Menorrhagia - what is it? Menorrhagia: causes, symptoms, treatment. Menorrhagia in adolescence

Menorrhagia (hypermenorrhea) is a prolonged and profuse uterine bleeding during menstruation, the interval between which is significantly reduced.

In women suffering from menorrhagia, menstruation is usually prolonged (7 or more days), while the patient loses about 100 ml of blood.

The main symptom of menorrhagia is not only copious excretion blood, but also the presence of clots in it.

Large blood loss sometimes provokes the occurrence of such complications as anemia. After heavy menstruation, this is a fairly common phenomenon in which a woman appears:

- feeling of weakness

Deterioration of well-being

Dizziness,

Fainting state.

Sometimes menorrhagia causes bruising and bruising on the body, as well as bleeding gums and nosebleeds. Wherein menstrual bleeding so plentiful that a woman has to change sanitary pads or tampons every hour. Every woman should know that excessive menstruation is an occasion to contact a professional who will help solve this problem.

Why does menorrhagia occur?

The causes of menorrhagia can be the following violations:

- hormonal disbalance, especially in adolescents and women of preclimatic age;

Diseases of the female reproductive system (myoma, polyps, adenomyosis of the uterus) caused by hormonal imbalance in a woman's body;

Complications when using intrauterine contraceptives;

Poor blood clotting due to vitamin K deficiency, thrombocytopenia, or medications that affect blood clotting;

Diseases thyroid gland, liver, heart and kidneys can be the cause of menorrhagia.

That is why, with heavy menstruation, the specialists of our clinic recommend consulting a therapist and an endocrinologist in order to exclude general somatic and endocrine causes of bleeding and any factors that cause the body to activate the mechanisms of adaptation to new conditions (excessive loads, abrupt change climate) provoke the development of menorrhagia.

In addition, menorrhagia is often inherited through the female line.

Diagnosis of menorrhagia

With any bleeding, the doctor must initially exclude the patient from pregnancy, especially ectopic. To do this, in the laboratory of our clinic, it is necessary to take a blood test for pregnancy (to detect the hormone chorionic gonadotropin in the blood).

To find out the causes of menorrhagia, the doctor examines the female genital organs.

During the inspection, the possible presence of:

- tumors;

Polypov;

foreign bodies;

Inflammatory processes;

Traumatic injury.

If there is suspicion of various pathologies uterus or ovaries, the doctor, in addition to ultrasound, prescribes a biopsy, hysteroscopy, analysis of endometrial tissue and curettage.

The technical base of the laboratory of our clinic allows us to examine the patient's blood:

- for hemoglobin;

For coagulability;

On definition hormonal background;

Not tumor markers.

If the patient's menstruation is too heavy, she is advised to menstrual calendar to mark the duration, nature and abundance of the discharge.

How is menorrhagia treated?

In their practice, the doctors of our clinic use two methods of treating menorrhagia:

- therapeutic (drug);

Surgical.

Medical treatment includes anti-inflammatory drugs and hormonal contraceptives in combination or separately. Hormonal preparations contain the hormones estrogen and progesterone, which prevent the growth of the endometrium and thus reduce the volume of secretions.

Anti-inflammatory drugs are very effective in the treatment of menorrhagia, but in some patients they provoke irritation of the gastric mucosa.

Surgical treatment of menorrhagia is used for:

- damage to the genital organs or their physiological disorders;

recurrent menorrhagia;

iron deficiency anemia.

If medical treatment for menorrhagia is ineffective, then doctors use the following surgical procedures:

1) Removal of the uterus (hystroectomy). Such an operation makes pregnancy impossible, so it is very rarely done to women. reproductive age. After a hystrectomy, a woman's body recovers quite quickly.

2) Inspection of the walls of the uterus with a special tool. With the help of this procedure, it is possible not only to diagnose violations, but also to eliminate them. Before the examination, the doctor prescribes an analysis for hepatitis B, syphilis, determination of the patient's blood group, her Rh factor. Treatment of menorrhagia in this way is effective in about 80 percent of cases.

Every woman should remember that menorrhagia is serious illness. Treatment must be immediate. Therefore, in no case should you postpone a visit to the doctor, in order to avoid irreversible consequences. Be attentive to your health!

menorrhagia- these are regular menstruations that come on time with an abnormal duration (sometimes up to 14 days) and large blood loss. Menorrhagia may appear in young girls during the formation of the correct menstrual cycle, in adult women, as well as in patients entering the menopause period.

