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Bleeding Tips

Why Go For Hysteroscopy In Case Of Uterine Bleeding?

Dr. Rashi Sinha 87% (140 ratings)
MBBS, MS, DNB, Rcog London
Gynaecologist, Muzaffarpur
Why Go For Hysteroscopy In Case Of Uterine Bleeding?

Abnormal uterine bleeding, also known as AUB, is one of the most common causes requiring gynecologic evaluation. Hysteroscopy is a procedure wherein a thin camera called hysteroscope is introduced into the uterus via the vagina and this light helps in a thorough examination of the uterus. In cases where there are cysts or fibroids or even cancerous growths, this is used to get more details on the lesions. However, hysteroscopy also has a therapeutic use in that it is used to treat conditions like abnormal uterine bleeding. Read on to know more about AUB and how hysteroscopy helps in treatment. 

Causes of Abnormal Uterine Bleeding: Vaginal bleeding that occurs more often than 21 days and farther apart than 35 days is known as abnormal uterine bleeding. The bleeding is also abnormal if it lasts longer than 7 days and more than 80 mL of blood is lost during each cycle. 

Some causes include: 

  1. Hormonal imbalance 
  2. Cancer 
  3. Uterine polyps 
  4. Uterine fibroids 
  5. Cervical infections 

Diagnosis/Treatment: 

When a woman has abnormal bleeding, further diagnosis is required to confirm the exact cause of the bleeding. This is where the hysteroscopy comes into the picture. Hysteroscopy, literally translates to viewing the uterus from inside directly through a camera. 

How it is done: 

Hysteroscopy is done as an outpatient procedure and normally takes about 3 to 4 hours. General or spinal anesthesia may be used depending on complexity and overall patient health. The uterus is filled with a fluid like saline or glycerin and a thin lighted instrument called the hysteroscope is inserted through the vagina, up the cervix, and into the uterus. This tube is flexible and so can be moved across the uterus to identify any areas of abnormality. It also has a camera and so can be used to take pictures of suspicious areas. 

Causes for infertility may also be detected using hysteroscopy. Small knives can also be used to remove the lesion like fibroid or polyp. These are often the cause of abnormal bleeding. Samples can also be taken for biopsy to confirm if any cancerous growth is detected.

Hysteroscopy is a safe and effective way to examine the cervical canal and uterine cavity. It is better to accompany D&C with hysteroscopy instead of going for blind dilatation and curettage, especially in women who are peri or premenopausal. Hysteroscopy is a safe procedure if done by a doctor, specialised in gynecological endoscopy and helps in both diagnosis and treatment of abnormal uterine bleeding.

5 people found this helpful

Postmenopausal Bleeding - Is It Normal?

Dr. Nidhi Gandhi Chandak 90% (60 ratings)
MBBS, MD - Obstetrtics & Gynaecology, Diploma In Reproductive Medicine
Gynaecologist, Nagpur
Postmenopausal Bleeding - Is It Normal?

Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women's gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.

If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.

Postmenopausal bleeding or PMB, as it is popularly called, can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.

  • Atrophic vaginitis: Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.
  • Endometrial atrophy: Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
  • Polyps: Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding.
  • Infections: General infection of any area along the uterine tract could lead to occasional bleeding.
  • Cancers: Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.

Diagnosis: As repeated above, reach out to your doctor if you notice postmenopausal bleeding. Diagnostic methods could include the following:

  1. Physical examination
  2. Transvaginal ultrasound
  3. Endometrial biopsy
  4. Hysteroscopy
  5. Dilatation and Curettage

Treatment: Needless to say, this would depend on the diagnosis. For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy. For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient. Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.

Cancer: This would depend on the type and location and require a combination of chemotherapy and surgery.  Removal of the uterus also may be required in some cases. So, if you have had bleeding of any sort after a year of menopause, do not ignore it.

3843 people found this helpful

Reasons That Can Lead To Post Menopausal Bleeding!

Dr. Shakuntla Kumar 88% (146 ratings)
Diploma In Endoscopic Surgery, DGO, MBBS
Gynaecologist, Lucknow
Reasons That Can Lead To Post Menopausal Bleeding!

What is menopause?
Menopause is that phase in the life of a woman when she can no longer reproduce. It involves the loss of fertility and the cessation of the menstrual cycle. The woman will stop bleeding every month and the ovaries stop producing eggs that can be fertilized. Menopause normally sets on after the age of 40 and bleeding may permanently stop by the age of 50.

