Why does it bleed on day 9-10 of the cycle. Bloody discharge in gynecology. Symptom of a dangerous disease

Light spotting outside of a period or bleeding between periods is common. They are found in many women. Bloody discharge, as a rule, occurs before menstruation or a few days after it ends. However, they can appear on any day in the middle of the cycle. Most often, the nature of such secretions is normal and is not considered a symptom of any serious disease. But the unreasonable occurrence of bleeding, which is profuse, may be a sign of diseases of the uterus and other disorders of the organs of the female genital area.

It is worth pointing out that the normal duration of the menstrual cycle is from 21 to 35 days, the duration of menstrual bleeding is 3-7 days, while blood loss is from 40 to 80 ml. Monthly blood loss of more than 50-60 ml contributes to the occurrence of an acute shortage of iron in the female body.

Causes of bleeding in the middle of the cycle.
Intermenstrual bleeding is understood as uterine or vaginal bleeding that occurs between periods, earlier or later than the expected start of menstruation. This phenomenon is also known as vaginal bleeding between periods and is expressed in the form of blood clots in the middle of the menstrual cycle. Some women classify this phenomenon as a short cycle, but this is not at all the case. A short cycle (polymenorrhea) involves severe blood loss that occurs on the 13th or 15th day after the end of the last menstruation. Such a phenomenon as polymenorrhea, as a rule, is observed with a disorder of uterine contractions in conditions of slow regeneration of the mucous membrane of its cavity, as well as disorders of blood clotting. Therefore, this kind of phenomenon does not apply to polymenorrhea.

Intermenstrual bleeding most often occurs 10-16 days after the end of the last menstrual period. This type of bleeding is not abundant (that is, you can get by with the use of "daily") and lasts an average of twelve to seventy-two hours. If the intensity of bleeding does not change, then there is no reason for concern. If blood loss increases, and the duration of bleeding is more than three days, it is necessary to visit a gynecologist. In case of severe bleeding, you should call an ambulance. It also happens that, having already become pregnant, a woman has her last menstruation, while she is completely unaware of conception. Therefore, in cases where such bleeding is accompanied by severe pain, there is a suspicion of an ectopic pregnancy, miscarriage, etc.

Intermenstrual bleeding is observed in almost thirty percent of women and is the norm. This phenomenon is caused by fluctuations in estrogen levels during ovulation, which cause the endometrium to weaken and bleeding occurs. Most often, in this situation, a woman is prescribed hormonal agents with estrogen to normalize hormone levels. Bleeding in the middle of the cycle is observed in women with frequent violations of the functions of the genitourinary system, while the nature of the bleeding is more intense.

There are two main types of bleeding that occur between periods:

• bleeding between two periods - intermenstrual bleeding;
• metrorrhagia - severe uterine bleeding.

• hormonal changes or disorders in the body;
• insufficient amount of thyroid hormones;
• miscarriage;
• diseases of the endometrium of the uterine cavity;
• use of intrauterine contraception (spiral);
• starting or stopping birth control pills;
• starting or stopping estrogen-based drugs;
• severe depression or stress;
• diseases of the cervix;
• carrying out some gynecological procedures (in particular, cauterization and biopsy of the cervix);
• taking certain medications;
• vaginal infections or trauma to the vagina;
• benign neoplasms in the cervix, vagina, or urethra.

In cases with intermenstrual bleeding, it is recommended to rest more and avoid stressful situations and depressive conditions in every possible way. Therapy of this type of bleeding is necessary if this phenomenon causes pain in a woman, and is also caused by the development of serious diseases. In these cases, appropriate treatment is prescribed.

It is very important to visit a gynecologist to prevent the development of serious diseases with a constant delay in menstruation, with painful menstruation, with abundant or scanty bleeding during menstruation, in violation of their duration. There is no need to despair if any pathology was detected during the diagnosis, because the treatment of the disease at an early stage is quite effective.