Menorrhagia is a symptom, not independent disease. In fact, it is a long, profuse menstruation that comes every month on time. Important diagnostic criterion menorrhagia is its regularity, since sometimes this symptom is confused with another type of menstrual irregularity - irregular intermenstrual bleeding.

Menorrhagia in women is due to large quantity causes, but always associated with violations right process rejection of the mucous layer of the uterus during menstruation.

In order to correctly interpret the nature of menstruation, it is necessary to determine its normal parameters which are considered to be the norm. As a rule, physiological menstruation comes once every 28 days (25-35 days are allowed), lasts not longer than a week(but not less than 2 days) and is not accompanied by too much blood loss (from 40 to 150 ml). Usually women measure the amount of blood lost by the number of pads used per day. If it does not exceed four pieces, menstrual blood loss is conditionally taken as the norm. The duration of menstrual bleeding with menorrhagia increases, so the intermenstrual period is shortened.

Define valid criteria menstrual function not so easy. long and heavy menstruation, as well as short and meager, can appear in a woman in her youth and continue throughout her life without harming her health and reproductive ability. Situations when an atypical course of menstruation is observed in a patient all her life (primary menorrhagia), is not combined with a disease or reproductive dysfunction, does not belong to the pathological, but is taken as an individual norm.

If menorrhagia occurs after a period of normal menstruation, it is customary to speak of its secondary origin.

The causes of menorrhagia are not limited to the gynecological sphere, since the menstrual cycle is closely related to the central nervous system, work endocrine glands and largely depends on the condition immune system. All of them lead to hormonal dysfunction, which is considered the leading cause of menstrual irregularities.

Sometimes, when studying the nature and cause of menorrhagia, its idiopathic nature is indicated. Idiopathic menorrhagia is a primary disorder of the formation normal menstruation, which occurs independently, without the participation of external dysfunction. Idiopathic menorrhagia depends only on pathological processes in the uterus and observed at normal operation ovaries (that is, in women with ovulation).

Menorrhagia in women is often combined with symptoms of gynecological diseases, but it can also be triggered by temporary factors: stress, acclimatization, excessive physical activity, and others.

The diagnosis of menorrhagia is never definitive. In fact, he only states the presence of a violation of normal menstrual function and requires further examination to determine the cause of its occurrence. Treatment for menorrhagia depends on its cause.

It should be noted that single episodes of menorrhagia are also experienced by healthy women. Throughout life, every woman experiences situations that change the course of the normal menstrual cycle. However, such a situation always has a good ending, when the body restores the violations on its own, or they are eliminated by simple therapeutic methods.

Pathological menorrhagia always indicates serious reason and require treatment.

Causes of menorrhagia

Menorrhagia is associated with structural changes in the lining of the uterus at the time of menstruation. To understand the mechanism of its development, it is necessary to remember the cyclic physiological processes occurring in the uterine mucosa and functionally related organs.

The menstrual cycle is the time elapsed from the onset of menstrual bleeding to the onset of the next. The first day of the cycle is also the first day of menstruation, and its last day coincides with the beginning of the next period. Through the menstrual cycle, a woman realizes reproductive function, that is, can conceive and endure a child.

The menstrual cycle always consists of joint successive changes in the ovaries and uterus under the control of the central nervous system more specifically, the pituitary and hypothalamus.

The normal menstrual cycle is always biphasic. The first (folliculin) phase is accompanied by the maturation of the egg in the ovary. It is located in the follicle - a vesicle containing follicular fluid. At the end of the maturation of the egg (mid-cycle), the follicle ruptures and releases it outside the ovary (ovulation). In the uterine mucosa (endometrium), at the same time, the processes of growth (proliferation) of the inner layer begin. The endometrium becomes thick, loose, germinates blood vessels, so he prepares the uterus for a potential pregnancy: if the egg is fertilized and enters the fallopian tubes into the uterine cavity, the overgrown endometrium will become the site of fetal development.

If fertilization does not occur within two days, the egg dies, and all changes that have occurred in the endometrium in the first, folliculin, phase of the cycle begin to be eliminated. The second (luteal) phase of the cycle is accompanied by rejection of the overgrown endometrium and ends with the evacuation of the contents of the uterus to the outside - menstruation. Regeneration (recovery) of the endometrium begins 36 hours after the onset of bleeding.

All of these changes in the uterus and ovaries occur with the controlling participation of hormones. The maturation of the follicle and the egg is accompanied by the follicle-stimulating hormone (FSH) of the pituitary gland, and the proliferation of the endometrium is stimulated by estrogens. After ovulation, luteinizing (LH) hormone from the pituitary gland dominates in the ovary, and progesterone is responsible for changes in the uterus.

