Juvenile Uterine Bleeding: Causes, Differential Diagnosis, and Treatment
Juvenile uterine bleeding is considered a fairly common violation of the reproductive system during puberty. Many girls face this problem, and therefore it is important to know the main causes and symptoms of the disorder. After all, in the absence of qualified medical care, the ailment can lead to dangerous and unpleasant consequences, including infertility.
So why do dysfunctional bleeds appear? What forms of pathology exist? What does the diagnostic process look like and can you always notice the presence of the disease yourself? What methods of treatment can young patients expect? Are there methods of prevention and treatment? To what doctor to address? Many girls are interested in answering these questions.
What are juvenile bleedings?
Uterine bleeding in adolescence is a fairly common problem. According to statistics, about 20-30% of girls face in one form or another of this pathology. It should immediately be noted that the appearance of bleeding from the uterus is not related to the organic lesions of the organs of the reproductive system. The main factor in this case is the violation of the hormonal background.
The period of puberty in girls is different. Moreover, it is difficult even to establish exact age limits for the puberty period, since in some girls it starts at 8 years old, others - at 11. Normally, the active development of the reproductive system begins no earlier than 8 years and must fully end to the age of sixteen. On the other hand, variations are also possible here - for example, the first menstruation often appears in a girl of 18 years of age.
The girl's body goes through a series of major changes. In this process, not only the uterus and the ovaries participate, but also the areas of the brain that regulate the production of female sex hormones. It is during this period of instability of the hormonal background that puberty uterine bleeding occurs, which often coincide with the onset of ovulation. So what to do in such cases? What specialists to contact?
Juvenile uterine bleeding in adolescents: causes of
Naturally, in the first place, patients, as well as their parents, are interested in the causes of the development of pathology. Juvenile uterine bleeding is most often due to the non-synchronous functioning of the ovaries and the hypothalamic-pituitary system. It is this part of the brain that is a kind of "control center".Here neurohormones are developed, which control the work of all the glands of internal secretion, including organs of the reproductive system. On the background of desynchronization, the processes of folliculogenesis are violated, which leads to a change in the normal menstrual function.
When the relationship between the brain and the ovaries is broken, hyperestagia often develops( a sharp increase in the level of estrogens in the blood).This, in turn, leads to hyperplasia of the endometrium of the uterus. Often against the background of such disruptions, the formation of cysts in the organs of the reproductive system is observed.
Because functional uterine bleeding in juvenile age is associated with instability of the hormonal background, several risk factors can be identified. For example, constant stresses, nervous overstrain, emotional exhaustion affect the release of hormones, and therefore may well provoke the appearance of bleeding.
According to statistics, many adolescent girls face a similar problem after suffering from infectious diseases, including colds, rubella, chicken pox, influenza, parotitis, etc. Chronic inflammatory diseases that gradually deplete body reserves, for example, tonsillitis.
Pathology can be triggered by intense physical exertion, constant training( especially for girls who professionally engage in sports).It is important and proper nutrition, because the diet should contain all minerals and vitamins. Often, bleeding begins after a severe hypothermia of the body.
The causes of bleeding include blood clotting disorders, but this condition is associated not only with the uterus - blood loss is possible in almost any organ, and it is very difficult to stop it.
It is proved that there is a certain genetic predisposition. It is noted that if the mother had a problem pregnancy, gestosis, abnormalities of the reproductive system or the same juvenile uterine bleeding in adolescence, the chances of developing the ailment in her daughters are much higher.
Forms of pathology
Depending on the characteristics of the hormonal changes, juvenile uterine bleeding can be of two types:
- Hyperestrogen pathology, which, incidentally, are observed most often. They arise against the background of an increase in the level of estrogens and are accompanied by copious, prolonged secretions from the genital tract. Typically, similar bleeding occurs after a slight delay in menstruation( from 1 to 3 months).
