Menstruation has not been clean for a long time

Under normal circumstances, women's menstruation lasts for 3-5 days. If it lasts too long, you should consider whether it is caused by prolonged menstruation. There are many reasons why women's menstruation does not end for a long time, and many pathological factors can cause it. Candidal vaginitis can also have this symptom, and endometrial inflammation can cause frequent shedding of the endometrium, thus causing menstrual bleeding to not end. So, what are the other reasons why menstruation does not end for a long time after it comes?

1. Inspection

1. Perform routine blood tests, hormone level tests, coagulation function tests, platelet adhesion and aggregation function tests, BBT tests, and perform endometrial or blood progesterone tests at an appropriate time.

2. Hysteroscopy, laparoscopy, B-ultrasound, and uterine artery angiography.

2. Diagnosis

Based on the clinical manifestations and the above-mentioned related examinations, measuring the blood progesterone concentration 5 to 9 days before menstruation can help determine whether it is ovulatory dysfunctional uterine bleeding.

Treatment

1. Medication

(1) For patients who do not require contraception or are unwilling to use hormone treatment, antifibrinolytic drugs such as tranexamic acid or anti-PG synthetic drugs such as flufenamic acid (flufenamic acid) and mefenamic acid (mefenamic acid) can be used. Adverse reactions may include nausea, dizziness, headache, etc.

(2) For patients who require contraception, endometrial atrophy treatment can be used.

(3) Others: Danazol is a derivative of 17a-ethynyltestosterone. It can inhibit the secretion of gonadotropin-releasing hormone, inhibit the peak of the gonadotropin cycle and the production of ovarian sex hormones, and reduce blood loss. However, attention should be paid to side effects such as rash, liver damage, and virilization. Gonadotropin-releasing hormone enhancers are effective in suppressing ovarian function, but due to side effects caused by low estrogen levels, they can only be used for a short period of time. Cottonpol has a strong effect in atrophying the endometrium and can also act directly on the ovaries. Potassium chloride (slow-release potassium) should be taken in addition to prevent the side effect of hypokalemia. Suitable for patients in the menopausal transition period who no longer desire fertility.

2. Surgery

For patients who are ineffective with drug treatment, whose disease persists, who are elderly, and who do not desire to have children, surgical removal of the hysterectomy can be performed. In recent years, transcervical endometrial resection (TCRE) has been used, which uses laser, microwave, or electrocoagulation to destroy the functional layer and part of the basal layer of the endometrium under the monitoring of B-ultrasound examination through hysteroscopy, so that it loses the ability to respond to ovarian sex hormones, thereby reducing menstrual blood loss. This type of operation takes a short time, involves little trauma, and has a quick recovery. It is suitable for those who are not suitable for or unwilling to have their uterus removed and have no desire to have children. It can also remove small submucosal fibroids at the same time. Before surgery, gonadotropin-releasing hormone enhancers are used to shrink the endometrium.