What causes vaginal bleeding?

Vaginal diseases are very common. If you have such a disease, you need to seek timely treatment. Otherwise, when the vaginal disease becomes serious, the treatment will become complicated. In addition, the most common treatment for vaginal diseases is medication. This treatment method is simple and very effective in alleviating the condition. It also does not have much impact on your health. So what is vaginal bleeding? Let me introduce it in detail below.

What causes vaginal bleeding?

Endocrine-related vaginal bleeding

The most common disease is functional uterine bleeding, the pathogenesis of which is related to the following factors.

1. When there is an imbalance in sex hormone secretion and anovulatory functional uterine bleeding, the single and long-term estrogen stimulation causes the endometrium to proliferate progressively, proliferate to a highly adenocystic type, adenomatous hyperplasia, and even gradually become endometrial cancer. Due to the lack of progesterone antagonism and glandular secretion, the endometrium is thickened, the glands increase, the glandular cavity is enlarged, and the glandular epithelium proliferates abnormally. The intimal blood supply increases and the spiral arterioles become tortuous. The polymerization and gelation of acidic particulate polysaccharide (AMPS) caused by estrogen reduces the permeability of blood vessels in the interstitium, affects the exchange of substances, causes local endometrial tissue ischemia, necrosis, and shedding, and causes bleeding. The coagulation effect of acidic particulate polysaccharide also hinders the shedding of the endometrium, causing asynchronous exfoliation of the endometrium and causing long-term irregular bleeding of the endometrium.

When there is ovulatory functional uterine bleeding, the corpus luteum may degenerate prematurely, resulting in a short luteal phase and frequent menstruation; or it may be incompletely atrophied and continuous secretion of progesterone, resulting in luteal phase (premenstrual) bleeding, prolonged menstruation, and continuous spotting, or both. The mechanism is insufficient secretion of estrogen and progesterone, especially insufficient secretion of progesterone, which causes the endometrium to be completely secreted, with immature development of glands, stroma and blood vessels, and due to the asynchronous withdrawal of estrogen and progesterone, irregular exfoliation of the endometrium and abnormal bleeding occur.

2. The role of prostaglandins It is known that prostaglandins (PGs), especially PGE2, PGF2 thromboxane (TXA2) and prostacyclin (PGL2), are a group of highly active vascular and coagulation function regulatory factors. They affect endometrial bleeding function by regulating uterine blood flow, spiral arterioles and microcirculation, muscle contraction activity, endometrial lysosomal function and coagulation fibrinolytic activity.

TXA2 is produced in platelets, which causes microvascular constriction. Platelet aggregation, thrombosis, and hemostasis. PGL2 is produced in the blood vessel wall and has the opposite effect to TXA2, strongly dilating the microvessels, resisting platelet aggregation and preventing thrombosis. PGFa can cause constriction of endometrial spiral arteries, while PGE2 can dilate blood vessels. So TXA2 and PGL2, PGF2a. Disturbances in PGE2 function and dynamic balance can cause endometrial bleeding.

3. Abnormal structure and function of endometrial spiral arterioles and lysosomes Abnormal spiral arterioles interfere with the endometrial microcirculation function, affect the shedding of the endometrial functional layer and the repair of blood vessels and epithelium on the detachment surface, affect vasoconstriction and local coagulation and fibrinolysis function, and lead to abnormal uterine bleeding. From the follicular phase to the luteal phase, the number of lysosomes and the activity of their enzymes increase progressively. Progesterone stabilizes while estrogen destabilizes the lysosomal membrane. Therefore, when the estrogen/progesterone ratio is unbalanced before menstruation, the stability of the lysosomal membrane will be destroyed. The rupture of the lysosomal membrane will cause the precipitation and release of destructive hydrolases, which will cause endometrial cell rupture, endometrial layer collapse, necrosis and bleeding.

4. Functional uterine bleeding is often accompanied by a decrease in coagulation factors, deficiency of coagulation factors V, VII, X, and XII, thrombocytopenia, anemia, and iron deficiency. At the same time, the amount of endometrial plasmin-activating substances increases and the activity is enhanced, activating plasminogen to form plasmin. Plasmin cleaves fibrin, increasing myofibrin degradation products and reducing plasma fibrin, resulting in a defibrinogenated state in the uterus, which in turn affects the coagulation and hemostasis process at the tip of the normal endometrial spiral arterioles and the vascular lake, leading to long-term heavy bleeding.

Vaginal bleeding related to pregnancy

Vaginal bleeding related to pregnancy is common with miscarriage. Most of the embryos in early abortions are dead, and the basal decidua is necrotic and hemorrhaged, causing the embryo's villi to detach from the decidua and the blood sinuses to open and bleed. Before 8 weeks of pregnancy, the chorionic villi are not yet mature and the connection with the uterine decidua is not yet firm. The entire blastocyst can easily be completely separated from the uterine wall, and there is often not much bleeding. During the 8th to 12th week of pregnancy, the chorionic villi are vigorously developed and deeply embedded in the uterine membrane, with a firm connection. The placenta villi are not completely separated and cannot be expelled at the same time as the fetus. Some placental tissue remains in the uterine cavity, affecting uterine contraction and causing severe bleeding. Late miscarriage, such as retained membranes or placenta, can also result in heavy bleeding.

Tumor-related bleeding

1. Uterine fibroids Uterine fibroids are a common cause of vaginal bleeding. ① Patients with fibroids often suffer from endometrial hyperplasia and polyps due to excessive estrogen, leading to excessive menstrual flow; ② Fibroids cause the uterus to increase in size, the endometrial area to increase, and the amount of bleeding is excessive or the bleeding lasts too long. Especially in the case of submembranous fibroids, the area of ​​the uterus increases and bleeding increases; ③ In the case of submembranous fibroids, the surface of the membrane often ulcerates and necrotizes, leading to chronic endometritis and causing continuous bleeding; ④ Intramural fibroids affect uterine contraction and the effect of clamping blood vessels, or the endometrium of submembranous fibroids cannot contract itself, all of which lead to excessive bleeding and prolonged bleeding time; ⑤ Larger fibroids may be combined with pelvic congestion, making the blood flow vigorous and large in amount.

2. The second is vaginal bleeding caused by cervical cancer and endometrial cancer. Cervical cancer bleeding is mainly seen in the exophytic type, also known as the cauliflower type, which is brittle and often causes contact bleeding. Later, as the tumor grows and tissue necrosis and shedding occur, heavy bleeding occurs. In endometrial cancer, the endometrium presents as polyp-like protrusions that are enlarged, hard, and brittle, with superficial ulcers on the surface. In the late stage of the disease, there are ulcers and necrosis, involving the entire endometrium, and the necrotic tissue sheds and bleeds in small to moderate amounts or continuously.

After understanding what causes vaginal bleeding, when relieving vaginal bleeding, you should do it according to your own reasons. At the same time, it should be noted that during the treatment of vaginal bleeding, you should choose simple foods in your diet and avoid eating complex foods to avoid affecting the treatment of your own disease.