- More rarely, patients are diagnosed with gopoestrogenic forms that develop against a background of estrogen deficiency. As a rule, bleeding begins after a long delay in menstruation( from 2 to 8 months).Allocations are not very abundant and often disappear quickly on their own.
What are the symptoms of pathology?
Unfortunately, quite often teenage girls can not distinguish bleeding from menstruation. By the way, the first episodes of pathology often fall on the first menstruation. Nevertheless, they can continue for several years after the onset of ovulation.
Bleeding is rarely accompanied by severe pain. Nevertheless, we can note an increased amount of secretions. Often, bleeding lasts for several consecutive days( 8 or more) - this is cause for concern. Pathology can manifest not only during menstruation, but also between them. In addition, the cycle time is shortened - it is less than 21 days.
Against the background of permanent blood loss anemia develops. Girls complain of weakness, chronic fatigue, decreased efficiency, learning difficulties, fatigue, constant dizziness. The skin becomes pale.
What complications are possible?
Immediately it is worth noting that girls 18 years and older, as a rule, no longer suffer from similar pathologies, as the hormonal background can be aligned with the help of properly conducted therapy. But with improper treatment or even its absence, the consequences can be dangerous.
Massive blood loss is dangerous in itself. Moreover, intermittent bleeding leads to the development of anemia. In turn, this disease is fraught with oxygen starvation and exhaustion of the body. It is also possible to develop persistent hormonal disorders that provoke a variety of problems, including the formation of cysts and tumors in the tissues of the ovary, as well as infertility.
Modern diagnostic methods
Certainly, the diagnostic process should include several stages. First, a teenage gynecologist will try to collect a complete anamnesis. It is important to know when there were discharges, whether there were provoking factors, whether the patient's mother was suffering from gynecological diseases, whether the girl had had any infectious diseases, etc.
Next, a standard gynecological examination followed by an ultrasound examination of the pelvic organs- this makes it possible to assess the status of the ovaries, detect the presence of cysts or other neoplasms, check whether there is an inflammatory process, etc. In order to more closely examine the internal sexorgans, sometimes performed hysteroscopy.
Since the juvenile uterine bleeding of girls is associated with hormonal imbalance, an obligatory part of the diagnosis is a blood test for hormones. In particular, check the level of progesterone, FSH, estradiol, LH, testosterone and thyroid hormones. If violations are detected, the patient is sometimes referred for advice to an endocrinologist.
Depending on the data obtained during the diagnosis, an additional blood coagulation test can be performed additionally. Only after receiving all the necessary data the doctor can make an effective treatment regimen.
Drug treatment: drugs for stopping uterine bleeding
Treatment of this pathology largely depends on the degree of its severity, as well as the causes of development. If juvenile uterine bleeding is more or less associated with physical or emotional stress, they need to be eliminated - sometimes even this is enough to ensure that episodes of the disease do not recur.
Unfortunately, in most cases, the condition of patients is more severe, and bleeding requires hospitalization. The first task in this case is to stop the loss of blood. To begin with, girls are prescribed haemostatic drugs, in particular, "Vikasol", "Dicinon", as well as aminocaproic acid and ascorutin. It is also necessary to take oxytocin, which causes uterine contractions and helps stop bleeding. Intravenously injected glucose solution.
If the above described therapy scheme does not have the desired effect, the patient is prescribed hormone estrogen-gestagenic drugs, in particular, Marveloy, Rigevidon, and Mersilon. Such drugs in most cases help to stop blood loss within a day, after which their dose is gradually reduced. Nevertheless, the course of taking tablets lasts 21 days. Such therapy helps not only to eliminate bleeding, but also gradually normalize the normal menstrual cycle, which is important, especially if the pathology is associated with a serious hormonal imbalance.
In addition, the patient is prescribed the intake of vitamin complexes, iron-containing products, vasoconstrictor medications - this helps to eliminate anemia and restore the balance of minerals and nutrients in the body. With severe anemia, it is necessary not only to take iron, but also folic acid, vitamins C and B12.Massive blood loss is an indication for transfusion of erythrocyte mass and frozen plasma. Physiotherapy is also necessary. Complex treatment should also include feasible physical exertion, healthy diet, proper working and rest.