Bloody discharge in the middle of the cycle.
Bloody discharge, which is meager (mostly no need to use pads), occurs much more often than intermenstrual bleeding. They are expressed in the form of pinkish or light brown mucus from the vagina, which can only be seen on toilet paper. Underwear does not get dirty.

This kind of discharge occurs approximately two weeks before the onset of menstruation and is absolutely normal. Basically, this period falls on ovulation, so the discharge indicates the readiness of the egg for fertilization. These selections help to accurately determine

Content

Bloody discharge before menstruation is an alarming sign, indicating a pathology in the reproductive organs. When they appear, you should consult a gynecologist. By the nature of the discharge, you can recognize the cause of their occurrence. Therefore, it is recommended to pay attention to their consistency, color and intensity.

What does bleeding before menstruation mean?

The duration and frequency of menstruation varies from woman to woman. On average, critical days last 5-7 days. The beginning of menstruation is considered the first day of spotting. But in some cases, blood appears a few days before menstruation. This symptom is most often a sign of a gynecological disease. Possible reasons for the deviation include:

• damage to the vaginal mucosa;
• the presence of bad habits;
• unbalanced diet;
• an abundance of stressful situations;
• lack of sex hormones;
• physical fatigue;
• adverse climatic conditions;
• a sharp change in body weight;
• complications after abortion.

Spotting can cause abdominal trauma or damage to the mucosa during intercourse. Sometimes blood occurs in the early stages of pregnancy, with an increased risk of interruption. A woman may not be aware of her situation due to the absence of a delay at that time. Therefore, it is very important to pay attention to the symptoms of various gynecological diseases in a timely manner. Ignoring them is fraught with the development of serious complications.

Attention! Bloody discharge before critical days can even be triggered by a change in climatic conditions.

Bleeding 3 days before period

Blood before menstruation is considered the norm if it does not cause discomfort to a woman. Smearing discharge can be a harbinger of beginning menstruation. The following signs indicate the development of the pathological process:

• spasms in the pelvic area;
• increase in body temperature;
• muscle weakness;
• lowering blood pressure;
• nausea and vomiting;
• dizziness.

One of the causes of spotting is a decrease in the level of progesterone in the body. It is necessary to maintain the luteal phase of the cycle. The hormone is produced by the corpus luteum, which forms at the site of a non-ovulated follicle. Its deficiency can lead to problems with conception. Against the background of a decrease in the amount of progesterone, the level of LH also changes.

With an ectopic pregnancy, minor bleeding may occur before menstruation. But most often it occurs against the background of a long delay. The symptom is accompanied by acute pain in the abdomen and deterioration of well-being. Dizziness appears and performance decreases sharply. The outcome depends on how quickly the woman goes to the doctor.

Bleeding 4 days before period

Normally, blood from the vagina can occur only during menstruation. To determine why spotting appears before menstruation, it is necessary to characterize them. For this purpose, the following parameters are evaluated:

• volume;
• consistency;
• the presence of foreign impurities;
• smell;
• accompanying symptoms.

A bloody secret with an unpleasant odor, including purulent impurities, indicates the presence of an infectious disease. If the discharge has a brown tint, the likelihood of developing endometriosis is high. This disease is a process of spreading the functional uterine layer outside the genital organ. With polyps and erosion, discharge with blood before menstruation appears after intimacy or examination by a gynecologist. They are pinkish in color.

Bleeding 5 days before period

Spotting is a common symptom of hormonal imbalances. If it is detected, it is required to take tests for hormones. It is equally important to exclude the possibility of the presence of infectious diseases. Blood discharge a few days before menstruation can be the result of banal stressful situations. Despite this, leaving them unattended is extremely dangerous.

Important! Disturbance of hormones in the luteal phase can be caused by excessive physical exertion.

Bleeding a week before period

Blood a week before menstruation is one of the signs of an accomplished conception. This phenomenon in gynecology is called implantation bleeding. It is very rare. Blood is released as a result of the introduction of the embryo into the uterine cavity. A woman notices a drop of blood before menstruation on her underwear, an implantation retraction occurs on the basal temperature chart. But in most cases, implantation is asymptomatic.

