned about fever, pain in the lower abdomen, general weakness, chills, excessive sweating.
- endometrial polyps. The emergence of polyps is promoted by curettage of the uterine cavity, caesarean section.
- Incorrectly selected doses of hormonal contraceptives. An inadequate dose of hormonal contraceptives can cause hormonal failure in the body, and this, in turn, metrorrhagia.
- Infectious processes in the vagina and cervix. The presence of inflammation inside the vagina and cervix can become an obstacle to the release of menstrual blood, which will continue to flow even during the menstrual period.
- Hormonal disbalance. The menstrual cycle is regulated by sex hormones. Each phase of the cycle is characterized by its own hormone, therefore, with a hormonal failure, menstruation can occur even in the middle of the cycle.
- Endometriosis. This disease is characterized by the appearance of foci of the endometrium in places where it should not be - the cervix, vaginal walls, external genitalia, etc.
- Means of intrauterine contraception (spirals). This contraceptive increases the risk of inflammation of the endometrium, and, accordingly, the appearance of bleeding in the intermenstrual period.
- Benign and malignant neoplasms of the uterine wall(myomas and fibromyomas of the uterus, cancer of the uterus and its cervix).
- Psycho-emotional shock. Severe stress can reflect on the hormonal background of a woman, causing it to fail. In addition, stress can exacerbate chronic diseases of the reproductive system, which will become a provoking factor in intermenstrual bleeding.
Regular examinations by a gynecologist are an effective measure for the prevention of diseases of the female genital organs. Every healthy woman should visit this specialist twice a year.
With regular and prolonged intermenstrual bleeding, the gynecologist will definitely prescribe a series of studies that will help determine the cause of the menstrual cycle.
In the diagnosis of menstrual disorders, the following methods can be used:
- gynecological examination of the vagina and cervix using mirrors;
- colposcopy - examination of the cervix using a special device - a colposcope;
- vaginal smear for microflora;
- smear from the cervix for cytological examination;
- general clinical blood test;
- blood test for sex hormonal panel;
- a blood test for the Wasserman reaction (detection of antibodies to the causative agent of syphilis);
- tissue sampling for histological examination;
- ultrasound examination of the pelvic organs, including transvaginal or transrectal;
- blood test for HIV;
- diagnostic curettage of the uterine cavity with further histological analysis of the material, and others.
Thus, only an experienced specialist, a gynecologist, can correctly determine the cause of intermenstrual bleeding. In this case, we do not recommend engaging in self-diagnosis and self-treatment, since such amateur activity can lead to irreversible health consequences. After all, the choice of treatment method directly depends on the causative factor.
Recall once again that every healthy woman should visit a gynecologist for a preventive examination every six months.
Often, brown, bloody or other discharge that suddenly appears 10 days after menstruation frightens a woman. However, when faced with this, you should not immediately panic. They do not always indicate problems, diseases and do not require medical intervention.
The discharge can be with or without an unpleasant odor. They differ in texture and color. According to the first feature, they are divided into foamy, curd or jelly-like. By shade:
- brown;
- red;
- pink;
- greenish;
- whitish, etc.
They are spotting or plentiful
In the period close to ovulation, the appearance of stretching, transparent, egg-like mucus is normal. As long as it is fresh, there should be no smell. It appears as a result of the multiplication of bacteria. Unpleasant "aroma", itching, burning, unnatural - these are symptoms that indicate the need to see a doctor.
Main reasons
Bleeding and other similar manifestations after the end of menstruation are not uncommon. One of the common reasons is the jumps in the level of estrogen in the blood, especially during the period of ovulation. To eliminate the problem, the doctor prescribes special hormonal drugs. There are frequent cases when smearing dark or light brown discharge is one of the body's reactions to stress.
Minor bleeding after a few days after menstruation is possible due to the use of a new hormonal contraceptive. This is natural, while the female body adapts to it. However, if the situation does not change within a few months, then you should consult a gynecologist. Another possible cause is internal trauma to the genitals as a result of:
- inept examination of the doctor;
- excessively "hard" sex, etc.
Most often, the mucous membranes are injured due to a lack of estrogens during lactation, menopause. In this case, the color of the discharge is predominantly bloody, bright red, although it can also be brown, and if sexual rest is observed for several days, they end.
If new bloody periods began during the second week or a little earlier, and at the same time the woman feels unwell, she has dizziness, lower blood pressure, pain in the lower abdomen, then an ectopic pregnancy may be the cause of these symptoms. Only a gynecologist is able to accurately diagnose the development of an embryo not in the uterus. And you should contact him as soon as possible.
Caution, possible illness
Bloody, brown or other discharge that appears 7-16 days after menstruation is often a signal of the presence of inflammatory processes and various diseases. Fungal, bacterial infections cause inflammation of the uterine lining - endometritis. They are transmitted sexually, may occur after diagnostic curettage, abortion, and other similar interventions. Among the local symptoms most often noted:
Pain when pressed in the uterus;
purulent, brown discharge a week or more after menstruation.
