Intermenstrual bleeding and periods in the middle of the cycle

The volume and duration of bleeding is one of the main signs that distinguishes dysfunctional uterine bleeding from menstrual bleeding. This pathology can occur in any woman and at any age, and if it occurs, you should consult a doctor.

One of the main causes of dysfunctional bleeding from the uterus is disturbances at the hormonal level. Lack of qualified assistance and supervision from a doctor can cause the development of serious diseases.

Content:

1. Determination of intermenstrual bleeding in the middle of the cycle
2. Types of intermenstrual bleeding
3. Causes of bleeding and menstruation in the middle of the cycle
4. Diagnosis of bleeding in the middle of the cycle
5. Treatment and prevention of bleeding in the middle of the cycle
6. Poor blood flow during pregnancy

Many women experience menstruation in the middle of their cycle at least once in their lives.
Naturally, an irregular menstrual cycle causes anxiety in women. Such disorders can occur in teenage girls and women of reproductive age. Often, spotting in the middle of the cycle is not a symptom of any disease and is considered normal. But sometimes the appearance of bleeding between periods can be a sign of serious gynecological diseases.

Endometrial hyperplasia

Spotting, bloody, brown discharge at the end of the cycle before menstruation or for a long time after menstruation may indicate endometrial hyperplasia. The causes of hyperplasia can be of different nature. Most often, this pathology develops due to hormonal imbalances, as well as carbohydrate, lipid and other types of metabolism. An important role may be played by hereditary predisposition, the presence of uterine fibroids, cancer of the genital organs and breast, hypertension and other diseases, manifestations of damaging effects during the prenatal period of development, diseases during puberty and the disorders of menstrual and subsequently reproductive function caused by them. The appearance of hyperplasia in adulthood is often preceded by previous gynecological diseases, abortions, and genital surgeries.

Determination of intermenstrual bleeding in the middle of the cycle

Menstruation is one of the phases of the menstrual cycle of the female body, characterized by the release of blood from the vagina. The beginning of the menstrual cycle is counted from the first day of menstruation.

Sometimes it can be difficult to distinguish dysfunctional uterine bleeding from normal menstruation. Many girls do not remember when their menstrual cycle began and do not know how to calculate their menstrual cycle, so they may mistakenly think that menstruation came earlier or later than expected. For each woman and girl, the duration of the monthly cycle is individual

How to calculate the monthly cycle? It is not difficult. The easiest way is to keep a monthly calendar. It needs to mark 1 day of the onset of menstruation and 1 day of the next menstruation. The number of days between them will be the duration of the menstrual cycle. You need to know that normal menstruation lasts 2-7 days, and the normal menstrual cycle is 21-35 days. The most optimal duration of the monthly cycle is 28 days. Women who experience an irregular menstrual cycle should consult a gynecologist.

Ovulation is the process of the release of a mature egg from the follicle. In women with a normal monthly cycle, ovulation occurs approximately on the 14th day from the start of menstruation. With an irregular menstrual cycle, it may occur earlier or later than this time. After ovulation, the level of estrogen in the female body decreases, and bleeding does not occur because the corpus luteum maintains hormonal balance. A sharp increase or decrease in the level of the hormone estrogen during ovulation can provoke uterine bleeding between, before and after menstruation, and this is not a deviation from the norm. This phenomenon is observed in 30% of women.

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The reasons why a woman may experience bleeding from the uterus, vagina or other part of the reproductive tract, which prevail in different age groups, are different. Regardless of age, their danger lies in the occurrence of anemia (anemia), if blood loss is large enough and bleeding occurs regularly. If a woman is not pregnant and is not in labor, then the following types of bleeding can be distinguished, the source of which is the uterus:

• Dysfunctional bleeding in girls - occurs at a young age, a little after menarche, due to hormonal disruption of the ovaries
• Dysfunctional bleeding in women of reproductive age requires increased attention from a doctor, as it can serve as a harbinger of infertility.
• Menopausal bleeding occurs as a result of hormonal changes in the female body and may indicate a proliferative process, both benign and malignant. Most often it is benign: the appearance of polyps, myomatous nodes due to hyperestrogenemia (excess of the female sex hormone estrogen)
• Bleeding that occurs in postmenopause occurs some time after the onset of menopause, during which there was no bleeding from the genital tract. They may be a symptom indicating the process of tumor formation in the female reproductive organs.
• Postcoital bleeding is a special type of uterine bleeding that occurs after intercourse. It can be based on different reasons, both formidable and not posing a danger to a woman’s health.

