Bleeding after exercise

Nowadays, more and more people like to do sports, which can make their physical fitness better. However, excessive physical exercise can also cause some bad effects, causing bleeding below, especially for female friends. If there is vaginal bleeding, further examination should be done to find the real cause of the bleeding.

1. Vaginal bleeding during childhood

The possibility of precocious puberty or genital tract malignancy should be considered.

2. Vaginal bleeding with pain during puberty

Pain in the vagina and vulva, accompanied by varying amounts of bleeding, may be caused by trauma.

3. Women of childbearing age have a small amount of vaginal bleeding between menstruation

Vaginal bleeding may be due to ovulation, which is normal.

4. Postmenopausal vaginal bleeding

Women with ectopic pregnancies also often experience vaginal bleeding after menopause, which is often accompanied by dull pain in the lower abdomen and a long bleeding time. Therefore, it cannot be simply assumed to be ovulation bleeding without confirming pregnancy. Miscarriage also has vaginal bleeding.

5. Contraceptive pills cause bleeding

Bleeding after taking birth control pills is called breakthrough bleeding.

6. Postmenopausal vaginal bleeding

Vaginal bleeding 2 years after menopause. Attention should be paid to excluding malignant lesions, such as cervical cancer, endometrial cancer, etc., and then considering inflammation, polyps, endocrine factors, etc.

7. Incomplete uterine involution and puerperal infection

Incomplete restoration of the uterine placental attachment surface can cause blood clots to fall off and blood sinuses to reopen, leading to uterine bleeding. Puerperal infection is most commonly endometritis, which can cause poor restoration of the uterine placental attachment surface and poor uterine contraction, as well as incomplete sinus closure leading to uterine bleeding.

8. Uterine bleeding caused by endometritis, myometritis, salpingitis, pelvic cellulitis, etc.

9. Genital tumors

Uterine fibroids, cervical cancer, endometrial cancer, ovarian cancer, etc.

(1) Laboratory examination: routine blood and urine examination. Patients of childbearing age often require urine or blood HCG testing to rule out pregnancy or pregnancy-related diseases. Depending on the situation, thyroid function, liver function, kidney function, coagulation function and sex hormone tests may also be required.

(2) Cervical cytology and HPV testing: Patients who have bleeding during sexual intercourse or cervical inflammation, polyps, or bleeding should undergo this examination, which can help diagnose early cervical cancer.

(3) Ultrasound examination: B-ultrasound (transabdominal or transvaginal): Patients with uterine bleeding often need to undergo pelvic B-ultrasound examination to understand the size and shape of the uterus, the thickness of the endometrium, whether there are abnormal echoes in the uterine cavity, whether there are masses in the adnexal area and the characteristics of the masses, whether there is abdominal effusion, etc.

(4) Biopsy: ① Lesions of the vulva, vagina, and cervix can be directly biopsied to confirm the diagnosis. If choriocarcinoma is suspected, biopsy should be avoided because uncontrollable massive bleeding from the lesion may occur. ② For patients with uterine bleeding, a diagnostic curettage is often required (generally limited to married patients) to confirm the diagnosis or stop bleeding, and the scraped tissue must be subjected to pathological examination. For those suspected of endometrial cancer, segmental diagnostic curettage is performed. That is, the cervical canal is scraped first, then the depth of the uterine cavity is explored and the endometrial tissue is scraped. After the source of the specimens is marked, they are sent for pathological examination to assist in the diagnosis of endometrial cancer.