However, it should be remembered that the disease can be asymptomatic.
With a deficiency of thyroid hormones, the thyroid gland develops hypothyroidism. In women, one of its manifestations is menstrual irregularities. Toward the end of 2 weeks after the end of menstruation, new spotting or brown discharge may begin.
Another pathology associated with the unexpected appearance of blood stains on underwear during this period is endometriosis. It is associated with the growth of uterine tissue in other organs. The exact causes of the disease have not been established, some of them are hereditary predisposition and disorders in the immune system. For many women, the most unpleasant consequence is infertility.
As a result of hormonal imbalance, benign tumors - uterine fibroids - can form.
They appear:
- heavy menstruation;
- feeling of compression of the pelvic organs;
- brown, bloody discharge after the end of menstruation.
Most often they are found in women 25-35 years old, for the most part they do not require operable intervention, with the exception of cases of fibroids on the "leg" or with a significant size of the tumor.
What to do
If unscheduled brown, bloody or other discharge is accompanied by discomfort, pain or smell, then you need to see a gynecologist. It is better to do this immediately after their completion. With prolonged manifestations, a visit to the doctor is allowed and at any time. Based on the results of the initial examination, the doctor, if necessary, prescribes tests, possibly ultrasound. At the next visit, a course of treatment is signed.
Today, failures of menstruation are not uncommon. The appearance of brown, bloody spots on the pad after 1.5-2 weeks after the end of menstruation may indicate damage to the internal membranes of the genital organs, hormonal disruptions, or the development of serious diseases. Therefore, if you have any concerns, it is better to consult a doctor.
Thank you
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
Many women consider any discharge from the genitals a sign of some kind of disease, and seek to get rid of them. This is a fundamental misconception. Vaginal discharge just as physiological as the secretion of the salivary and lacrimal glands, gastric juice, etc. Trying to get rid of all these secretions is not only pointless, but also unsafe. In some cases, this also applies to spotting. But their appearance occupies a special place in gynecology- the admixture of blood in the vaginal secretion often serves as a sign of various pathologies. Let's try to understand in more detail what spotting means, and in what cases, when they appear, you need to see a doctor.Bloody discharge in girls
Secretion from the genital organs is characteristic of the female body at almost any age, with the exception of the period from birth to 9-11 years. Before puberty, girls should not have vaginal discharge. This is due to the structure of the genital organs and the peculiarities of the hormonal profile in this age period. The menstrual function is still absent, the eggs do not mature, the production of female sex hormones is very low, and their effect on the girl's body is minimal. This is the so-called period of physiological rest.Therefore, the appearance of a vaginal secretion in a girl up to 10-12 years old, and even more so bloody discharge in a newborn, clearly indicates the presence of problems. This may be pathologically early puberty, an infectious lesion, or even a disease of the digestive or urinary tract, which are located nearby.
In any case, the appearance of spotting before puberty is a reason for seeking advice from a pediatric gynecologist.
Bloody discharge in girls
Spotting during this period is called juvenile, or puberty.Most often, these are uterine bleeding, which are a violation of the menstrual cycle in girls aged 12-18 years. They are also often called dysfunctional - associated with violations of the hormonal function of the ovaries.
Clinical signs
Most often, spotting in girls appears after a delay in the next menstruation for several weeks. They usually last more than a week. In some cases, such juvenile bleeding can be observed for several months, periodically weakening, then intensifying. With such prolonged bleeding, the patient's condition can be quite severe. Intense and prolonged spotting can lead to the development of anemia. This condition requires urgent medical attention.
Treatment of bleeding in girls
Adequate therapy of juvenile bleeding is necessary in order to avoid such severe complications as hemorrhagic shock or anemia.
With a timely visit to the gynecologist and the beginning of treatment, in most cases, spotting disappears, and the menstrual cycle returns to normal. But if bleeding during adolescence remains untreated, then it can turn into bleeding of reproductive age, which can cause infertility and the development of diseases already in an adult woman.
Bloody discharge in women of reproductive age
When can they normally meet?
As a rule, such discharges appear in women about a few days before the onset of menstruation, and gradually develop into more heavy menstrual bleeding. In addition, they can continue for several days after the end of menstruation. Most often, this phenomenon is observed in women who are protected with an intrauterine device. In such cases, if the discharge is not very abundant, then they are considered a physiological norm, and no special treatment is required.Bloody discharge from the vagina as a sign of pathology
An important factor in determining the danger when such secretions appear is their amount and relationship with the woman's menstrual cycle.Profuse bleeding
If a woman has abundant spotting that is not related to the physiological menstrual cycle, this is a sign of a serious pathology. Such a patient should be examined by a gynecologist as soon as possible. This symptom is potentially life-threatening for a woman, and the loss of time can result in serious consequences for women's health.
Brown spotting, and in some cases even black, is a consequence of the destruction of blood cells in the uterine cavity. It is necessary to determine the cause of bleeding as soon as possible.
