Unscheduled vaginal bleeding

If you feel irregular vaginal bleeding, it is not a normal physiological phenomenon. Female friends only have menstrual bleeding during their menstrual period. Bleeding that occurs at other times is due to problems inside the body. At this time, you should choose the treatment measures that suit you based on your clinical symptoms. Generally, drug treatment is the main method.

When asking about the medical history, pay attention to the patient's age, as age is important in identifying vaginal bleeding. Newborn girls have a small amount of vaginal bleeding a few days after birth. This is because a sudden drop in estrogen from the mother causes withdrawal bleeding, which usually stops on its own within a few days. Vaginal bleeding in early childhood and after menopause should be considered as a malignancy. Vaginal bleeding in adolescent girls is often functional uterine bleeding. Vaginal bleeding in women of childbearing age should be considered to be related to pregnancy.

Ask about the age of menarche, menstrual cycle, menstrual period and menstrual blood volume before the onset of the disease. Whether there was a history of amenorrhea before vaginal bleeding and the exact date of the last menstrual period. The duration of vaginal bleeding, whether it is continuous or intermittent irregular bleeding, the amount of bleeding and whether there is any accompanying tissue discharge.

Increased menstrual flow and prolonged menstrual period with normal cycle are generally seen in patients with uterine fibroids, adenomyosis, irregular endometrial shedding and intrauterine contraceptive device placement. Shortened cycles and frequent menstruation are mostly due to luteal insufficiency. A small amount of bleeding between two menstrual periods is mostly ovulation bleeding. When postmenopausal vaginal bleeding occurs in women of childbearing age, the first thing to think of is pregnancy-related diseases; if it occurs in menopausal women, it is mostly dysfunctional uterine bleeding. Irregular vaginal bleeding after menopause should be considered as a malignant tumor of the reproductive tract.

Bleeding after sexual intercourse should be considered as early cervical cancer, cervical polyps, cervical erosion and submucosal myomas. Ask whether vaginal bleeding is accompanied by abdominal pain and its nature. Paroxysmal abdominal pain is common in miscarriage. Continuous severe abdominal pain suggests the possibility of ectopic pregnancy rupture. Severe pain during menstruation should be considered endometriosis. Vaginal bleeding with foul-smelling leucorrhea should be considered as a sign of advanced cervical cancer or submucosal myoma with infection.

Ask whether the patient has any systemic diseases such as hypertension, anemia, liver disease, thrombocytopenic purpura, etc. Find out whether the patient is taking sex hormone drugs including contraceptives, and whether an intrauterine contraceptive device is placed. [1]