Post menopausal bleeding
You are known to reach menopause when you have not been bleeding for 1 entire year. Even a small amount of spotting should not have taken place. Post-menopausal bleeding is when bleeding occurs after a year of attaining menopause. It can be a serious health disorder and requires medical attention without any further delay.

Reasons behind post menopausal bleeding

  1. Polyps that are mostly non-cancerous, unwanted growths on the cervical canal, uterus or ovaries are known to cause post-menopausal bleeding.
  2. Thinning of the endometrium that lines the uterus can cause unexpected bleeding. It can be due to the rapidly receding levels of estrogen in the blood. It is also known as endometrial atrophy.
  3. Endometrial hyperplasia is a condition that leads to the thickening of the inner lining of uterus (endometrium). It also leads to the growth of abnormal and malignant cells.
  4. Endometrial cancer
  5. Other health conditions such as reaction to hormone therapy, infections of the blood or reproductive organs, certain medications and blood-thinning drugs
  6. Cancer of the ovaries, uterus or cervix

How it can be treated?

  1. For diagnosis, you can undergo blood tests, ultrasounds, sonography and biopsy.
  2. Hysterectomy is done to remove the uterus and cervix can be conducted for a complete cure. It also removes the ovaries, fallopian tubes and other lymph nodes.
  3. Chemotherapy and other radiation therapies may be done for those who are in an advanced stage of endometrial cancer.
  4. Medications such hormone regulators must be taken to prevent complications.
3849 people found this helpful

Diagnosis And Treatment Of Abnormal Uterine Bleeding!

Dr. Archana Gupta 91% (10 ratings)
MBBS, Post Graduate Diploma In Sonography Obs - Gynae & Abdomen
Gynaecologist, Delhi
Diagnosis And Treatment Of Abnormal Uterine Bleeding!

Any kind of bleeding from the uterus, which is not normal, can be termed as abnormal uterine bleeding. This refers to bleeding between periods or before periods, bleeding after having sex, spotting, abnormally heavy bleeding or bleeding after attaining menopause. If you are suffering from any of these issues, you need to check with the doctor. 

Diagnosis
It is very important to diagnose abnormal uterine bleeding. There are several examinations and tests that have to be carried out, depending on age. For irregular spotting, a pregnancy test can be undertaken in case you think you could be pregnant. If your uterine bleeding is very heavy, a test has to be performed to check blood count. This is done to observe whether you have anemia. An ultrasound test of the pelvic region will also be advised by your doctor to know the cause of the bleeding. Several hormonal tests and thyroid function tests are required as well.

Other diagnostic tests include:

  1. Sonohysterography: When fluid is placed within the uterus and ultrasound images of the uterus are taken. An image of the pelvic organs is obtained.
  2. Hysteroscopy: It can be carried out when a device is inserted via the vagina and enables the doctor to examine the uterus internally.
  3. Magnetic resonance imaging: This is also used to get images of the organs.
  4. Endometrial biopsy:  It involves insertion of a catheter to take out a tissue which is microscopically observed. 

Treatment
There are different types of treatment for abnormal uterine bleeding depending upon factors such as the cause of bleeding and the age of the patient.

  1. Medications: Several medicines are used to treat abnormal uterine bleeding. Sometimes hormonal medicines are used. Birth control pills are also used to improve the regularity of periods. Hormonal infections, vaginal creams and an IUD device releasing hormone can be used. Non steroidal anti-inflammatory drugs are also used to control bleeding. Several antibiotics may also be prescribed.
  2. Surgery: In some cases of abnormal uterine bleeding, a woman has to undergo a surgery for the removal of growth such as polyps and fibroids, which results in bleeding. While some fibroids can be removed via hysteroscopy, others require different techniques for treatment.
  3. Endometrial ablation: It can be undertaken to control bleeding. This mode of treatment aims at reducing the bleeding permanently. In case all treatment methods fail, hysterectomy has to be carried out. This is a serious surgery and after it is performed, a woman does not have periods anymore and will not be able to conceive a child.

Abnormal uterine bleeding is a serious health condition, which may lead to severe complications. Immediate diagnosis and appropriate treatment methods should be undertaken in case of any abnormal uterine bleeding.

3427 people found this helpful

Excessive Bleeding - How To Manage It?