Scanty and spotting
If spotting, not associated with the menstrual cycle, is scarce, then they may indicate the following pathologies:
- menstrual irregularities;
- the presence of endometriosis;
- erosion of the cervix in severe form;
- cervical cancer;
- infectious lesions (with systematic spotting spotting, associated or not associated with the days of the menstrual cycle, and having a fetid odor).
The relationship of bleeding with the menstrual cycle
Bleeding before and after mensesBloody discharge after menstruation and before them is a fairly common occurrence. In her life, almost every woman at least once noticed unexpected vaginal bleeding.
It should be remembered that scarlet spotting, which gradually becomes more and more abundant, is considered the norm on the first day of menstruation.
Brown dark spotting before menstruation indicates the presence of a pathological process in the uterus: endometriosis, polyp, hyperplasia (growth) of the endometrium, etc. Pink discharge like diluted blood with an unpleasant odor before and after menstruation is a symptom of chronic endometritis or chronic endocervicitis.
Abundant and prolonged spotting after menstruation and before them are most often dysfunctional. They need to be stopped, and then to find out and start treating the causes of their appearance. They arise due to violations of the hormonal function of the ovaries. It is in these organs that the eggs mature cyclically and female sex hormones are produced, which are involved in maintaining the normal menstrual cycle.
The causes of spotting after menstruation and before them can be:
- hormonal disorders in the body with various diseases and stress;
- endocrine pathologies, most often - a small amount of thyroid hormones;
- stopping or starting hormonal contraceptives;
- use of emergency contraceptive drugs: Postinor, Ginepriston, etc.;
- certain medications, and starting or stopping estrogen supplements.
Experts say that intermenstrual light bleeding from the vagina is a phenomenon that does not pose a danger. It is caused by hormonal fluctuations associated with the onset of ovulation. Bloody discharge between periods occurs in almost 30% of women. Normal discharge during ovulation is characterized by the following features:
- small total volume (spotting spotting);
- duration - no more than 72 hours;
- slimy consistency of scarlet, pinkish or brown;
- no need to use feminine hygiene products;
- the examination does not determine other causes of bleeding from the genital organs.
Often, unexpected spotting from the genital tract, even a small amount, can also be a sign of gynecological diseases.
Bleeding between periods usually begins on the 10-16th day, counting from the first day of the last menstruation, that is, from the beginning of the cycle. Normally, they look like poorly visible mucous secretions with streaks of blood, which last from half a day to three days. If, over time, spotting becomes stronger, or does not stop for more than three days, then you should definitely contact a gynecologist.
The doctor must stop the bleeding and prescribe the necessary examinations. But even if such bleeding has stopped on its own, then it is still worth it to undergo an examination by a gynecologist and perform an ultrasound of the pelvic organs. Such a phenomenon can serve as the only symptom of the presence of a latent gynecological disease.
Causes and treatment of spotting in the middle of the cycle
The most common cause of uterine bleeding between periods in a healthy woman is a sudden sharp fluctuation in the level of estrogen in the body. During ovulation, the level of this hormone rises rapidly. And since it affects the lining of the uterus, a similar symptom appears. Bloody discharge during or after ovulation is considered a physiological norm if no signs of other diseases are found during a medical examination. However, they are subject to medical correction. For the treatment and prevention of such hormonal surges, a woman is usually advised to avoid stressful situations and prescribe herbal preparations.
Smearing brown, pink or dark spotting in the middle of the menstrual cycle occurs when:
- the release of the egg from the follicle at the time of ovulation;
- the presence of an intrauterine device;
- taking hormonal contraceptives;
- the use of certain other drugs that affect the menstrual cycle;
- performing gynecological procedures, for example, cauterization or conization of the cervix;
- low functional activity of the thyroid gland;
- polyposis, endometriosis, cervical erosion, chronic inflammation of the uterus (endometritis);
- genital infections (for example, gonorrhea);
- genital injuries;
- fibromas and other tumors of the genital organs.
Of course, bleeding is an integral part of menstruation. However, in some cases, a change in the consistency of the discharge may be a sign of pathology.
So, if spotting instead of menstruation takes on the character of large clots, this may indicate:
- pathological bend of the cervix;
- violation of blood clotting and a tendency to thrombosis;
- insufficiency of vitamins of group B;
- pathological processes in the uterus (myoma, polyp, endometriosis).
- consultation with a gynecologist;
- bacteriological and microscopic analysis of secretions;
- Ultrasound of the pelvic organs.
Bloody discharge during pregnancy
Bloody discharge as a sign of pregnancyMinor bleeding from the genital tract can occur when a fertilized egg (implantation) is introduced into the wall of the uterus. It is associated with microscopic damage to the uterus and possible traumatization of small vessels in it. Such secretions, called implantation ones, are scarce, hardly noticeable and do not pose any threat to health.
Implantation bleeding most often occurs about 7-9 days before the expected start of the next period. Many women, noticing it, believe that this is a harbinger of normal menstruation, and do not consider this symptom as a sign of pregnancy.
