Bleeding after gynecological examination

Nowadays, many people pay great attention to gynecological examinations and may go for a gynecological examination every six months. However, some people find that they are bleeding from their lower body after the examination. If it is very serious, it should not be ignored. Because usually the examination will not harm people's body, the occurrence of vaginal bleeding means that their vagina has been damaged and must be treated as soon as possible.

1. Neonatal vaginal bleeding

Under the influence of large amounts of estrogen in the placenta, the female fetus's uterus and ovaries are affected to a certain extent, resulting in partially developed follicles and atretic follicles in the ovaries, and hyperplasia of the endometrium. In a small number of baby girls, due to the interruption of maternal estrogen supply after birth, the endometrium undergoes hormone withdrawal shedding, resulting in menstrual-like vaginal bleeding that disappears on its own after a few days and does not require treatment.

2. Bleeding related to contraceptive drugs

When taking contraceptives, vaginal bleeding, also known as breakthrough bleeding, occurs. Most of the time, it occurs after missing a pill. For a few women who have not missed a pill, vaginal bleeding is related to insufficient hormones. If bleeding occurs in the first half of the menstrual period, it is often due to insufficient estrogen, causing endometrial necrosis and exfoliation bleeding. If bleeding occurs in the second half, it is caused by insufficient progesterone. Bleeding caused by the use of contraceptives is mostly irregular spotting or increased menstrual flow and prolonged menstrual period.

3. Dysfunctional uterine bleeding

It often occurs during adolescence and menopause. The length of menstrual period varies, and the amount of blood can be several times the amount of menstrual blood and even cause shock. In contrast, the amount of blood can be continuous. Therefore, the ovarian function in both phases is unstable and most of the bleeding is anovulatory. Patients often experience a period of amenorrhea followed by uterine bleeding. Sometimes it starts with heavy or prolonged menstruation and then turns into irregular or persistent uterine bleeding. Sometimes bleeding can last for more than ten days or longer, and pelvic examination shows no lesions. The basal body temperature is monophasic; the endometrial biopsy shows proliferative endometrium or excessive hyperplasia, which can confirm the diagnosis.

Middle-aged women with prolonged menstrual periods, increased menstrual blood volume, and a certain regularity of the menstrual cycle should consider ovulatory uterine bleeding. The basal body temperature is atypically biphasic; endometrial biopsy shows a poor secretory reaction, which can be diagnosed as uterine bleeding caused by an incomplete corpus luteum; if the endometrial biopsy performed on the fifth day of the menstrual period still shows a secretory phase reaction, then uterine bleeding caused by incomplete corpus luteum atrophy is confirmed.

4. Intermenstrual bleeding

It usually occurs on the 12th to 16th day of the menstrual cycle, lasts for 1 to 2 hours or 1 to 2 days, with a small amount, and very rarely reaches the menstrual volume. The cause is usually due to the rupture of the follicle and a temporary drop in estrogen levels. Sometimes it is accompanied by mild abdominal pain. As long as the bleeding pattern is carefully checked and there are no other causes, the diagnosis is usually not difficult.

5. Postmenopausal uterine bleeding

In recent years, the increasing use of estrogen and progesterone has led to an increase in the rate of uterine bleeding. In addition, for some patients, although the amount of estrogen secreted by the ovaries decreases after menopause, the adrenal glands still secrete a small amount of estrogen, which gradually accumulates and can cause endometrial hyperplasia and lead to uterine bleeding.