Dr. Nikhil D Datar 89% (12 ratings)
MD - Obstetrics & Gynaecology, DGO, MBBS , FCPS, DNB, FICOG, LLB
Gynaecologist, Mumbai
Excessive Bleeding - How To Manage It?

Every woman has her own pattern of menstruation. Abnormal bleeding can lead to excessive and unnecessary blood loss and may result into anemia. If a woman notices that the amount and or number of days of menstruation are more... she should get herself checked to find out why is she having excessive bleeding. Many women think that it is good that they are bleeding heavily. But that is a myth. 

Causes: 

  • Hormonal imbalance 
  • Polyps or fibroids 
  • Uterine infections 
  • Cancer of the cervix, endometrium, or uterus 
  • Pregnancy 
  • Pre-menopausal age, when there is ovulation and altered levels of hormones 
  • Hormone replacement therapy after menopause 

Diagnosis: 

  • Blood test to check hemoglobin level 
  • Pregnancy test 
  • Ultrasound 
  • Endometrial biopsy to check for growths 
  • Hysteroscopy 

Management: Once the cause is diagnosed, then depending on the age and the woman’s gynecologic history, a treatment plan is made. 

  1. Weight loss: Obesity is one of the causes of excessive bleeding so losing weight can help in controlling bleeding. Optimal weight also helps in controlling hormone levels. 
  2. Hormonal imbalance: This can be corrected medically. A medicated intrauterine device lthat releases the medication in sustained manner can help in controlling bleeding. 
  3. Birth control pills: These are hormones again which can prevent the lining of the uterus from becoming too thick, which in turn contributes to the bleeding. It also helps to regularize the cycles and controls cramping
  4. Dilation and curettage: A biopsy is obtained from the lining of the uterus by sucking it out or scraping it out. This can guide the doctor to decide what medicine will be best suited to treat the condition. There are many medications available to treat the condition, thus avoiding surgery completely. 
3552 people found this helpful

Visit Your Dental Surgeon Regularly!

Dr. Puneet Kansal 91% (812 ratings)
MDS - Orthodontics, BDS
Dentist, Meerut
Visit Your Dental Surgeon Regularly!

What is periodontal disease?

Periodontal disease is a highly common infection of the periodontal tissues (gums and bone) that are responsible for supporting the teeth. These infections are caused by bacteria that grow on the teeth near the gum line due to poor brushing and flossing practices. Periodontal disease is known as gingivitis during its earliest stages, which is typically characterized by a sore, swollen gums that may bleed easily. Allowed to progress, an advanced periodontal disease may set in causing pain, receding gums and pockets between the gums and teeth. Known as periodontitis, this type of periodontal disease is the leading cause of tooth loss among adults even more so than decay.

Did you know?

Periodontal disease has been associated with a number of risk factors aside from poor brushing and flossing habits. In fact, the risk of developing gingivitis or periodontitis increases if you have a systemic disease like heart disease, as well as conditions like diabetes and aids. Other factors that may contribute to the development of periodontal disease include stress, genetics, crowded teeth, faulty dental restorations, and the use of certain medications that may cause dry mouth. According to the centers for disease control, women are also at an increased risk for periodontal disease when they are undergoing hormonal changes, such as with menopause or pregnancy.

Frequently asked questions

Do I have periodontal disease?

You may have gingivitis or periodontitis if you are experiencing any of the symptoms listed above. However, the only way of knowing for sure whether you have a periodontal disease is via a professional dental exam. Keep in mind that you may have periodontal disease and be asymptomatic; so be sure to visit your dentist for a thorough exam and cleaning at least twice per year.

What will my dentist do if I am diagnosed with periodontal disease?

Your treatment will depend on whether you are diagnosed with gingivitis or periodontitis. Minor cases of periodontal disease are usually treated with a thorough cleaning and topical antibiotic. If, however, your periodontal tissues have begun to deteriorate and your gums have begun pulling away from your teeth, you may require a more complex treatment, such as flap surgery or bone and gum grafting.

Will I need to do anything to prevent periodontal disease from returning?

Yes. Periodontal disease can reoccur  especially if you do not make any changes to your brushing and flossing habits. By brushing after every meal, flossing once daily, avoiding tobacco, and getting frequent professional dental cleanings, you could help prevent periodontal disease from returning in the future.
 