Bloody discharge in pregnant women
A woman should be alerted to any spotting (of any duration, in any amount, of any color) that occurs during pregnancy, even if they are not accompanied by pain. The reason for such allocations may be:
- premature detachment of the placenta;
- detachment of the fetal egg;
- improper location of the placenta (previa);
- threatened miscarriage.
Another, but not so dangerous, cause of bleeding during pregnancy is microtrauma and rupture of the vessels of the cervix during its erosion. Only a specialist can accurately determine the true cause of bleeding, therefore, if any such discharge appears, it is necessary to undergo an examination by a gynecologist.
Bleeding during pregnancy is characterized by the fact that it can sharply and unexpectedly intensify, leading to very serious complications and consequences. A danger to the health, and sometimes the life of a pregnant woman, may be the appearance of copious brown, scarlet, pink or dark spotting.
It is urgent to call an ambulance for the following symptoms:
- a sharp decrease in blood pressure;
- weak pulse;
- general weakness;
- pale skin;
Bloody discharge in early pregnancy
In the early stages of pregnancy, the appearance of spotting can mean the threat of spontaneous miscarriage. As a rule, such discharge in the first trimester occurs if the process of rejection of the fetal egg begins. Therefore, in order to prevent abortion and the threat of losing a child, a woman must be hospitalized as soon as possible in the gynecological department. Only specialists in a hospital will be able to carry out all the necessary measures aimed at maintaining pregnancy.
Discharge in late pregnancy
At a later date, spotting may indicate a threat of premature placental abruption, or mean premature onset of labor. In such cases, emergency assistance from gynecologists is necessary.
However, the appearance at 38-40 weeks of spotting brown, not red, in small quantities is not a cause for particular concern. In many women, such discharge occurs as a result of weak bleeding from the vessels that are located on the cervix. However, at the next scheduled visit to a gynecologist, a pregnant woman must tell him about the noticed vaginal discharge.
Bloody discharge during miscarriage
Bloody discharge from the genitals during pregnancy is the most common symptom of a threatened miscarriage. At the same time, pain in the lower back and pulling pain in the lower abdomen can accompany the discharge, or precede their appearance.It must be remembered that if a woman suddenly had bloody discharge from the vagina, and she was diagnosed with a threatened miscarriage, this does not mean at all that the pregnancy will be terminated in any case. Most women, despite the presence of bloody discharge in the early or late stages, with timely and adequate treatment, successfully endure pregnancy and give birth to healthy children.
Bloody discharge after childbirth
Normal discharge after childbirth (called lochia) is pink and resembles dilute blood or ichor. This is postpartum physiological discharge from the uterus, which includes blood, mucus and torn off non-viable tissues of the decidua of the uterus. Most often, the duration of the allocation of such lochia is from 3 to 6, occasionally up to 8 weeks after childbirth. A necessary sign of the normal course of this process is the tendency to reduce the amount and clarify the discharge. Lochia in the first week resemble regular periods, only more abundant and sometimes containing blood clots. Every day their number should decrease.
Gradually, the lochia becomes yellowish white due to the increase in mucus, begins to resemble egg white, but may still contain small blood impurities. Around the 4th week after childbirth, only meager, "smearing" discharge should be observed. By the end of 6-8 weeks after childbirth, vaginal discharge should acquire the same character and quantity as before the onset of pregnancy.
Bloody discharge after examination by a gynecologist
The appearance of scanty spotting after a gynecological examination is not uncommon, and should not cause much concern. During the examination, microtrauma of blood vessels and minor damage to the mucous membranes are not excluded. Often such discharge occurs in cases where the doctor uses a mirror when examining, or takes a smear. The smear is taken from the mucous membrane of the vagina, urethra and canal of the uterine neck. Simply put, the cells of the mucous membrane are simply scraped off the wall of the vagina or other organ. It is quite natural that damaged tissue may bleed for some time.The main thing to remember is that spotting should stop as soon as possible. In any case, it will be useful for a woman to monitor her condition. If the discharge of blood does not stop, or itching, burning or pain joins it, then you should immediately contact a gynecologist, describing all the details.
Bleeding after an abortion
Any abortion is associated with more or less extensive trauma to the vessels of the uterine wall. Therefore, the appearance after an abortion of spotting, different in color and quantity, is almost inevitable.In about 80% of women after drug exposure, a complete abortion occurs after a week, and spotting completely stops. In 95% of women, a complete abortion occurs by the 14th day after the manipulation. Scanty secretions of a bloody nature after a medical abortion can be observed until the next menstruation.
Menstruation after a medical abortion should begin approximately after such a period, the duration of which for a particular woman is a normal menstrual cycle. In addition, they can normally be delayed up to 10 days. Although in some cases (in about 13% of patients), the first menstruation after a medical abortion may begin only 2 months after the abortion procedure.
Abundant spotting after an abortion is quite rare. This usually serves as an indicator of violations of the blood coagulation system. It must be remembered that after an abortion, uterine bleeding is considered severe if:
1.