Based on the moment at which bleeding from the genitals was detected, they can be classified into menorrhagia: this is the name for bleeding that coincides with menstruation, but the volume of blood lost clearly exceeds normal; as well as metrorrhagia: such bleeding does not coincide with the beginning of the menstrual cycle, but is noted by a woman before or after her menstrual period.

It is also worth noting three conditions that require immediate, urgent, prompt seeking of medical help

• A) Bleeding from the genital tract that occurs during pregnancy. It is important to note that such bleeding can rapidly increase in speed and lead to serious complications for both the fetus and the expectant mother.
• B) Bleeding that does not stop for a long time, which is accompanied by symptoms of anemia. The latter include pallor of the skin, decreased blood pressure, dizziness when trying to stand up or even sit down, constant headaches, a rare and weakened pulse in the radial arteries (on the wrist), and fainting.
• B) Internal bleeding. You should think about it if the bright symptoms of anemia are combined with the absence of visually recognizable blood discharge from the genital tract, especially if the patient also has a feeling of severe pain in the abdomen, and its anterior wall is very dense to the touch, board-shaped.

Uterine bleeding in women during the reproductive period

Many women suddenly notice bloody vaginal discharge that occurs between periods, or an excessive increase in the latter. If spotting, a small amount of discharge occurs at the time of ovulation (the release of an egg from a ruptured ovarian follicle), usually on the 14-18th day of the cycle, depending on its duration for a particular woman (28-32 days), then this should be considered normal . However, severe sudden bleeding should alert a woman, as it may indicate a gynecological pathology. If metrorrhagia that suddenly arises intensifies or simply does not end for a long time, then you need to consult a doctor who will stop the bleeding and also prescribe the necessary examinations to understand the reasons for its occurrence.

In addition to ovulation, the cause of uterine bleeding that occurs between two adjacent menstruation can be sudden changes in the amount of the female sex hormone estrogen in the blood, which is produced by the ovaries, any pathological process in which can cause the above-described manifestation. In addition, the basis of such metrorrhagia may be the end or beginning of the use of hormonal contraceptives, a significant decrease in the level of thyroid hormones, the use of emergency contraceptives, as well as other medications that somehow contain estrogen. In addition, bleeding between menstruation may be due to an infectious, tumor process of the genital organs or trauma, miscarriage, or the consequences of recent gynecological manipulations.

Treatment of the bleeding described above is prescribed according to the main reason due to which they occurred. If metrorrhagia is caused by a gynecological disease, then properly selected treatment for this disease will also stop bleeding.

Uterine bleeding in young girls

Bleeding from the genital tract that occurs in girls aged 12-18 years is called pubertal or juvenile. If such bleeding is severe, then there may be a threat to the health and life of a teenage girl, and therefore it is necessary to quickly consult a doctor who can prescribe adequate treatment so that this bleeding does not progress into the reproductive period, in which, in this case, it will increase danger of infertility for this patient. Quite often, juvenile metrorrhagia occurs in the winter-spring period due to a lack of vitamins and microelements in the girl’s body. Often the main cause can be stress, infectious processes or unhealthy diet. Most often, in the puberty period, bleeding in girls occurs after menstruation has been delayed (several weeks), and lasts more than seven days, sometimes increasing in intensity, sometimes decreasing, which can ultimately lead to large blood loss and anemia. This process needs to be stopped, and therefore it is necessary to contact an obstetrician-gynecologist immediately.

