Excessive vaginal bleeding

Introduction A large amount of bleeding in the vagina during non-menstrual periods.

Cause

Causes of excessive vaginal bleeding:

Abortion, ectopic pregnancy, genital malignant tumors, etc.

an examination

Related inspection

Gynecological routine examination of genital gynecological routine examination electronic colposcopy

Examination and diagnosis of excessive vaginal bleeding:

Pay attention to the age of the patient when asking about the medical history is important for the identification of vaginal bleeding. A small number of vaginal bleedings on the day after the birth of a newborn baby girl is due to the sudden drop in estrogen from the mother and the withdrawal of bleeding usually stops within a few days. Malignant tumors should be considered in early childhood and postmenopausal vaginal bleeding. Adolescent girls with vaginal bleeding often for functional uterine bleeding women of childbearing age should consider more pregnancy-related diseases. To ask about the age of menarche, the menstrual cycle before menstruation and the amount of menstrual blood. There is no history of menopause and the exact date of the last menstrual period before vaginal bleeding. Whether the duration of vaginal bleeding is persistent or intermittent irregular bleeding, the amount of bleeding and the presence or absence of tissue excretion.

Increased menstrual period, prolonged menstrual period, normal cycle, generally seen in uterine fibroids, adenomyosis endometrial irregular detachment and placement of the IUD. The cycle is shortened, the menstrual frequency is often more than the luteal function is less than two times, a small amount of bleeding between menstruation is mostly ovulation bleeding. After menopause, vaginal bleeding occurs in women of childbearing age. First, pregnancy-related diseases should be thought of; if menopausal women are mostly dysfunctional uterine bleeding, irregular vaginal bleeding after menopause should consider genital malignant tumors. Post-sexual bleeding should consider early cervical cancer, cervical polyps cervical erosion and subtympanic myoma.

Ask whether vaginal bleeding is associated with abdominal pain and its nature. Paroxysmal abdominal pain is more common in abortion. Sustained severe abdominal pain may indicate rupture of ectopic pregnancy. Menstrual period pain should be considered endometriosis. Vaginal bleeding with malodorous leucorrhea should be thought of advanced cervical cancer or department. Submembranous fibroids are complicated by infection.

Ask about the presence or absence of systemic diseases such as hypertension anemia, liver disease, thrombocytopenic purpura and other diseases to understand whether or not to take sex hormone drugs, including contraceptives, whether to place intrauterine devices.

Differential diagnosis

Symptoms of vaginal bleeding and confusing symptoms:

1. Ovarian endocrine dysfunction: including anovulatory dysfunctional uterine bleeding and ovulatory menstrual disorders.

2. Uterine bleeding associated with pregnancy: common abortion, ectopic pregnancy, gestational trophoblastic disease, part of the postpartum placenta, uterine incompleteness and so on.

3. Genital inflammation: such as vulvar ulcers, vaginitis, acute cervicitis, cervical polyps.

4. Genital tumors: ovarian tumors, vaginal cancer, cervical cancer, endometrial cancer, uterine sarcoma, choriocarcinoma, etc.

5. Injury, foreign body and exogenous sex hormones: genital tract trauma such as vulva, vaginal riding cross injury, hymen bleeding or vaginal injury caused by sexual intercourse, placement of intrauterine birth control ring, etc., improper use of estrogen or progesterone.

6. Vaginal bleeding associated with systemic diseases: thrombocytopenic purpura, aplastic anemia, leukemia, etc.

Pay attention to the age of the patient when asking about the medical history is important for the identification of vaginal bleeding. A small number of vaginal bleedings on the day after the birth of a newborn baby girl is due to the sudden drop in estrogen from the mother and the withdrawal of bleeding usually stops within a few days. Malignant tumors should be considered in early childhood and postmenopausal vaginal bleeding. Adolescent girls with vaginal bleeding often for functional uterine bleeding women of childbearing age should consider more pregnancy-related diseases. To ask about the age of menarche, the menstrual cycle before menstruation and the amount of menstrual blood. There is no history of menopause and the exact date of the last menstrual period before vaginal bleeding. Whether the duration of vaginal bleeding is persistent or intermittent irregular bleeding, the amount of bleeding and the presence or absence of tissue excretion.

Increased menstrual period, prolonged menstrual period, normal cycle, generally seen in uterine fibroids, adenomyosis endometrial irregular detachment and placement of the IUD. The cycle is shortened, the menstrual frequency is often more than the luteal function is less than two times, a small amount of bleeding between menstruation is mostly ovulation bleeding. After menopause, vaginal bleeding occurs in women of childbearing age. First, pregnancy-related diseases should be thought of; if menopausal women are mostly dysfunctional uterine bleeding, irregular vaginal bleeding after menopause should consider genital malignant tumors. Post-sexual bleeding should consider early cervical cancer, cervical polyps cervical erosion and subtympanic myoma.

Ask whether vaginal bleeding is associated with abdominal pain and its nature. Paroxysmal abdominal pain is more common in abortion. Continued severe abdominal pain may indicate rupture of ectopic pregnancy. Endometrial ectopic should be considered in menstrual period.

Symptoms of vaginal bleeding with malodorous vaginal discharge should be concomitant with advanced cervical cancer or subdural fibroids.

Ask about the presence or absence of systemic diseases such as hypertension anemia, liver disease, thrombocytopenic purpura and other diseases to understand whether or not to take sex hormone drugs, including contraceptives, whether to place intrauterine devices.

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