Two sanitary pads of the largest size are completely soaked with blood within an hour.
2.
This goes on for over two hours straight.
In such cases, a woman needs to urgently undergo a second consultation with a gynecologist and do an ultrasound scan. To stop uterine bleeding, your doctor may prescribe additional drugs that shrink the uterus and reduce bleeding.
Regardless of the presence or absence of spotting, a week after the abortion, you must definitely contact the gynecologist again and undergo a control ultrasound.
Bloody discharge after intercourse
Bloody discharge of a brown tint, pink or dark spotting that occurs after intercourse, most often has fairly safe causes that are easily eliminated with a timely visit to a gynecologist. However, it must be remembered that if spotting during or after sex is profuse and accompanied by severe pain, then you need to seek medical help as soon as possible. Bloody discharge that occurs in women after intercourse is called postcoital bleeding. Consider the main reasons for their appearance.
Mechanical damage
The release of blood after sex from the genitals can be caused by physical impact. Most often, these are injuries that a woman can get in the process of too rough or active sex:
- injuries and ruptures of the walls or fornix of the vagina;
- damage to the mucous membrane of the cervix;
- damage to the eroded cervix.
infectious diseases
Often the cause of spotting after intercourse can be an infectious lesion - chlamydia and other sexually transmitted diseases. Another symptom of an infectious pathology of the reproductive system is the addition of a fetid odor to the secretions.
Inflammatory lesions
Bloody discharge after and during sex can occur due to inflammatory diseases of the female genital organs. Most often, bleeding after sex occurs with cervicitis (inflammation of the cervix) or vaginitis (inflammation of the vagina). In both cases, bleeding from the genitals of a woman occurs not only after sex. Sexual intercourse in this situation is only a stimulating factor.
Polyps and cervical erosion
A common cause of spotting after sex is polyps and erosion of the cervix. Such secretions, as a rule, are very transient, disappear in just a few hours, but resume again at the next sexual contact. To get rid of this symptom, you need to contact a gynecologist and undergo a course of treatment for cervical erosion. But polyps, which can cause the development of malignant tumors in the future, must be removed.
The use of drugs
Bleeding after intercourse may be due to taking certain medications that reduce blood clotting (such as aspirin) and birth control. Taking such drugs is associated with the risk of developing hypoplasia (reducing the thickness) of the uterine mucosa, which can lead to trauma.
The cause of spotting can also be errors in taking contraceptives. Skipping the next dose of these drugs, or using them late, can provoke bleeding after sex. In such cases, the gynecologist may advise changing the drug that caused the adverse reaction, or temporarily stop it if the bleeding was caused by errors in its use.
Other pathologies
In rare cases, the cause of spotting after sex can be pathological changes in the cells of the cervix (dysplasia), certain blood diseases and uterine cancer. The presence of such pathologies is determined by laboratory analysis of the vaginal discharge, and other examinations.
Bleeding while using contraceptives
Brown spotting in the first two months after the start of taking hormonal contraceptives is considered a variant of the norm. During the use of medications such as Regulon, Yarina, Jess, spotting can appear in any phase of the menstrual cycle, which is associated with the suppression of ovulation. After the use of postcoital hormonal contraceptives, such as Postinor, spotting can also occur due to sudden changes in the hormonal balance of the body.It should be remembered that if spotting does not stop in the third and fourth months of continuous use of the drug, the woman should consult a gynecologist. Most likely, this oral contraceptive simply does not suit her, and it needs to be replaced.
Bloody discharge during menopause
Bleeding during menopause (even the smallest spotting) is a symptom of diseases, and sometimes quite serious, up to uterine cancer. Therefore, in no case should such a situation be ignored. Many women are quite hard to endure menopause. Signs of its pathological course are:
- strong and frequent hot flashes;
- violations of metabolic processes in the body;
- increased blood pressure;
- the appearance of psychological disorders;
- periodic bleeding from the genitals.
The widespread belief that any symptoms are possible during menopause leads many women to ignore bleeding that should not be normal. They occur quite often - according to statistics, more than half of patients over 45 years old turn to a gynecologist because of bleeding during menopause.
Causes and treatment of bleeding in menopause
Symptoms of pathological menopause are primarily due to hormonal changes in the female body, that is, they are dysfunctional. But we must not forget that in some cases, bleeding indicates the presence of tumor neoplasms of a benign (polyps and fibroids) or malignant nature.
Bloody discharge can occur if a woman after menopause uses hormone replacement therapy. In this case, taking progesterone can stimulate the recovery of light menstrual bleeding. They can be observed within 1-2 years, usually pass painlessly and easily, lasting no more than 3-4 days. This is the only type of spotting in menopause that does not require immediate interruption of the course and treatment. But if a woman takes progesterone, and menstrual bleeding starts at the wrong time, lasts longer than expected, is very plentiful or contains blood clots, then you should definitely consult a gynecologist.