At the same time, both sudden and severe bleeding and prolonged and sluggish bleeding can lead to anemia. The symptoms of anemia are similar regardless of the cause that caused it: pale skin, weakness, dizziness when trying to sit or stand, drop in blood pressure, short-term loss of consciousness.

If a girl stops metrorrhagia on her own, she still needs to see a doctor, since the goal of treatment, in this case, will be to prevent anemia and a terrible complication - hemorrhagic shock.

Menopausal uterine bleeding

It is impossible to ignore the discharge of blood from the genital tract during menopause, as it can be a symptom of a pathological process, even uterine cancer. For many women, menopause is quite difficult. Along with uterine bleeding, surges in blood pressure, mental disorders, and metabolic disorders can occur.

Typically, the cause of menopausal bleeding from the genital tract is massive hormonal changes in a woman’s body, but they can also indicate tumor growth. Menopausal bleeding can be classified into:

• Metrorrhagia in premenopause
• Metrorrhagia in postmenopause

During the premenopausal period, bleeding from the reproductive tract most often occurs due to improper production of sex hormones due to disorders associated with the ovulation process, which, in turn, leads to changes in the change in the functional layer of the endometrium (epithelial lining of the uterus). Such bleeding may recur over several years with varying strength and frequency. Anemia in this case occurs infrequently, compared to teenage girls, however, if it occurs, it can be combined with uterine fibroids or with more complex and dangerous pathological processes in the female body.

Bleeding occurring in the postmenopausal period is the most dangerous, as it requires an immediate diagnostic search to exclude malignant neoplasms. Such metrorrhagia is an indication for diagnostic hysteroscopy (curettage of the uterine cavity and cervical canal).

Postcoital bleeding

If bleeding occurs in a woman immediately after intercourse, then it is called post-coital (coitus. Sin.: penetration, copulation, copulation, sexual intercourse). Such bleeding from the genital tract can be caused by a number of reasons:

• Mechanical trauma to the genital tract
• Sexually transmitted diseases (often chlamydia)
• Inflammatory diseases of the reproductive tract (vaginitis - in the vagina, cervicitis - in the cervix, etc.)
• Erosions and polyposis (require surgical treatment)
• Due to the use of certain medications, including hormonal
• Dysplastic changes (replacement of the epithelium with the wrong one for a given part of the reproductive tract) up to the tumor process

If bleeding is accompanied by severe pain and occurs suddenly during or after copulation, then it is necessary to call an ambulance, because the situation can be life-threatening. In this case, you need to pay attention to the symptoms in case the woman has internal bleeding, which may be accompanied by acute pain in the abdomen, groin, lower back, weakness, dizziness, fainting, profuse sweating (“cold sweat”).

Timely consultation with a doctor usually contributes to a quick cure.

Metrorrhagia after medical abortion

Typically, bleeding that occurs after a medical abortion stops in most women during therapy. And the cycle is completely normalized within 1-2 months. However, if, due to metrorrhagia after an abortion, two sanitary pads are completely soaked within one hour, then the bleeding should already be considered severe and requiring immediate intervention by a gynecologist.

Treatment of bleeding from the reproductive tract

The goals of treating metrorrhagia usually come down to stopping the bleeding itself and replenishing the lost blood volume, finding and eliminating the already found cause of metrorrhagia, preventing recurrence of bleeding and treating its consequences (anemia, hemorrhagic shock).

Uterine bleeding should be treated taking into account its causes. Often the bleeding itself stops when its cause is eliminated surgically or conservatively. Therapy should be comprehensive: hormonal, symptomatic, restorative (promotes the restoration of the female body). Treatment is usually based on hormonal therapy and symptomatic therapy - drugs that increase blood clotting and uterine contraction. In addition to the conservative approach, a surgical approach is often used: this occurs if the bleeding is quite severe and/or prolonged. Such treatment usually begins with diagnostic hysteroscopy.

It should be remembered that contacting a gynecologist should be an indisputable and indispensable component of the treatment of uterine bleeding. There should be no talk of self-medication, because if the cause of the bleeding is serious enough, the latter can cost the woman her health, and often her life itself.

