Not all blobs are menstrual bleeds!

Medipol Hospital Professor of Obstetrics and Gynecology. Dr. C. Gürkan Zorlu stated that all the bleeds were not menstrual bleeds, "So for a person, 20 ml of normals, 60 ml of bleeding actually points to bleeding three times more. Although it appears at the normal limit, such a condition should not be regarded as normal. Other than that, it is actually 'abnormal uterine hemorrhages' and certainly there is either a hormonal or anatomic pathology underneath.

Istanbul Medipol Hospital Professor of Obstetrics and Gynecology. Dr. C. Gürkan Zorlu said normal menstrual bleeding was defined as hemorrhage occurring every 21 to 35 days, less than seven days and totaling less than 80 ml, and abnormal bleeding was irregular menstrual bleeding or unstoppable long-term bleeding without any cause .

When talking about abnormal vaginal bleeding, Zorlu stated that it is appropriate to know exactly how the menstrual cycle in women is, and stated that any vaginal bleeding, which is expressed as menstrual bleeding, is actually a symptom of a regular hormonal return. Zorlu said, "Real menstrual bleeding is regular and ovulation (ovulation) followed by hemorrhages."

Zorlu reminded that everyone should be aware of their normal level and that there may be differences among people. "So for a person, 20 ml normals, 60 ml hemorrhage actually shows normal bleeding for 3 times more bleeding. Such a situation is not considered normal. Other than that, it is actually 'abnormal uterine hemorrhages' and certainly there is either a hormonal or anatomic pathology. So not all blobs are menstrual bleeds. There must be an ovulation in front of every normal menstrual bleeding. So reproduction starts with spawning, not with menstruation. There is an ovulation in front of every menstruation. "

Medipol Hospital Professor of Obstetrics and Gynecology. Dr. C. Gürkan Zorlu answered questions that were curious about abnormal hemorrhages:

What are the consequences of difficult-functioning hemorrhage?

"Dysfunctional uterine bleeding" refers to dysfunction or deviation from functions. Therefore, these bleeds are a term that refers to anovulation without any pathology, ie endometrial bleeding disorders due to ovulation. The terms "abnormal uterine bleeding" and "dysfunctional uterine bleeding" are used interchangeably. Because it is necessary to distinguish pathologies originating from the uterine cervix (uterine or tubal), including pregnancy problems, tumors or infections.

What are the obstacles to dysfunctional bleeding?

Dysfunctional hemorrhages are anovulatory, and the unbreakable eggs may have been cysticized and problems may arise. Cysts may rupture or turn around. These can be intense and severe painful. It should be kept in mind that sometimes bleeding into the cyst (hemorrhagic cyst) or bleeding into the abdomen may cause trouble. Apart from the recurrence of functional cysts, where the ovulation is not frequent, only the estrogenic effect, that is, the estrogen that has not been met with progesterone, can cause the development of malignant diseases over a long period of time. Such prolonged anovulation is more likely to occur in patients with poliical over syndrome. Rare menstrual or amenorrheic episodes seen in these patients pose a risk and must be met with progesterone. These patients will be eligible to receive biopsy in the near term for menopause. In young and infantile patients, the infertility problem should be solved with ovulatory agents.

How are irregular hemorrhages treated during adolescence?

The menstrual period that will come to mind first during adolescence should not be sitting and the ovulation should be lacking. Because the first two years after the anovulation of 60-90% confrontation occurs. However, at the end of the 5th year this rate decreases to around 20-30%. This is often the result of the inadequacy of the newly mature brain centers. It should be kept in mind that there may be other systemic diseases or hormonal disorders. Of course, all the bleeds are not caused by ovulation. Some of them are in patients with mild bleeding during ovulation. This is called "mittel-schmerz" and is sometimes added to this with a slight pain. In addition, some women may also have pre-menstrual staining and should not be counted as such, should be considered normal.

What other than malfunction may occur?

Tumors, vaginal trauma, foreign bodies, hemorrhages due to infectious changes must be distinguished in the younger daughters in which the first menstruation has begun, and consequently ovulation disorder and dysfunctional bleeding should be called. At older ages, further thickening of the intrauterine tissue (hyperplasia), polyps and frequent fibroids should be suspected and bleeding due to anovulation should be considered in their absence. Rarely, tumors should be kept in mind because skipping the existence of such an event would have catastrophic consequences. Dysfunctional bleeding does not occur after menopause, when menstruation is completely cut off because the functions are already stopped. If hormone replacement is frequently performed in this period, bleeding due to it, bleeding due to tissue weakness (atrophy) or tumors will come out.

What else comes to mind?

Thyroid functions should be assessed when the hormones are taken care of and corrected if the disorder is present. This often occurs in patients with hypothyroidism, but sometimes even in mild disorders. Prolactinomas or other pituitary adenomas also overcome the hormonal balance and create anovulation. In addition, there may be more or less short or long-term bleeding during infections. In cases of endometriosis, too much menstrual bleeding or pre-menstrual stains may occur. Intrauterine devices may increase the number of units if they are not of progesterone-containing types, and may cause pain due to contractions. It is reported that there is menstrual irregularity after tube-lining operations, but very often I do not get confused.

What to do in treatment?

All types of bleeding are first stopped by hormonal manipulation. Sometimes it may be necessary to take a sample before it is often over the age of 40 or when we expect a pathology. In addition to these, it is appropriate to determine the degree of blood loss of the patient and how much support it needs and to support it. If the abnormal bleeding is due to the problem of ovulation, the bleeding is regulated and the ovulation is immediately provided, but if the baby is not wanted, the regular contraceptive pill is used or regulatory estrogen and consecutive progesterone preparations are given. In addition, intrauterine systems can be used. These are progesterone. We use this in cases where the uterine tissue attached to the ovary does not lie more thickly, and we prefer menopausal patients. With this treatment, the effects of estrogen in the uterus are reversed. Sometimes during puberty and adolescence, the patient gets transient menopausal bleeding from bleeding due to clotting problems. This may also be preferred in the presence of irregularities that may occur in patients receiving chemotherapy.

Do you need surgical intervention?

Surgical treatment can be selected in patients who complete the family and do not plan to give birth. Also, if the problem identified is surgical, it should be preferred first. We generally prefer endoscopic methods here. Often hysteroscopic, such as fetal myoma or polyp in the uterus or bleeding is done in the form of making the function completely. Sometimes laparoscopic removal of the uterus is needed as a last resort.