All cyclic actions of the pituitary gland, ovaries and uterus are “looked after” by the hypothalamus, located in the brain.

Thus, a change in the normal functioning of any link in the "hypothalamus - pituitary gland - ovaries - uterus" system can lead to a change in the nature of the menstrual function.

The physiological causes of menorrhagia are:

- Psycho-emotional disorders, overwork;

- Changing the nature of nutrition: a sour-milk diet causes the liver to produce substances that reduce blood clotting.

- Incorrectly dosed physical exercise. Sports or heavy physical labor during and on the eve of menstruation lead to a violation of uterine contractility and improper rejection of the endometrium.

- drastic change climatic conditions.

- Dysfunction of the liver, endocrine glands, thyroid gland () or blood coagulation system.

- Deficiency of vitamins involved in the blood coagulation system (C, P, K, calcium and others).

- The period of the formation of the menstrual function (puberty) or its extinction (menopause).

– Reception hormonal drugs, aspirin, anticoagulants.

- Intrauterine contraception.

When such causes are eliminated, normal menstrual function is stabilized.

Pathological causes of menorrhagia always imply the presence of a disease accompanied by menstrual disorders, namely:

— Cervical polyps;

- Ovarian dysfunction.

Symptoms and signs of menorrhagia

Clinically, menorrhagia is manifested by prolonged (more than a week) menstrual bleeding, sometimes the interval between them can be reduced (less than three weeks). The period of heavy bleeding usually takes no more than three days. hallmark menorrhagia is the presence menstrual blood with clots. Since rejection processes occur unevenly in the endometrium, the blood, before pouring out, accumulates in the uterine cavity and has time to curl up and form clots.

Significant menstrual blood loss affects general condition patients with menorrhagia, in the case of anemia, weakness appears, fainting is possible.

If menorrhagia appears against the background of cervical or uterine polyps, menstruation becomes not only profuse and prolonged, abdominal pain appears. Fibromyoma of the body of the uterus, especially with a central location in the submucosal layer, also causes pain during menstruation.

The diagnosis of menorrhagia implies a consistent diagnostic search for the cause of its occurrence. Due to very a large number possible causes the appearance of this symptom, sequentially performed:

- Conversation. It is important to find out when menorrhagia appeared, whether she has obvious reason(stress, overwork, etc.), the nature of bleeding and the presence of accompanying symptoms(especially pain).

- Gynecological examination. In the presence of a myomatous node in the uterine cavity, the size of the uterus and its consistency can be changed, and cervical polyps on a long stalk are visualized in the area of ​​​​the external pharynx when viewed in mirrors. The uterus on palpation and displacement can be painful. The presence of whiter in the vagina will indicate an infectious and inflammatory process.

- Collection of material (contents of the vagina and cervical canal) for laboratory research.

— Hormonal study according to the phases of the cycle. Estradiol, FSH, LH, progesterone are determined.

- Blood test to determine the degree of anemia.

— Ultrasound scanning of the pelvic cavity. It allows you to see the follicles in the ovaries (or their absence), assess the state of the endometrium relative to the phase of the cycle, see fibroids, polyps or ovarian tumors.

- Hysteroscopy. Allows you to visually examine the entire uterine cavity, detect and immediately remove the polyp and take the material (endometrium) for histological examination.

Treatment of menorrhagia

Unfortunately, patients rarely seek qualified help in a timely manner when the first menorrhagia appears. Usually, if bleeding is not accompanied by a significant deterioration in well-being, they first try to cope with unwanted symptoms on their own with the help of hemostatic and pain medications. Really, symptomatic therapy can often eliminate external manifestations ailment, but helps only with menorrhagia of physiological origin. When the basis of the violation of normal menstruation is a disease, menorrhagia will not disappear. If menorrhagia recurs two or three cycles in a row, you should definitely consult a doctor.

The treatment for menorrhagia depends on the underlying cause. In fact, it coincides with the treatment of a disease that provokes menstrual dysfunction. First of all, all provoking factors are eliminated. Then proceed to eliminate the immediate cause of menorrhagia.

Hormonal disorders are corrected with the help of adequately selected drugs, using cyclic oral contraceptives and progestogens. They have a hemostatic, anti-inflammatory effect, and also restore the correct hormonal balance. Preparations are selected taking into account the age and nature of the menstrual function. Utrozhestan, Duphaston, Norethisterone are more commonly used.

uterine fibroids require additional curative measures, and polyps are certainly removed during hysteroscopy.