It is necessary to distinguish between two types of bleeding in menopause:
1.
Bleeding during menopause.
2.
Bleeding during the postmenopausal period.
Bloody discharge in premenopause
Bleeding during premenopause is usually caused by a violation of the production of sex hormones in women aged 45-50 years, up to the complete cessation of menstruation. Their cause is violations of the timing of ovulation, which lead to the failure of cyclic changes in the thickness of the uterine mucosa.
Usually, menopausal bleeding in premenopause appears after a delay in menstruation, and sometimes they begin on the day of the expected menstruation, or even a little earlier. Such spotting can have a different intensity, and be observed for several weeks, or even months. They are characterized by relapses that sometimes occur within 4-5 years.
Especially often, spotting during menopause is observed in women suffering from metabolic disorders and various endocrine diseases. Therefore, the appearance of the first signs of menopausal bleeding is a reason for a mandatory examination in order to identify violations of the functions of the thyroid and pancreas, liver, fat and carbohydrate metabolism.
Bloody discharge in postmenopausal women
Any spotting in the postmenopausal period, that is, after the complete cessation of menstruation, should always be considered as a threatening symptom. Such bleeding is a sign of tumors, including malignant ones. In such cases, diagnostic curettage is almost always performed, affecting the mucous membrane of the body of the uterus and the canal of its neck, as well as the subsequent histological examination of the scraping.
Diagnosis and treatment of bleeding
Which doctor should I contact with bloody discharge from the genital tract?
With the appearance of spotting of various nature and quantity in women and girls of any age, you should contact gynecologist (make an appointment). If we are talking about teenagers or girls under 10 years old, then you should contact a pediatric gynecologist.Despite the fact that bloody discharge from the vagina can be evidence not only of diseases of the female genital area, but also a symptom of a disorder of the blood coagulation system, you still need to contact a gynecologist when they appear, since coagulopathy (blood clotting disorders) are much less common than gynecological pathology . This means that the doctor will examine the woman and, if necessary, refer her to hematologist (make an appointment).
In addition, every woman and girl should know that the discharge of blood from the genital tract in some cases is a sign of an emergency, the essence of which is that some kind of catastrophe occurs in the body and immediate medical attention is required to save a life. If signs of such a dangerous condition appear, you should immediately call an ambulance and be hospitalized in a hospital so that doctors can provide the assistance necessary to save a life.
So, urgently call an ambulance and be hospitalized in a hospital if during or after intercourse in the abdomen or vagina there is severe pain and heavy bleeding begins. In this situation, urgent help is needed due to the fact that during sexual intercourse an injury occurred to the organs and tears and traumatic injuries must be sutured so that the woman does not die from blood loss.
In addition, it is imperative to call an ambulance and be hospitalized for pregnant women at any gestational age if they have bloody discharge from the vagina. Any discharge of blood from the vagina during pregnancy should be considered dangerous. Although theoretically bleeding from the vagina during pregnancy can be harmless, due, for example, to cervical erosion, it is difficult to distinguish them from dangerous ones. Moreover, at the beginning, spotting may have signs of benign, but this is deceptive, since at any moment they can intensify, take on their true nature and become very dangerous (for example, with an ectopic pregnancy, miscarriage, placental abruption, etc.) .
In addition, bloody discharge from the vagina in women and girls of any age should be considered dangerous if it increases or does not decrease with time, possibly combined with severe pain in the lower abdomen (right, left, in the middle or everywhere) or lower back, high body temperature, a strong and rapid deterioration in well-being after the onset of spotting, blanching, decreased pressure, increased heart rate, profuse sweating, possibly fainting. Remember that with a dangerous discharge of blood from the vagina, the woman's condition quickly and sharply worsens so much that she literally cannot stand and sit, and almost faints.
Treatment of bleeding from the genital organs in women of any age has several goals:
1.
Stop heavy bleeding as soon as possible and replenish blood loss.
2.
Eliminate the cause that caused the bleeding.
3.
Compensation for the consequences of blood loss (for example, anemia).
Examination for bleeding
Before prescribing treatment, the gynecologist conducts an examination to establish the true cause of bleeding.
The program of examinations, as a rule, includes:
- a detailed survey of the patient, on the basis of which the doctor draws conclusions about her psychological state, hereditary diseases in the family, etc.;
- visual examination of the vagina with the help of mirrors;
- laboratory examination of vaginal smears;
- examination of the tissues of the cervix using colposcopy or biopsy;
- ultrasound examination of the pelvic organs;
- in certain cases - diagnostic curettage of the uterine cavity, followed by microscopic examination of endometrial tissues;
- determining the level of hormones;
- general blood analysis .
What tests and examinations can a doctor prescribe for bloody discharge from the vagina?