To prevent uterine bleeding, every woman should visit a gynecologist twice a year for examination. In this case, early diagnosis of diseases associated with the reproductive tract will become possible, which will allow for quick and gentle treatment without waiting for dangerous bleeding.

Types of intermenstrual bleeding

Intermenstrual bleeding often occurs 10-16 days after the end of the last menstrual period. They are not very abundant and last from 12 to 72 hours. But if the bleeding lasts longer or gets worse, consult your gynecologist.

Spotting in the middle of the cycle is more common than intermenstrual bleeding. A woman's vagina comes out with a little blood that can barely be seen on the toilet paper. This is usually mucus that has a pinkish color. Such discharge appears approximately 14 days before the onset of menstruation and is not a pathology. Intermenstrual bleeding indicates that the egg is ready for fertilization.

Frequent periods can also occur with proyomenorrhea (short monthly cycle). Periodically appearing and usually not intense bleeding lasts 2-3 days. Such spotting is caused by premature rejection of the uterine mucosa due to a decrease in estrogen production in the middle of the menstrual cycle.

Benign organic pathologies

Uterine fibroids and endometrial polyps are among the most common causes of vaginal bleeding during the fertile phase. The former are nothing more than abnormal growths of muscle tissue, and the latter - the endometrial mucosa. They can increase in size and often, in combination with hormonal changes, cause bleeding in the form of menorrhagia and metrorrhagia. In this category, it is also important for us to consider ovarian cysts.

Endometriosis means the abnormal presence of endometrium in organs other than the uterus, such as the ovary, fallopian tube, peritoneum, vagina, intestines, lungs. These ectopic lesions may also bleed during the normal menstrual cycle.

Occasional light-colored spotting, possibly worsening with sexual intercourse, may be caused by the presence of an ectropion (an "ulcer" on the cervix).

Genital infections can cause various types of vaginal discharge, but only rarely do they cause bleeding. The most common are those that are sexually transmitted - chlamydia and gonorrhea.

Causes of bleeding and menstruation in the middle of the cycle

Often, an irregular menstrual cycle is observed in teenage girls, since at their age the hormonal background has not yet become stable. If, after 2 years after the first menstruation, girls still have periods in the middle of the cycle, then you need to consult a gynecologist who will prescribe treatment to normalize the menstrual cycle.

Constant strong stressful situations, smoking, and alcohol have a bad effect on the body. As a result, women experience irregular menstrual cycles and may experience periods mid-cycle. Such phenomena often occur in women with frequent dysfunction of the genitourinary system; bleeding in such cases is more profuse.

If you move to another city, country or go on vacation to the sea, be prepared for the fact that the start of your menstrual cycle may occur earlier than usual and your period may begin in the middle of the cycle. After all, climate change is also stressful for the body, and it needs time to get used to it.

There can be many factors that provoke bleeding between periods. The main ones:

• pathologies of the endocrine system (diseases of the thyroid gland and adrenal glands, etc.);
• uterine fibroids;
• hormonal disbalance;
• miscarriage;
• the presence of an intrauterine device;
• gynecological procedures (cauterization or cervical biopsy);
• taking certain medications and contraceptives;
• vaginal trauma and vaginal infections.
• depression and stress.
• infectious diseases;
• poor blood clotting;
• deficiency of vitamins K and C;
• inflammation of the urogenital system;
• pathologies of the development of the internal genital organs of a woman (uterine inflection);
• ovarian tumors and cysts;
• chronic diseases (heart, kidney, liver and metabolic disorders);
• physical injuries.

Also, intermenstrual discharge may indicate such serious problems of the female genital area as uterine cancer, polyps and fibroids of the uterus, and the presence of adhesions.

Causes

There are many reasons for the appearance of bloody mucus from the vagina. Some of them do not signal anything, while others speak of pathologies. Before you panic, you should determine what is causing the problem. It is quite possible that it is associated with an incorrect lifestyle or changes in hormonal levels.