To reduce blood loss, hemostatic agents are used (Tranescam, Vikasol and the like).

Eliminate anemia help drugs containing iron.

Regular menorrhagia of unknown origin sometimes requires the removal (curettage) of the entire mucous layer, followed by histological examination.

Even the most proper treatment menorrhagia without addressing its immediate cause will not be effective.

menorrhagia called heavy uterine bleeding during menstruation, which are accompanied by the release of blood clots. In addition to massive blood loss, characteristic symptom menorrhagia is poor general health, dizziness and even anemia. The causes of menorrhagia may be a violation reproductive system, diseases of the female genital organs, stressful situations and wrong image life. In order to diagnose menorrhagia, a woman undergoes gynecological examination, Ultrasound of the pelvic organs, analysis of gynecological history and more. Treatment of menorrhagia can be therapeutic (with the appointment of drugs that stop the blood) and surgical (curettage of the walls of the uterus, as well as removal of the uterus itself in more severe cases).

Menorrhagia - what is it?

Menorrhagia (or heavy periods)- prolonged uterine bleeding, which are repeated at regular intervals. If bleeding during menstruation exceeds the volume of 150 ml for more than 7 days, then it is customary to make a diagnosis of menorrhagia. This disease can be a sign of a violation of the female reproductive system. Inflammatory processes in the uterus, ovarian dysfunction, uterine fibroids, neuropsychological overwork - all this can be the cause of menorrhagia. As a rule, menorrhagia entails a violation of the normal working capacity of a woman. Abundant menstruation can later even cause anemia. According to statistics, 35-37% of women of reproductive age are diagnosed with menorrhagia. Finding yourself menorrhagia is not difficult. If a woman notices that during menstruation she began to change tampons or pads more often, if menstruation is so plentiful that personal hygiene products do not have time to absorb blood, and blood flows onto the bed or clothes, then such heavy menstruation indicates the development of menorrhagia.

Menorrhagia in adolescents

What is menorrhagia we found out. Let's now try to figure out why menorrhagia is so common in adolescents. Most often, menorrhagia occurs in adolescents aged 13-17 years. It is during this period that the hormonal background is formed. main reason heavy menstruation in adolescents is an imbalance of the hormones estrogen and progesterone. It is these hormones that are involved in the processes of maturation and, as a result, rejection of the endometrium of the uterus.

Menorrhagia is especially difficult to tolerate in adolescence. Therefore, as soon as a teenager discovers the main symptom this disease, namely constant heavy menstrual bleeding, you should immediately consult a doctor. Usually, the effectiveness of the treatment of such a disorder can be assessed only after six months. This period is necessary for the final restoration of menstrual bleeding in normal volume. After undergoing effective treatment, a teenager should be registered with a gynecologist and visit a doctor twice a year.

The main causes of menorrhagia

One of the main causes of menorrhagia is a violation hormonal balance(or, in other words, hormonal levels), which can lead to the appearance and development of menorrhagia. The risk group includes both a teenager who has recently begun menstruation, and a woman who has entered into menopause. What a teenager, what a woman experiencing menopause experience for themselves hormonal changes, which can take place with certain failures of the endocrine system.

One more important reason, which should be paid attention to, and which causes the development of menorrhagia, is a violation of the reproductive system, leading to a particular disease. Such a disease can be ovarian dysfunction, uterine fibroids, fibroids, adenomyosis of the uterus, polyps. All this can provoke the occurrence of menorrhagia. In the presence of benign tumor menorrhagia may also occur in the uterus.

A possible cause of the appearance and development of menorrhagia may be improper use intrauterine contraceptive. Such a drug leads to a side effect, which is heavy menstrual bleeding. If a woman using intrauterine contraceptives notices the appearance of heavy menstruation in herself, she should immediately stop using this drug. Otherwise, there is a risk of developing menorrhagia.

In some cases, such a phenomenon as menorrhagia can be a symptom of a serious disease, such as cancer of the female reproductive system (cervical cancer, ovarian cancer, etc.). The cause of the appearance of profuse bleeding, repeated with enviable regularity, can be an ectopic pregnancy. Menorrhagia can also be triggered by a blood disease associated with a violation of its coagulability. Menorrhagia can be caused by a lack of vitamin K in a woman's body, as well as a disease such as thrombocytopenia. In very rare cases, heavy periods can be hereditary and passed from mother to daughter.