Bloody discharge from the vagina can be provoked by various diseases and conditions, for the diagnosis of which different methods are used. The choice of a diagnostic method in each case of bleeding from the vagina is carried out by the doctor individually, depending on the accompanying symptoms, due to which it is possible to presuppose the disease that caused bleeding or spotting. Below we will consider what tests and examinations a doctor can prescribe for bleeding from the vagina with various concomitant symptoms, and we will only touch on those situations where there is no need to urgently call an ambulance.Dark spotting from the vagina (brown, brownish, maroon, dark red, etc.) in large or small amounts, appearing outside of menstruation or before menstruation, makes the doctor suspect a pathological process in the uterus (for example, endometrial or cervical polyps channel, endometrial hyperplasia, endometriosis, etc.). In such a situation, the doctor prescribes the following tests and examinations:
- Bimanual gynecological examination;
- Inspection of the genital tract in the mirrors;
- Vaginal smear for flora (make an appointment);
- Hysteroscopy (make an appointment);
- Ultrasound of the pelvic organs (make an appointment);
- Separate diagnostic curettage (sign up);
- Magnetic resonance imaging (make an appointment);
- General blood analysis;
- General urine analysis ;
- Blood chemistry;
- Coagulogram (sign up);
- Blood test for luteinizing hormone;
- A blood test for follicle-stimulating hormone;
- Blood test for testosterone.
If the examinations did not reveal any diseases, and there are spotting, the doctor prescribes tests for genital infections ( chlamydia (sign up), mycoplasmosis (sign up), ureaplasmosis (sign up), trichomoniasis, candidiasis, gardnerellosis, gonorrhea (sign up), syphilis (sign up)).
If a woman systematically has spotting spotting that emits an unpleasant or fetid odor, and they can be observed on any days of the menstrual cycle, the doctor suspects an infectious and inflammatory process in the genital organs and prescribes tests for genital infections (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis , gardnerellosis, gonorrhea, syphilis), as well as ultrasound of the pelvic organs. For analysis for sexual infections (sign up) you can donate blood, vaginal discharge and urethra. As a rule, the doctor recommends to the woman which tests she needs, and which biological material should be taken for this.
If periodically pinkish discharge appears before menstruation, resembling diluted blood and emitting an unpleasant odor, endometritis or endocervicitis is suspected. In this case, the doctor prescribes the following tests and examinations:
- Gynecological examination (make an appointment);
- General blood analysis;
- smear on flora;
- Bacteriological culture of the vaginal discharge;
- Ultrasound of the pelvic organs;
- Hysteroscopy;
- Separate diagnostic curettage with histological examination of the material;
- Extended colposcopy (make an appointment);
- Cervical smear for cytology (make an appointment);
- Bacteriological culture of a smear from the cervical canal;
- Blood tests or vaginal discharge for sexual infections (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis, gardnerellosis, gonorrhea, syphilis) by ELISA methods, PCR (sign up) and etc.;
- Biopsy of the cervix.
If endocervicitis has been detected, then, first of all, an extended colposcopy is prescribed and performed and a smear is taken for cytology to determine whether there is a cancerous degeneration of cells. Next, a blood or vaginal discharge test is prescribed for sexual infections and bacteriological sowing of a smear from the cervical canal in order to determine the microbe that has become the causative agent of the infectious process. If, according to the results of cytology, the presence of tumor cells is revealed, then biopsy (make an appointment) cervix for early detection of cancer.
Scanty and spotting spotting of any nature (pink, red, brownish, etc.) in various parts of the menstrual cycle (in the middle, before menstruation, after menstruation) makes us suspect menstrual irregularities, endometriosis, polyps, endometritis, fibroids, genital infections , genital trauma, cervical erosion, cervical cancer. In such a situation, the doctor first of all prescribes a gynecological examination, examination in the mirrors, a smear on the flora and ultrasound of the pelvic organs, since these simple examinations reveal a number of additional signs that can be used to accurately diagnose an existing disease and then conduct other additional studies to confirmation of the diagnostic guess.
So, if as a result of the examination, damage to the genital organs is revealed, the doctor eliminates it - sutures the tears, removes foreign objects, treats the mucous membrane with an antiseptic, etc. In such a situation, other examinations are not prescribed, since they are not needed. If, during the examination and ultrasound, an erosion or an incomprehensible formation on the cervix was detected, the doctor prescribes a colposcopy, a smear for cytology, or immediately takes a biopsy of the affected area to understand if there is erosion or if it is a precancer or cancer.
If, according to the results of ultrasound, endometriosis is detected, tomography is prescribed to clarify the localization of ectopic foci and blood tests for hormones - testosterone, luteinizing and follicle-stimulating. If the examination and ultrasound reveal polyps or a tumor (myoma, etc.), hysteroscopy is additionally prescribed. If the examination and ultrasound revealed endometritis, a separate diagnostic curettage is additionally assigned. If ultrasound and examination revealed signs of genital infections, then a blood test or vaginal discharge for inflammatory pathogens (chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, candidiasis, gardnerellosis, gonorrhea, syphilis) is prescribed. And when the results of ultrasound and examination did not reveal any pathology, the doctor prescribes blood test for thyroid hormones (make an appointment), since in such a situation, most likely, scanty spotting is due to a violation of the work of this particular organ.