If blood after menstruation appears a week later and goes away completely without pain, we can say that there are no pathologies as such, and the blood appeared due to ovulation or hormonal imbalance. In this case, the woman should not feel any discomfort, unpleasant odor or itching. She just needs to remember what could have caused the blood to appear. This may be due to sexual intercourse between partners, pregnancy, or changes in hormonal levels.

A completely different picture is observed if blood impurities become frequent, abundant and cause discomfort. Here the cause should be sought together with a doctor, who will prescribe the necessary additional diagnostics.

Diagnosis of bleeding in the middle of the cycle

First of all, to diagnose the causes of intermenstrual bleeding, a gynecological examination is necessary. In addition, you must undergo the following examinations:

• cytological studies of aspirate from the uterine cavity;
• Ultrasound of the pelvic organs;
• study of the hormonal background of the body;
• thyroid examination;
• hysteroscopy and curettage of the uterine cavity and cervical canal;
• histological examination of scrapings obtained from the uterine cavity and cervical canal.

Also, if necessary, the gynecologist can prescribe a study of the pituitary gland using magnetic resonance imaging, radiography, computed tomography. Sometimes the brain is also examined using these methods.

Prices for services

Initial appointment with a gynecologist + ultrasound (assessment of complaints, medical history, examination in a gynecological chair, pelvic ultrasound, consultation)

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Repeated appointment with the gynecologist

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Ultrasound of the pelvis in women (uterine cavity, ovaries)

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Treatment and prevention of bleeding in the middle of the cycle

Treatment methods for bleeding in the middle of the cycle depend on the causes of this deviation, as well as on the woman’s age. Treatment can be conservative or surgical. In case of ovulatory bleeding, conservative treatment is carried out. For anovulatory bleeding (not associated with ovulation), both surgical and conservative treatment may be necessary. The exception is anovulatory bleeding in adolescents, when surgical treatment is used only as a last resort.

Conservative treatment is based on the use of hormonal drugs to normalize the irregular menstrual cycle and stop bleeding. Your doctor may also prescribe sedative medications to treat untimely periods caused by stress.

For severe bleeding, women are prescribed iron supplements. It should be remembered that a balanced diet (including foods such as beef, legumes, liver, vegetables and fruits), proper rest and sleep will help restore health faster.

To prevent bleeding in the middle of the cycle, you need to: regularly see a gynecologist, refuse abortions, have a regular sex life, control your weight, play sports, give up bad habits.

If you notice that your period starts earlier or later each time, please consult a qualified healthcare professional. Untimely treatment of pathologies that cause disruption of the monthly cycle and bleeding can lead to anemia, infertility, and cervical cancer.

Symptoms

Along with vaginal bleeding, other symptoms sometimes occur due to the underlying pathology. The most common:

• abdominal or pelvic pain (due to anovulation and other causes);
• vaginal discharge (with genital infection);
• asthenia and general malaise;
• nausea and vomiting;
• feeling tired;
• pallor and tachycardia associated with anemia secondary to bleeding that reduces hemoglobin levels.

Poor blood flow during pregnancy

During pregnancy, it is extremely important to continuously monitor the state of the maternal body of the mother and the baby, it is important that they perform all vital functions. One of the most significant studies is the analysis of blood flow in the arteries of the uterus, the woman’s umbilical cord, as well as cerebral vessels and the fetal aorta. The main causes of perinatal morbidity and mortality include disorders of the uteroplacental blood flow of 1A, 1B, second and third degrees.

Blood flow in the placenta

The placenta, in which the fetus is located, supplies the embryo with nutrients, as well as oxygen from the mother’s blood; it also removes waste products from the child’s body. It is this organ that unites two rather complex vascular systems - the female, which connects the vessels of the uterus and placenta, and the fetal, which passes into the umbilical arteries and leads to the child.

The circulatory systems mentioned above are separated by a membrane, which does not allow maternal and child blood to mix. The placenta is a kind of barrier that is resistant to numerous harmful substances, as well as viruses.