Menorrhagia disease can be triggered by diseases of the kidneys, pelvis, thyroid gland, liver and heart. Endometriosis can also cause menorrhagia. According to doctors, there are a great many reasons for the appearance and development of menorrhagia in women. Menorrhagia can be caused even by experienced stress, overwork, increased level physical stress that a woman experiences and even a change in climatic conditions.

Whatever the reason for the development of menorrhagia, having discovered the symptoms of this disease in herself, a woman should immediately consult a doctor. First of all, it is necessary to consult with a therapist and an endocrinologist in order to exclude possible somatic and endocrine causes development of menorrhagia.

Symptoms of menorrhagia

So, having found out that menorrhagia is prolonged and profuse uterine bleeding during menstruation, it will not be difficult to determine the symptoms of this disease. Main symptom- profuse menstrual flow, in which a woman loses significantly more blood than during normal menstruation. Another symptom must be considered a prolonged period of bleeding, which once again confirms the diagnosis of menorrhagia. If menstruation lasts more than seven days, then this is a sure sign of the development of menorrhagia in a woman. Menstrual flow during menorrhagia occurs with blood clots. Additional symptoms menorrhagia are weakness, dizziness, general malaise, and fainting.

Diagnosis of menorrhagia

Diagnosis is necessary as soon as a woman has certain symptoms characteristic of menorrhagia. As mentioned earlier, primary menorrhagia is characterized by heavy bleeding during menstruation. To begin with, the doctor must exclude possible pregnancy. For this, a pregnancy test is performed. Second mandatory procedure for diagnosing menorrhagia is a blood test to detect human chorionic gonadotropin in it. For diagnosis, the data of anamnesis, accounting for the course of past pregnancies, the complexity of the course of childbirth, and the use of a particular medication in the past are also important.

Laboratory diagnostics for menorrhagia helps to examine the level of hemoglobin, as well as to properly carry out a biochemical blood test and conduct a coagulogram to determine the hormonal background. Menorrhagia is also determined by conducting an analysis using tumor markers CA 19-9 and CA-125.

To determine menorrhagia, the doctor may order a Pap smear cytology test. This analysis makes it possible to identify precancerous or cancer cells on the cervix.

For all women with suspected menorrhagia or those who have been accurately diagnosed with menorrhagia, doctors recommend keeping a menstrual calendar where each month the woman notes the duration of her menstruation, as well as how heavy her menstruation is. Determining whether your period is heavy or not is very simple - just pay attention to how often the pad or tampon is changed.

Therapeutic treatment of menorrhagia

Therapy for a disease such as idiopathic menorrhagia is made depending on one or another reason that caused this disease, as well as taking into account the duration of menstruation and how heavy menstrual bleeding is. Doctors forbid self-medication, especially when it comes to menorrhagia in a teenager.

Drug treatment of a disease such as menorrhagia involves the use of oral contraceptives(hormonal drugs) that would regulate hormonal balance. It is known that the prescribed hormonal preparation containing estrogen and progesterone can prevent and prevent the growth of the endometrium, as well as reduce the amount of menstrual bleeding by more than 40-45%. Selection hormonal drug should only be carried out by a gynecologist. The drug should be taken strictly according to the doctor's prescription.

For a woman with more prolonged menorrhagia, the doctor prescribes an iron supplement to prevent the development of a possible iron deficiency anemia. Especially to reduce bleeding during menstruation, doctors often prescribe rutin or ascorbic acid.

In order to treat menorrhagia, an anti-inflammatory drug such as ibuprofen is also prescribed, which affects the level of menstrual bleeding, as well as its duration. In the case of very heavy bleeding, special hemostatic drugs are prescribed: calcium chloride (gluconate), dicynone, aminocaproic acid and others.

In addition to drugs the best treatment for a woman, this is a restorative day regimen, restoration of balance labor day and rest, normalization of sleep and nutrition. As soon as menstruation ends, it is necessary to conduct a course of special physiotherapeutic procedures, which involve about 15-17 separate procedures of ozocerite and diathermy. AT special occasions treatment of menorrhagia is not limited medicines. In some situations, menorrhagia requires emergency treatment in the form of surgery.