When large blood clots appear in a woman during menstruation, this suggests a bending of the cervix, a pathology of blood clotting, a deficiency of B vitamins, endometriosis, or neoplasms in the uterus (polyps, fibroids). In such a situation, the doctor, first of all, performs a gynecological examination and examination in the mirrors, prescribes an ultrasound of the pelvic organs, a general blood test, a coagulogram (APTT, PTI, TV, fibrinogen, clot retraction, etc.). If the results of the coagulogram reveal a pathology, the woman is referred to a hematologist. If the results Ultrasound (make an appointment) and inspection revealed a bend of the cervix - prescribe therapy. If ultrasound and examination revealed endometriosis, tomography is prescribed, blood tests for hormones - testosterone, luteinizing and follicle-stimulating. If ultrasound and examination revealed polyps or fibroids, hysteroscopy is prescribed.
If a girl or woman develops heavy and prolonged dysfunctional bleeding before or after menstruation, hormonal imbalance is suspected, in which case the doctor prescribes the following tests to understand why the ovaries do not function normally and do not produce the necessary amount of hormones to maintain the correct menstrual cycle:
- Blood test for the level of thyroid-stimulating hormone (TSH, thyrotropin);
- Blood test for the level of triiodothyronine (T3);
- Blood test for thyroxine level (T4);
- Blood test for the level of follicle-stimulating hormone (FSH);
- Blood test for luteinizing hormone (LH) levels;
- Blood test for prolactin level (sign up);
- Blood test for estradiol levels;
- Blood test for testosterone levels.
If, after an abortion, a woman has heavy uterine bleeding, then the doctor, first of all, performs an ultrasound scan to make sure there are no residues in the uterus. If any are found, scraping is carried out. If none are found, then a coagulogram is prescribed, and the woman is referred to a hematologist, since bleeding is considered to be caused by a pathology of blood coagulation.
If profuse bleeding develops in a woman in menopause, then a separate diagnostic curettage with a histological examination of the material is necessarily prescribed, since such a situation is often a sign of tumors or precancerous background diseases.
If spotting appears in a girl under 12 years old, the doctor prescribes a full range of diagnostic manipulations - ultrasound of the pelvic organs, tests for genital infections, tests for hormones (cortisol, triiodothyronine, thyroxine, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, testosterone). In addition, to exclude kidney disease, a general urine test is prescribed, and to exclude the pathology of the digestive tract, a biochemical blood test and Ultrasound of the abdominal organs (make an appointment).
Treatment of spotting
Conservative Methods:1. Most often, the basis of the therapeutic program is hormonal therapy. Such treatment courses are usually prescribed for up to 3 months. After its completion, a break is made in the treatment, during which the gynecologist evaluates its results.
2. In addition to hormonal agents, symptomatic treatment is also used - hemostatic drugs and drugs that enhance the contractile activity of the uterus.
3. General strengthening therapy, which helps to restore the female body as a whole.
4. Also, experts recommend avoiding physical and psychological stressful situations.
The selection of the optimal treatment regimen for spotting occurs individually. It should also be remembered that the treatment will last from 3-4 weeks to six months or more, depending on the cause of the violations. In order to restore the normal functioning of the female reproductive system, it may take several months.
Operational Methods
Surgical methods are also used to treat severe bleeding. For example, in patients who are in menopausal age, curettage of the uterus is the main diagnostic method. And with juvenile bleeding in adolescent girls, such a procedure is carried out exclusively for health reasons. After the application of surgical methods, treatment is prescribed aimed at preventing the recurrence of discharge.
Conclusion
Treatment of bloody discharge from the genital tract should only be carried out by a gynecologist. Self-medication is absolutely unacceptable even if a woman is sure that she knows the true cause of bleeding. Misdiagnosis
- Oral glucose tolerance test (OGTT)
- The main possible complications after vaginal plastic surgery
- The structure of the female organs of the small pelvis: a diagram
- How to take calcium so that it is well absorbed?
- What is the daily intake of calcium for pregnant women
- Reception OK "Lindinet" during menstruation
- How to get rid of constipation during pregnancy: suppositories, products, folk remedies
- Birth control pills Lindinet
- Is it possible to get pregnant after treatment of ureaplasmosis (ureaplasmosis)?
- Birth control pills Lindinet
- Dropsy of the testicle (hydrocele) in a man, in a boy, in newborn children - a description and causes of the disease, symptoms and diagnosis, treatment (surgery, puncture), swelling after surgery
- Analysis for cytomegalovirus: do you have a CVM?
- What are the best birth control pills to take
- Questions Delayed menstruation after emergency concentration
- Discharge is red, but not monthly: causes Spotting for more than 10 days
- Evra patch (Evra) Evra transdermal therapeutic system
- Feeling wet before period Feeling wet before period
- Signs of pregnancy during menstruation
- Other features of the period, deviations from the norm
- Can a chocolate cyst dissolve?