If bleeding occurs against a background of stressful situations or is associated with a mental factor, then it is mandatory to consult a therapist. Sometimes you need to take sedatives and other medications.
Surgical treatment: when is it necessary?
In some cases, this pathology requires surgical intervention. Hysteroscopy with diagnostic curettage of the uterine cavity is performed. This procedure is usually carried out under general anesthesia, but it is also possible with the use of local anesthesia. If possible, the doctor retains the hymen. The tissue obtained during the curettage is then sent to the laboratory for further research.
Surgical intervention is required for prolonged massive bleeding, which can not be established with conservative means. But even after curettage the patient needs treatment with medication, including hormonal drugs. It is worth noting that in cases of blood clotting disorders, the operation can not be carried out in any case.
Are there effective prevention methods?
It's not a secret for anyone that sometimes it is much easier to prevent the development of a disease than to undergo treatment and to deal with complications. Modern medicine recommends preventive maintenance therapy to prevent new bleeding.
From the fifth to the fifteenth day of the menstrual cycle, patients are prescribed vitamin E, folic and glutamic acid, as well as a solution of vitamin B intravenously. From the 16th to the 26th day of the cycle, the therapy scheme looks different: the girls take ascorbic acid and B vitamins. Such treatment is carried out within three months after the bleeding stops and, according to the reviews, gives really good results.
If the stop of bleeding was carried out with the help of hormonal drugs, the patient is shown taking small doses of progestins, in particular, "Logesta", "Novinet", "Silesta" and some other medicines. Girls who received scraping with a subsequent hormonal arrest of bleeding are prescribed estrogen-progestational medications.
Naturally, during the rehabilitation period, the general health procedures are of great importance. An important point is proper nutrition. We need to ensure that the body receives a sufficient amount of vitamins and minerals. Twice a year, a prophylactic intake of vitamin complexes is recommended.
All this will not only prevent the occurrence of bleeding in the future, but also help to normalize the menstrual cycle, to set up the reproductive system.
Positive physical health will affect regular physical activity( their intensity should increase gradually), swimming, walking on fresh air, rest by the sea, active tourism, sanatorium treatment.
Treatment with folk remedies: is it possible?
Many patients are interested in questions about whether there are folk remedies for stopping uterine bleeding. Certainly, folk medicine men offer some methods of fighting with pathology.
For example, an effective remedy is the infusion of yarrow and nettle. To make it, you need to grind 25 grams of nettle leaves and yarrow flowers. A tablespoon of the finished mixture is poured into a glass of boiling water, after which it is infused for two hours. Take the drug three times a day, 100 ml. The course of such home therapy lasts 10 days. It is believed that the remedy helps prevent the occurrence of uterine bleeding in the future.
You can stop blood loss with orange broth. To begin with, you need to cleanse seven oranges, pour on their peel with a liter of boiling water. The mixture should be boiled over low heat until only a third of the original volume of water is left in the pan. In the broth for flavor, you can add a little sugar. Take recommended for 12 tablespoons 3-4 times a day. It is believed that to stop the bleeding with the help of such a drug can be two days later.
You can make tea from mountain ash. Take equal parts of berries of mountain ash and mint leaves and mix them.10 g of the finished mixture should be poured a glass of boiling water and let it steam. It is recommended to drink tea three times a day. As a rule, complete recovery occurs 2-4 days after the start of therapy.
Despite the variety of folk recipes, do not forget that juvenile uterine bleeding is an extremely serious problem. The loss of a large volume of blood threatens dangerous consequences for the whole body. Moreover, home remedies are not able to normalize the hormonal background. Therefore, before starting any home remedies, consult your doctor. Uterine bleeding requires urgent medical attention - do not risk your health.