Surgical treatment of menorrhagia

In the case of a recurrent course of a disease such as menorrhagia, with a physiological disorder, as well as with possible damage to the genital organs and anemia that has arisen, with ineffective treatment with medications appointed surgery. To begin with, it is necessary to carry out such a procedure as hysteroscopy, which helps to identify any existing pathology of the uterus (for example, endometrial polyps) and eliminate it in a timely manner. Curettage of the uterine cavity can significantly reduce menstrual bleeding, thereby alleviating the symptoms of menorrhagia, but the result of such treatment may be short-lived. Therefore, in some cases, special surgical treatment is necessary. In the case of menorrhagia in the presence of polyps or fibroids, the disease is treated by surgical removal of the uterus. Such surgical treatment menorrhagia is prescribed for women after 40-45 years. If the woman is younger, such surgical treatment is used in especially severe cases.

Prevention of menorrhagia

Compliance with preventive measures will help prevent the development of menorrhagia in both adolescents and women middle age. Such preventive measures include abstinence from heavy physical exertion, the rejection of heavy strength exercises. Must be avoided stressful situations and don't get too tired. Changing climatic conditions also play a role in the development of menorrhagia. Acceptance of such multivitamin preparations like vitamins B and C, iron and folic acid are also preventive measures in preventing menorrhagia.

Menorrhagia is prolonged heavy bleeding from the uterine cavity. The beginning and end of bleeding coincides with the menstrual cycle.

Symptoms of menorrhagia in women

Menstrual cycle healthy woman is 21 to 35 days, in which the menstrual phase takes 2 to 7 days. For menorrhagia, duration menstrual phase increases from 8 to 14 days and has a number of other characteristic features:

• pads (tampons) are changed every 1-2 hours, and their number exceeds 4 pieces. per day;
• there is a need to change the gasket at night;
• heavy bleeding accompanied by the appearance of blood clots;
• appear pain in the lumbar region, lower abdomen;
• the color of the secreted blood is scarlet or brown;
• the volume of secreted blood reaches 80-150 ml, while the rate of blood loss these days is up to 44 ml (2-3 tablespoons).

During and after menstruation, women experience fatigue, shortness of breath, dizziness, bleeding from the nose or gums, and bruising may appear on the body. Against the background of a large blood loss, anemia develops.

With heavy, painful menstruation, a visit to the doctor is necessary measure since menorrhagia may be a symptom of serious gynecological diseases requiring immediate long-term treatment.

Examination methods

During the conversation with the patient, the gynecologist finds out whether stress, prolonged depression, overwork, and a change in climatic conditions could have provoked menorrhagia. Then a gynecological examination is performed with the sampling of material from the vagina and cervical canal for laboratory research, tests for hormonal studies are prescribed, ultrasound and hysteroscopy are performed.

At the beginning of the examination, the patient takes an analysis to determine the level of chorionic gonadotropin (hCG) in the blood to exclude menorrhagia as a complication of the first trimester of pregnancy. By clinical analysis blood, hemoglobin and erythrocytes are determined, according to biochemical analysis blood level serum iron and bilirubin. Hormonal studies to determine the causes of heavy menstruation are carried out in accordance with the phases of the cycle and include an analysis of the level of sex hormones in the blood: follicle-stimulating (FSH), luteinizing (LH), progesterone, estradiol. The cervix is ​​examined for possible infection, inflammatory process, dysplasia, cancer. An endometrial biopsy is done to rule out possible violations on the cellular level. To identify the cause of the disease, the following examination methods are used:

1. Ultrasound is performed to determine the condition of the uterus, ovaries and other organs pelvic floor; with menorrhagia, it is prescribed if there is a suspicion of the presence of uterine fibroids or endometrial polyps.
2. Sonohysterography is a method of examination carried out after the introduction of fluid into the uterine cavity. This method allows you to identify changes in the myometrium, examine the vascular structure of polyps, and examine the condition of the walls of the uterus.
3. Hysteroscopy - a study in which injection into the uterine cavity occurs physiological saline or carbon dioxide which improves the diagnosis of her condition. This method allows you to quickly eliminate the causes of heavy periods and take a tissue biopsy.

The examination allows you to identify factors that affect the occurrence of bleeding and prescribe effective treatment. The main causes of menorrhagia can be:

1. Changes in hormone levels. At risk are women whose age suggests hormonal changes in the body - these are girls puberty as well as women going through the developmental phases of menopause.
2. Diseases reproductive organs. These diseases include: uterine fibroids (causes bleeding and an increase in the area of ​​the endometrium; in most cases it is benign education), cervical polyps (the appearance of which is usually provoked hormonal changes in the body, injuries, inflammations), endometrial polyps (they are outgrowths from the endometrium with a loose vascular structure), endometrial hyperplasia (thickening of the mucous membrane of the uterine cavity), inflammatory processes of the pelvic organs, oncological diseases cervix, endometrium.
3. Use of intrauterine contraceptives (intrauterine devices). In this case, you can get rid of the disease only by removing the spiral and selecting alternative method contraception.
4. Blood clotting disorders provoked by thrombocytopenia, vitamin K deficiency, von Willebrand disease (episodic spontaneous bleeding), taking certain medications.
5. Stress, severe restriction of food intake, heavy physical exertion.