Bleeding 10 days before period

The time of bleeding may indirectly indicate the nature of their origin. Blood discharge before menstruation for 10 or 14 days may appear as a result of ovulation. It represents the moment of rupture of the follicular walls, as a result of which the egg is released. Within 48 hours after the completion of this process, peak fertility is observed. Unprotected intercourse during this period leads to the development of pregnancy. Usually, blood in this case is accompanied by cramping pain.

Why is there blood before menstruation

Not always, the blood preceding menstruation indicates a gynecological disease. In certain cases, this sign is considered absolutely natural. Physiological spotting before menstruation disappears on its own and does no harm. Pathological factors require immediate treatment.

Physiological causes

In certain situations, blood before menstruation without pain does not require therapeutic action. But even in this case, it is undesirable to neglect a visit to the doctor. The physiological causes of bleeding before menstruation include:

• taking hormonal drugs;
• postoperative period;
• the impact of stress;
• developing pregnancy;
• features of the structure of the reproductive organs.

Pathological causes

Immediate measures should be taken if the causes of spotting a week before menstruation are pathological in origin. These include the following:

• genital infections;
• ectopic pregnancy;
• endometritis or endometriosis;
• hormonal disorders;
• neoplasms in the pelvic area or in the vagina.

When to See a Doctor

Regular preventive examinations reduce the likelihood of developing serious diseases. Bloody discharge before menstruation is a serious reason for an unplanned visit to the gynecologist. Early diagnosis is considered the guarantor of successful treatment. Experts recommend to see a doctor in the following cases:

• the presence of pain in the abdomen;
• profuse blood loss;
• unpleasant odor from the genitals;
• sudden changes in blood pressure;
• blanching of the skin;
• loss of consciousness.

Advice! Women of childbearing age are required to visit a gynecologist at least once every six months.

Opinion of gynecologists

According to experts, a slight daub before menstruation is within the normal range. If it does not cause discomfort, there is no need to worry. A little bleeding a week before menstruation is not the norm, even if it stopped on its own. First, you need to find the root of the problem. For this, a diagnostic study is carried out. It includes: ultrasound monitoring, tests for infections and blood donation for hormones.

Hormonal disorders before menstruation are eliminated with the help of drugs based on synthetic hormones. Often, women are prescribed oral contraceptives to put the ovaries into a dormant state. An ichor a week before menstruation, provoked by endometriosis, is surgically removed. For the treatment of sexually transmitted diseases, antibiotics are prescribed that are active against the bacteria that caused the disease. After the treatment course, it is necessary to pass the tests again. Further action is taken, depending on the outcome.

Conclusion

Bloody discharge before menstruation occurs for various reasons. If they cause pain and discomfort, an urgent visit to the antenatal clinic is required. In some cases, the final outcome of events depends on the speed of decision-making.

Bleeding in the middle of the menstrual cycle may be a consequence of normal physiological processes or a sign of disorders in the functioning of the reproductive system and serious gynecological diseases. Moderate, non-excessive bleeding on the 14-16th day of the cycle (during the period of ovulation) is considered a variant of the norm. This condition can last another 1-3 days after ovulation and be accompanied by slight pulling sensations in the lower abdomen. In some cases, a woman's basal temperature may rise - this is also considered normal and is associated with increased production of progesterone, which is necessary for the successful attachment of the zygote (fertilized egg) to the walls of the uterus.

If the bleeding is profuse, accompanied by fever, severe pain, deterioration of health, you need to see a local gynecologist, since such a picture is uncharacteristic for a healthy woman. It is very important to describe not only the time of appearance of the discharge and their quantity, but also the appearance. Pathological discharge may be brown or brown in color, look like spotting, or have the appearance of a clear (cloudy) mucus streaked with blood. All this is of great importance for diagnosis and allows you to more accurately determine the preliminary diagnosis and prescribe the necessary examination.