Often, for completely different reasons, placental insufficiency may appear, which inevitably affects the performance of transport, metabolic, trophic, endocrine and other vital functions of the placenta. In this condition, the metabolism between the maternal and child organisms deteriorates significantly, which is fraught with various consequences.

What are the causes of impaired placental blood flow?

Poor circulation in the uterine cavity can be caused by pneumonia, increased blood pressure, various intrauterine infections, as well as insufficient oxygen supply to the child’s body (hypoxia).

To diagnose the blood flow system in modern obstetric practice, three-dimensional ultrasound (so-called Doppler ultrasound) is used, with which the vessels are visible in a 3D (three-dimensional) image. With the help of this diagnostic technique, there is a prospect of diagnosing retroplacental bleeding and assessing cardiac malformations by monitoring blood flow. This technique is irreplaceable, since with its help it is possible to examine defects even in the most microscopic vessels that form the microvasculature, to observe the peculiarities of the formation and development of intraplacental hemodynamics, and in addition to control the amount of nutrients, as well as oxygen, that should enter the fetal body . New prospects have opened up for the early detection of obstetric complications, and if treatment or correction is started without wasting time, then circulatory disorders and subsequent pathologies associated with it can be almost completely avoided.

Hemodynamic disorders during pregnancy

Hemodynamic disorders are divided into 3 degrees of severity:

1. 1st degree includes two subtypes:

• disturbance of patello-placental blood flow 1Is the mildest. Fetal-placental blood circulation is preserved with it. Intrauterine infections often lead to this problem;
• in degree 1B, uteroplacental blood flow is preserved, but fetal-placental pathologies appear.

2. Grade 2 is characterized by the presence of disturbances in both blood flow systems, however, these disturbances do not carry any fundamental changes. 3. In grade 3, uterine circulation disturbance causes defects in normal blood circulation at the level of the fetus.

In the case of the first degree of violations, timely detection and adequate treatment can avoid fetal death. In the case of the second degree, perinatal mortality is about 13.3 percent, in the case of the third - 46.7 percent. During Doppler diagnostics, it was revealed that treatment aimed at correcting placental insufficiency in women with third-degree uterine blood flow disorders was ineffective. In this situation, with conservative childbirth, perinatal mortality was 50 percent, then, thanks to a cesarean section, losses can be avoided. 35.5 percent of newborns are admitted to the intensive care unit with grade 1 blood flow disorders, 45.5 percent with grade 2, and 88.2 percent with grade 3.

Doctors' opinion

According to experts, spotting cannot be ignored. After all, they can cause hormonal imbalance, pathologies, and diseases. And in this case, timely treatment will provide effective results.

According to doctors, urine with blood in women without pain is not always a pathology, but still requires diagnosis. In this case, a number of examinations are carried out:

• General urine and blood tests that reveal inflammation and suggest what actions the doctor needs to take in the future.
• Biochemical tests, thanks to which it is possible to determine the content of components such as proteins.
• A three-glass urine test, with which you can clearly determine the cause of the appearance of blood.
• The Nechiporenko urine collection method, which reveals a more detailed picture of the disease.
• Bacterial urine analysis, thanks to which you can determine the type of infectious agents (if any).
• Ultrasound of the genitourinary system - shows the condition of the woman’s organs.
• X-ray of the kidneys and reproductive system is necessary if the ultrasound did not give a complete picture.
• Cystoscopy, urethroscopy - in this case, a smear is taken for biochemistry to exclude the presence of dangerous diseases.
• CT and MRI are indicated only for those women in whom doctors suspect the presence of tumors.

Each of these studies is very important, but a urine test should be ordered first. With its help, the doctor determines the basic picture of the disease and draws up a plan for further action.

Doctors also insist that you should not self-medicate. Only after a complete examination is complex therapy or surgery prescribed, and the patient must constantly notify the gynecologist about his condition. In this case, we can talk about a quick solution to the problem and the return of health to the woman.