Bleeding During Pregnancy: Everything You Need To Be Aware Of

Dr. Renu Jain 92% (55 ratings)
DGO, MBBS
Gynaecologist, Roorkee
Bleeding During Pregnancy: Everything You Need To Be Aware Of

Bleeding during pregnancy is relatively common and doesn’t always mean there is a problem. It can be daunting and scary. However contrary to common beliefs, bleeding need not be a necessary harmful to a pregnant woman. However, it is important to take bleeding seriously at any stage of the pregnancy.

What are the possible causes of vaginal bleeding during pregnancy?

Causes of vaginal bleeding during early pregnancy include

  1. Implantation bleeding: It is a harmless light bleeding that often occurs around the time your period would have been due. It occurs when the developing embryo implants itself in the wall of the womb.
  2. Cervical changes: Cervical changes due to pregnancy may sometimes cause bleeding specifically after sex.
  3. Miscarriage: During early pregnancy vaginal bleeding can be a sign of miscarriage. About 1 in 5 pregnancies miscarry and usually, the cause is in the fetus and not the mother or the partner. At the same time, it is important to note that many women who bleed at this stage of pregnancy go on to have normal and successful pregnancies.
  4. Ectopic pregnancy: An ectopic pregnancy is when fertilized egg implants outside the womb, for example in the fallopian tube. It can cause bleeding and is dangerous.

Early detection and appropriate management is a must in this case, so as to prevent any life-threatening complication. Other less common causes are molar pregnancy (a mass that forms inside the uterus that does not result in a baby) and problems with the cervix such as a cervical growth or cervical or vaginal infections. Vaginal bleeding might also occur during the later second or third trimester of the pregnancy.

Some of the commonly occurring includes

  1. Placenta praevia (low lying placenta): This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low lying placenta can be very heavy and put you and your baby at risk
  2. Placental abruption: It is a serious condition in which the placenta starts to come away from the womb wall.
  3. Vasa praevia: A rare condition where baby’s blood vessels run through the membranes covering the cervix. When your water breaks, these vessels are torn and cause vaginal bleeding.

Vaginal bleeding towards the end of the pregnancy is normal. Often bleeding mixed with mucous (which is called show) can be a sign of the starting of the labor. 

When to visit a doctor?

It is important to keep the doctor informed about any bleeding that may have occurred at any stage of the pregnancy. A woman should carefully note details such as the type of bleeding, its texture, whether it included any tissue or clots, other symptoms such as pain and dizziness To work out what is the causing the bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests and according to the cause and how many weeks pregnant you are it would be advised whether you need to be admitted to hospital or not and further treatment would be planned and advised.

1833 people found this helpful

What Is Periodontal (pyria ) Disease?

Dr. Hetal Chheda 85% (10 ratings)
BDS, Certificate of Speciality Training In Restorative Dentistry & Endodontics, Advanced Certificate Course In Aesthetic Dentistry
Dentist, Mumbai
What Is Periodontal (pyria ) Disease?

Swollen and bleeding gums are the early sign that your gums are infected with bacteria 

Peri means" around" and Dontal means" teeth".Periodontal diseases are infection of the structures around the teeth.They include gums, root, bone and the supporting structures.If nothing is done it can destroy the supporting structure and jaw bone and eventually your teeth become so loose that it has to be removed.

A regular interval of visits to dentist and maintainance of proper hygiene and nutrition is a must to prevent gum diseases 
 

1 person found this helpful

6 Symptoms Of Postpartum Hemorrhage And Its Prevention!

Dr. Indu Bala Khatri 93% (10 ratings)
MD - Obstetrtics & Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Delhi
6 Symptoms Of Postpartum Hemorrhage And Its Prevention!

Postpartum hemorrhage is a condition where a woman may lose a lot of blood (approximately 500ml to 1000ml) from her vulva shortly after childbirth. This usually occurs within the first 24 hrs of childbirth and can even result in severe blood loss threatening the mother’s life in case the blood loss is over 2000 ml. Secondary postpartum hemorrhage can also occur until 12 weeks after childbirth and this extra care should be taken, if there is any such possibility.

Symptoms of postpartum hemorrhage:
1. Rapid increase in heart rate.
2. Feeling dizzy while standing up.
3. Increase breathing rate.
4. Feeling cold and chilly even if the room temperature is normal.
5. Sudden fall in blood pressure levels.
6. Fainting or becoming unconscious.