Intermenstrual bleeding is a moderate or profuse discharge of blood from the genital tract, which can occur in the first half or middle of the cycle. The menstrual cycle in a healthy woman usually has a duration of 28-30 days, but in individual cases, shifts up or down are possible. If the cycle lasts 24 days or 35 days, there is no cause for concern if this cycle occurs constantly. The beginning of the cycle is considered the day of the onset of menstrual bleeding, therefore, the middle of the cycle is the period from 9 to 13 days after the end of menstruation.

There are two types of intermenstrual bleeding:

• metrorrhagia - dysfunctional uterine bleeding resulting from pathological disorders in the functioning of the organs of the reproductive system;
• physiological bleeding - bleeding, which is the result of physiological processes in the body of a woman and appears strictly on the 10-16th day of the cycle.

They may differ in the amount of blood released, accompanying signs, the duration of the discharge and other symptoms by which an experienced doctor can immediately classify the pathology.

When not to worry?

If a woman's cycle is irregular, bleeding 7 to 10 days before her due date may be menstrual bleeding. There are many factors that can cause early periods. These include:

• taking certain medications;
• severe stress;
• emotional stress;
• hormonal disruptions.

Even dietary errors can cause early menstruation. For example, abundant consumption of snacks, crackers, spices, spicy and fatty foods, alcohol negatively affects the state of all organs of the female body, including the reproductive system. If a woman abuses harmful products, she is more likely to experience a violation of the cycle between menstruation and diseases of the female genital area.

Moderate bleeding during ovulation and the next 2-3 days is also considered normal. This sign indicates that the mature egg is ready for fertilization. Bloody discharge in this case occurs due to the rupture of the dominant follicle, which “releases” a mature egg into the fallopian tube, where it can connect with the sperm and form a zygote.

Important! Slight spotting during and after ovulation is called "ovulatory syndrome". A woman during this period may experience pulling pains in the lower abdomen, lower back and coccygeal region. The temperature (including basal indicators) also usually rises by 0.5 ° -1 °. General well-being may worsen: weakness, drowsiness appear, working capacity decreases. All these symptoms should completely disappear on the 16-17th day of the cycle. If this does not happen, you should consult a doctor.

early symptom of pregnancy

Spotting brown discharge can be a sign of pregnancy. In this case, they are usually accompanied by pain in the lower abdomen, where the uterus is located, and other general symptoms, which include:

• dizziness;
• poor appetite;
• nausea after waking up (some women may feel sick all day long);
• weakness and drowsiness;
• forgetfulness;
• swelling of the mammary glands.

To check whether a woman is pregnant or not, you can use a test to determine the level of hCG in morning urine or do an ultrasound with a transvaginal sensor (but it should be borne in mind that in very short periods such an ultrasound may be uninformative).

Important! At the slightest suspicion of pregnancy, it is necessary to consult a doctor to exclude an ectopic position of the fetal egg. Brown discharge during early pregnancy can also indicate a miscarriage, so consulting a gynecologist for these symptoms is necessary.

Oral contraceptives

Oral contraceptives are contraceptives for women in the form of tablets or capsules (for oral use) that contain hormones. Most often, women are prescribed drugs based on estrogen or progesterone. It can be:

• "Diana-35";
• "Yarina";
• "Janine", etc.

Preparations of this group can be used to prevent unwanted pregnancy or treat gynecological diseases, such as uterine endometriosis. With uterine bleeding, women can also be given higher doses of hormones, but this method of stopping bleeding cannot be used on its own, especially if a woman has a history of benign or malignant formations.

You need to start taking oral contraceptives from the 1st day of the cycle (in some cases, the doctor may prescribe an appointment from 3-5 days from the start of menstruation). If a woman stops taking the drug before the end of the course (21 days), "withdrawal bleeding" may begin. This is profuse, breakthrough uterine bleeding, which in most cases can only be stopped with a curettage procedure or vacuum aspiration.

Important! Emergency contraception preparations (" Postinor», « Escapelle" or " Ginepriston”) can also cause profuse spotting, so after taking them, a woman needs to be under the supervision of a doctor for 10-14 days.