A timely examination and identification of the cause of menorrhagia allow us to develop the necessary medical tactics to eliminate the disease.

Treatment methods for the disease

In the practice of treating menorrhagia, drug therapy, surgical and unconventional methods treatment.

Medical therapy – one of the most priority methods of treatment, since it excludes surgical intervention into the body and preserves the woman's ability to conceive a child. In this case, the following groups of drugs are used:

• Antifibrinolytic - aimed at preventing and stopping bleeding. These drugs include aminomethylbenzoic acid and tranexamic acid, which are used as directed by a doctor until bleeding stops. These drugs do not cause side effects, except for mild disorders in the work of the gastrointestinal tract.
• Hormonal agents - are designed to restore the balance of estrogen and progesterone in the patient's body, to narrow the endometrial vessels. The efficiency of using micronized progesterone is about 30%; drugs - antigonadotropins are applicable for long-term treatment (more than 20 days). Termination hormone therapy is fraught with repeated heavy monthly bleeding, so it is important to constantly monitor the patient's condition. The effectiveness of therapy is 20-30%.
• Non-steroidal anti-inflammatory drugs - are used in the treatment of bleeding as anti-inflammatory and analgesic drugs, while exerting a depressing effect on the production of prostaglandins. The most common drugs in this group are: Aspirin, Paracetamol, Ibuprofen, Diclofenac, Piroxicam. The effectiveness of their application is 20-30%.
• Gonadotropin-releasing hormone (GnRH) antagonists, danazol, are intended for preoperative preparation organism. Their action is aimed at suppressing the production of estrogen by the ovaries, restoring its level to normal. The effect of drugs reduces the foci of endometriosis and eliminates pain in the pelvis.
• Intrauterine contraceptive systems - help to reduce the layer of the endometrium, reduce its blood supply. After 3 months of use, such systems can reduce blood loss in women with menorrhagia by 90%.

Scheme drug treatment effective and allow women of childbearing age to conceive and bear a child after menorrhagia.

Surgical treatments used when it is impossible or ineffective drug therapy. These methods include:

• Curettage - curettage of the uterine cavity. This procedure rarely used in medical practice, since the possibility of recurrence of symptoms of the disease after surgery is about 50%.
• Destruction of the endometrium is a resection of the thickness of the endometrium of the uterus using an electric current. This technique in 85% of cases saves the patient from bleeding.
• Hysterectomy (removal of the uterus) is the most extreme method for women of reproductive age, as it completely excludes the possibility of conceiving and bearing a child.

Non-traditional methods of treatment can be used as aids treatment of menorrhagia. The most common use of decoctions medicinal herbs: cuff ordinary; meadow geranium; collection of yarrow, chamomile, horsetail, horse chestnut, shepherd's bag. An effective remedy from heavy monthly bleeding is stinging nettle, shepherd's purse, angelica, cat's foot.

Self-medication for uterine bleeding is unacceptable, since it can lead to a number of complications that translate the disease from initial stage into neglected or incurable. Timely appeal and correct setting diagnosis will allow you to choose the right method of treatment for the complete elimination of menorrhagia.

Menorrhagia is profuse menstruation, which is characterized by a significant (exceeding physiological norm) blood loss. Menorrhagia has obvious symptoms - it is a general weakness, accompanied by heavy bleeding. Anything that is outside the norm can be dangerous, so you should always consult a doctor. Idiopathic menorrhagia requires careful diagnosis, after which appropriate treatment can be prescribed. The diagnosis of menorrhagia treatment may involve surgical and therapeutic methods. The entire treatment process is supervised by a gynecologist.

As already mentioned, menorrhagia is blood loss that exceeds normal performance. Recall that normally a woman loses up to 150 ml of blood during menstruation. If the norm is violated, then this may serve as a manifestation of any inflammatory processes female genital area, ovarian dysfunction, uterine fibroids, neuropsychic overwork. All other causes will depend on the cause of the underlying disease. Menorrhagia is one of the typical variants of hypermenstrual syndrome (that is, heavy periods), in which menstrual bleeding lasts more than 7 days.