Causes of postpartum hemorrhage:

  1. Uterine atony: This is a condition in which the uterus contracts and may lead to excessive bleeding. Infection in the placental tissue can also lead to postpartum hemorrhage.
  2. Trauma: This is a very common cause for postpartum hemorrhage. Sometimes, the uterus (womb), vagina, cervix (passage forming the lower end of the womb) and the perineum (area between the vulva and the anus) can get injured. These areas become vascular during the course of pregnancy and may rupture in the process of childbirth causing excessive bleeding.
  3. Tissue: At times, the whole placenta or fetus tissue does not come out of the body after childbirth. This can lead to profound blood loss resulting in postpartum hemorrhage.
  4. ThrombinThis is a disorder which occurs when there is excessive bleeding when the blood fails to clot inside the body.

How can you prevent postpartum hemorrhage?

  1. Oxytocin is a substance which is used after the delivery of the baby. This prevents postpartum hemorrhage. It can be administered in the following ways :
    • As an injection which is directly injected into the blood stream.
    • After delivery, breastfeeding your baby can also trigger natural oxytocin. This occurs as encouraging the baby to suckle also stimulates the nipples which release oxytocin, thus preventing postpartum hemorrhage.
    • In the form of intravenous drips mixed in with important medications. IV drips can administer oxytocin along with other important fluids along with it.
  2. Uterine massage is also recommended to prevent postpartum hemorrhage. After delivery, massaging the uterus makes the muscles relax and contract. This reduces the risks of excessive bleeding.

A lot of women can also die due to excessive bleeding after childbirth, especially in developing countries including India. This is a cause for concern and proper care should be taken if you start experiencing these symptoms.

3767 people found this helpful

Signs You Can Be Suffering From Postpartum Hemorrhage?

Dr. K S Anamika 91% (327 ratings)
Advanced Infertility, MIS TRAINING, FICMCH, PGDS, MD - Obstetrtics & Gynaecology, MBBS, Masters in Reproductive Medicine(UK)
Gynaecologist, Faridabad
Signs You Can Be Suffering From Postpartum Hemorrhage?

Postpartum hemorrhage is a condition where a woman may lose a lot of blood (approximately 500ml to 1000ml) from her vulva shortly after childbirth. This usually occurs within the first 24 hrs of childbirth and can even result in severe blood loss threatening the mother’s life in case the blood loss is over 2000 ml. Secondary postpartum hemorrhage can also occur until 12 weeks after childbirth and this extra care should be taken, if there is any such possibility.

Symptoms of postpartum hemorrhage:
1. Rapid increase in heart rate.
2. Feeling dizzy while standing up.
3. Increase breathing rate.
4. Feeling cold and chilly even if the room temperature is normal.
5. Sudden fall in blood pressure levels.
6. Fainting or becoming unconscious.

Causes of postpartum hemorrhage:

  1. Uterine atony: This is a condition in which the uterus contracts and may lead to excessive bleeding. Infection in the placental tissue can also lead to postpartum hemorrhage.
  2. Trauma: This is a very common cause for postpartum hemorrhage. Sometimes, the uterus (womb), vagina, cervix (passage forming the lower end of the womb) and the perineum (area between the vulva and the anus) can get injured. These areas become vascular during the course of pregnancy and may rupture in the process of childbirth causing excessive bleeding.
  3. Tissue: At times, the whole placenta or fetus tissue does not come out of the body after childbirth. This can lead to profound blood loss resulting in postpartum hemorrhage.
  4. ThrombinThis is a disorder which occurs when there is excessive bleeding when the blood fails to clot inside the body.

How can you prevent postpartum haemorrage?

  1. Oxytocin is a substance which is used after the delivery of the baby. This prevents postpartum hemorrhage. It can be administered in the following ways :
    • As an injection which is directly injected into the blood stream.
    • After delivery, breastfeeding your baby can also trigger natural oxytocin. This occurs as encouraging the baby to suckle also stimulates the nipples which release oxytocin, thus preventing postpartum hemorrhage.
    • In the form of intravenous drips mixed in with important medications. IV drips can administer oxytocin along with other important fluids along with it.
  2. Uterine massage is also recommended to prevent postpartum hemorrhage. After delivery, massaging the uterus makes the muscles relax and contract. This reduces the risks of excessive bleeding.

A lot of women can also die due to excessive bleeding after childbirth, especially in developing countries including India. This is a cause for concern and proper care should be taken if you start experiencing these symptoms. In case you have a concern or query you can always consult an expert & get answers to your questions!

4850 people found this helpful
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