What factors can trigger spotting in the middle of the cycle?

Very often, women who have an intrauterine device, a local hormonal agent that prevents fertilization, complain of mucous discharge with streaks of blood. The spiral (like the rings) must be changed after a certain period of time. If this is not done, an inflammatory process may begin, accompanied by an increase in temperature and a moderate release of blood. Incorrect installation of the coil can also cause injury to the mucous membranes and mild bleeding.

Other factors that can cause bleeding in the middle of a cycle are:

• chronic state of stress (during divorce, hard work, scandalous situation at home);
• lifting heavy objects (rearranging furniture, lifting heavy bags up stairs);
• trauma to the genitals and vagina (for example, when using sex toys);
• lack of vitamins C, A and E involved in the hematopoietic system;
• active or hard sexual intercourse.

Important! If bleeding started 1-2 days after visiting the gynecologist, it may be caused by medical manipulations and the use of gynecological instruments. Such discharge should not last more than 24-48 hours. If the bleeding does not stop, you should consult a doctor.

Video - Intermenstrual discharge

Possible diseases

If bleeding from the genital tract, which began in the middle of the menstrual cycle, is profuse, accompanied by other pathological symptoms, pain, deterioration of health, it is necessary to undergo an examination by a gynecologist to exclude possible diseases of the genitourinary and reproductive system.

Pathology of the mucous membrane of the uterus

The most common cause of bleeding on the 10-14th day of the cycle is the pathology of the mucous membrane of the uterus (endometrium). Abundant, breakthrough uterine bleeding is often observed with excessive growth of the epithelial layer - endometrial hyperplasia. The disease is caused by an excess of sex hormones - progesterone and estrogen - and requires correction with the use of hormonal drugs. Often a woman is prescribed diagnostic curettage, in which the doctor removes the entire endometrium with a special surgical knife (curette) and sends it for histological examination.

Other common pathologies of the endometrium are endometriosis and endometritis. Endometriosis is the pathological growth of mucosal tissue beyond this layer. If inflammation joins the process, the woman is diagnosed with endometritis. All disorders in the functioning of the endometrium are accompanied by characteristic symptoms, including:

• pulling sensations in the lower back and lower abdomen;
• violation of the menstrual cycle;
• bloody spotting between periods;
• problems with conception;
• pain during intercourse;
• insufficient production of vaginal secretions (lubrication).

note! Pathologies of the endometrium increase the risk of malignant processes several times, so you should not delay contacting a doctor.

Tumor processes

With various types of tumors, bleeding is chronic and appears in almost every cycle. The discharge may be red or brown (rarely a light pink tint), is not accompanied by pain, and is usually of moderate intensity.

Varieties of tumors in the uterus, ovaries and other organs of the reproductive system

Important! It is impossible to determine the signs of a malignant process on your own. This will require a doctor's examination, an oncologist's consultation, a biopsy of damaged tissues, colposcopy and other instrumental examination methods. Uterine cancer is curable only in 8-9% of cases and only if it is diagnosed in a timely manner, therefore, with any bleeding (especially if they often recur), you should consult a doctor.

Intermenstrual bleeding in most cases is a variant of the norm, but sometimes disturbances in the work of the most important organs of the reproductive system and even malignant processes can cause such symptoms. Only a doctor can accurately determine the cause of the pathology after examining, collecting an anamnesis and studying the results of the examination. In some cases, differential diagnosis with other female diseases may be required, so it is better not to delay contacting a gynecologist.

Video - Bleeding between periods

Video - Uterine bleeding

Thanks

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!

Bloody discharge in girls

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

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?

Bloody discharge from the vagina as a sign of pathology

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

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;
• the use of emergency contraception drugs: Postinor, Ginepriston, etc.;
• certain medications, and starting or stopping estrogen supplements.

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.

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.

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

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 needed.

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

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

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 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

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 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

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

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.

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?

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?

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

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