Prolonged and heavy menstruation disturbs about 30% of all women, but not all of them turn to a gynecologist with this problem. There is primary menorrhagia, which occurs in parallel with the first menstruation, and secondary - developing after a period of normal menstruation.

The main manifestation of menorrhagia is prolonged and heavy menstruation. Often there are blood clots of various sizes. Severe and prolonged blood loss often leads to anemia, that is, to a lack of blood. This complication is manifested by a deterioration in general well-being, dizziness, causeless weakness, development fainting. Quite often, with menorrhagia, bleeding from the nose and gums, bruises and bruises on the body can be noted. With menorrhagia, menstruation can be so heavy that a woman simply has to change her pad or tampon every hour, and in some cases every 30 minutes.

Menorrhagia causes different, and in each case they are individual. According to experts, in about 80% of all cases, menorrhagia is a symptom of a number of serious gynecological diseases. For example, fibroids or endometriosis (adenomyosis) of the uterus. Hormonal imbalance is very important. Also, heavy menstruation can be associated with any violations of the blood coagulation process (thromocytopenia) or with a violation of the thyroid gland. That is why, in addition to a gynecologist, it is advisable for a woman to consult with other doctors of the relevant profile, in particular with an endocrinologist. Do not forget about the work of the heart, liver and metabolic process.

Very often, the cause of heavy menstruation can be intrauterine contraceptives, as well as dysfunctional uterine bleeding. Women who are actively involved in sports should be aware that heavy physical exertion can also cause menorrhagia. A similar reaction in the body can cause all sorts of diets that are not selected in accordance with individual characteristics organism. Not infrequently, menorrhagia manifests itself as a family disease transmitted through the female line of inheritance. Complicate the whole situation various diseases kidneys, thyroid gland, heart, pelvic organs.

Since adolescents often experience hormonal instability, girls aged 13-16 often suffer from heavy menstruation. The main explanation for this is an imbalance between the levels of estrogen and progesterone, which directly affect the maturation and rejection of the endometrium of the uterus. It can also occur with a passion for the thyroid gland, genital tract infections, poor blood clotting. Other reasons include hereditary forms coagulopathy (that is, a violation of hemostasis). As a rule, adolescents do not tolerate menorrhagia, so they require immediate medical advice. If not assigned the right treatment, then 30% of girls develop polycystic ovaries in the future.

Menorrhagia treatment requires immediate treatment to avoid further problems. The method of treatment for menorrhagia is chosen depending on the cause and duration of menstrual bleeding. Everyone knows that self-medication only aggravates the situation, so it is better not to do this. As a drug therapy, long-term administration is prescribed to regulate hormonal balance. hormonal contraception. The composition of oral contraceptives includes estrogen and progesterone, which prevent the excessive growth of the endometrium, reducing the amount of discharge during menstruation by about 40%. Selection oral medications carried out by a gynecologist on an individual basis.

Women with menorrhagia are given long-term iron supplementation to avoid likely development iron deficiency anemia. Taking rutin and ascorbic acid will help reduce blood loss. The complex of treatment includes anti-inflammatory drugs (for example, ibuprofen), which affect the amount and duration spotting. If the patient develops heavy bleeding, then it is necessary to prescribe hemostatic drugs - calcium chloride or calcium gluconate, dicinone, aminocaproic acid. In case of hormonal imbalance, homeopathic treatment effectively shows itself.

As additional methods treatment using intrauterine systems with levonogestrel. The main action is a contraceptive effect, namely an obstacle to the proliferation of the endometrium, with a decrease in its thickness and blood supply. But, if metrorrhagia was caused by the use of an intrauterine contraceptive, then from this method worth giving up. Finally, women with this diagnosis are advised to rest and balanced diet. At the end of menstrual bleeding, a course of physiotherapy is prescribed.

The main indications for surgical intervention with menorrhagia:

— mechanical damage or physiological disorders of the genital organs.

- recurrent menorrhagia

- inefficiency therapeutic method treatment.

- Severe iron deficiency anemia.

with medical and diagnostic purpose with menorrhagia, hysteroscopy is performed, which allows you to diagnose any pathology of the uterus and eliminate it. By scraping the uterine cavity, bleeding is prevented for several menstrual cycles, after which menorrhagia resumes. If a woman has prolonged and heavy menstrual bleeding or she is diagnosed with fibromyoma and polyps, then they resort to extirpation of the uterus - that is complete removal uterus. As a rule, the uterus is removed after 40 years, and in young age this operation is done only in very severe cases.