Abundant first months

Abundant first months are a problem not only for adult women, but also for young girls, which makes you worry about your health and overall well-being. Diagnosis of this state is not difficult, but the establishment of a cause is sometimes a difficult task, albeit necessary. It is necessary to determine the genesis of such a pathology, and only then talk about treatment.

Epidemiology

The epidemiology of this problem is such that the problem of menstrual cycle disorders ranks first among all gynecological diseases. Abundant first months are a problem for more than 78% of girls on the way to the formation of a normal menstrual cycle. The cause of this in 90% of cases is precisely the physiological imbalance that passes with time, and only 10% of cases of copious first menses are caused by organic pathology requiring treatment.

[1], [2], [3], [4], [5], [6], [7],

Causes of the abundant first months

The clinic of profuse first months has a rapid development and serious consequences, so an integral part of the treatment is to identify the cause. Among all possible reasons, it is necessary to take into account, first of all, the age of a woman, and only then think about the circle of all possible factors.

When a girl first appears as a period, this is the beginning of a period of reproductive activity. Then the girl becomes a girl and can become pregnant. During this period, the girl's hormonal background changes in such a way that the phase of the hormonal cycle is established. In the first phase, the amount of follicle-stimulating hormone of the pituitary gland increases, which affects the ovaries. Thus, the first follicle grows in the girl's ovaries. This lasts for fourteen days, and then the amount of this hormone gradually decreases and the level of luteinizing increases. It is the concentration of hormones that is responsible for the onset of ovulation. In this case, the ovarian follicle is broken and the egg leaves it. In parallel, these processes in the uterus are changing under the influence of other hormones. Ovaries and adrenal glands secrete sex hormones - gestagens and estrogens. In the first phase, estrogens prevail, which stimulate the development of the functional layer of the uterus endometrium, and in the second phase progesterones prevail. When the end of the second phase decreases the amount of luteinizing hormone and progesterone, then the first menstruation begins.

Often, the reason for the plentiful first months in women of reproductive age may be a recent abortion or miscarriage. After such abortion, the endometrium is restored with a large number of cells, which is a risk factor for further bleeding.

Among other possible causes of profuse menstruation in women, benign lesions, such as fibroids, that can give the clinic a copious period should be mentioned.

Inflammatory diseases of the uterus contribute to the formation of cells of connective tissue along with epithelial cells, and this can also be the cause of profuse menstruation. If the inflammation occurs in the ovary, then the synthesis and the normal ratio of sex hormones to estrogen and progesterone are disrupted, and this in turn leads to a disruption in the synthesis of the uterine epithelium - which can also be the cause of profuse menstrual periods in the future.

In women of menopausal age, abundant periods are very frequent. This is due to the fact that gradually the body of a woman grows old, the ovaries lose their function and the amount of estrogens decreases. When such phenomena occur jerky, then excess estrogens can give the clinic a copious monthly. It often happens that after several years of the onset of menopause, for example, if there are no menstruation for five years already, there are such abundant spotting as the first menstruation. This is a very bad sign and the cause may be cancer of the uterus. This should be paid special attention and exclude this pathology in the first place.

Speaking about the reasons for the abundant first months, it must be stressed that there can be many. Therefore, it is necessary to limit not only clinical manifestations, but also the age of a woman, which directly affects the cause of this pathology.

[8], [9]

Risk factors

Speaking about the reasons for the abundant first menstruation in women, it is necessary to pay special attention to possible risk factors. Among the risk factors for this pathology are the following:

•  chronic inflammatory diseases of the ovaries;
•  surgical interventions on the uterus or ovaries;
•  uterine fibroids;
•  more than five births in the anamnesis with a distance between them less than three years;
•  recent miscarriage or abortion.

Such risk factors increase the likelihood of complications and cycle disorders in the future. The causes of the appearance of plentiful first months, for example, after childbirth, are associated with some hormonal imbalance. After the birth of the child, the woman's organism releases a huge amount of the hormone prolactin, which promotes lactation. Its second function is the delay in the development of the next egg, so in nursing moms, there is no monthly after delivery for at least six months. This condition works only when a woman actively breastfeeds and the distance between feedings is not more than three hours. Then prolactin is actively excreted and its constant amount delays the onset of menstruation. When the child turns six months, he rarely breastfeed and prolactin is less allocated - this leads to the fact that the first menstrual periods may occur. They should be established already with the first cycle, but there are some problems. The reason for the plentiful first months after birth may be a deficiency of prolactin or progesterone. If a woman did not have milk and she did not breast-feed the baby, menstruation may begin some time after the birth and it will be plentiful. The reason for this is precisely the deficit of prolactin. Parts of the membranes and tissues of the fetus, as well as the functional layer of the endometrium, can be strongly expressed, which will cause such abundant discharge. If labor was complicated by bleeding or delayed amniotic membranes, or after caesarean section - then this can be the reason for the copious first months, because in response to damage to the endometrium the body protects itself and the functional layer of the uterine epithelium increases.

[10], [11], [12], [13], [14],

Pathogenesis

The pathogenesis of the development of abundant first months in girls is associated with the hormonal background. When all the complex hormonal processes in the girl are not yet established, there is no balance of hormones that regulate the phases of the menstrual cycle. As a rule, girls have estrogens and there is a lack of luteinizing hormone. Therefore, at the first menstruation, the excess estrogen stimulates the growth of a large thickness of the endometrium. The consequence of this is a prolonged first menstruation. In normal conditions, the duration of menstrual periods from three to five days, this is for women already with the established cycle. But in girls, the abundant first months are a frequent phenomenon, which can be considered physiological several cycles in a row. Therefore, the main reason for the abundant first menstruation in girls can be considered hormonal imbalance.

[15], [16], [17], [18], [19], [20], [21], [22], [23]

Symptoms of the abundant first months

The first signs of profuse first months can be caused by the volume of blood loss. After all, under normal conditions, the woman's body is adapted to the monthly blood loss and the number of uniform elements and the liquid part of the blood is quickly restored. But with abundant first menstruation, especially in girls with asthenic physique, the first symptom of hemorrhage may be loss of consciousness. This is due to the fact that the amount of circulating blood in the body decreases and blood pressure decreases. In this case, there is a shortage of oxygen for the brain, which is manifested by fainting.

Other symptoms that may be present are also associated with blood loss. There is dizziness, weakness, lethargy, headache, palpitations. Sometimes these symptoms can be accompanied by nausea, decreased appetite and pallor of the face. All this develops due to a lack of oxygen for all cells of the body, which eventually leads to the fact that internal organs suffer. If such abundant periods are repeated for the first time, then anemia develops.

Abundant first months after birth can be normal, if this happens only once, and then the cycle should be restored. If such discharge is already several months and lead to severe health problems, then this should be noted. In this case, there may be symptoms of not only dizziness, pallor, exhaustion, but also may be fever, pain in the breast or lactation. Then one should think about the fact that after the birth, there are remnants of the membranes in the uterus and conduct a survey. If the first months after childbirth first appeared in six months, and they are plentiful for one or two times, then this phenomenon is considered normal formation of the menstrual cycle.

Abundant first months after cesarean are more often than after the physiological birth, because there is interference with the integrity of the endometrium. After all, together with the fetal membranes, it is possible that the deeper layer of the endometrium is also removed, and it takes more time to restore it.

The first plentiful monthly after miscarriage or abortion is also associated with interference in the normal structure of the functional layer of the uterus. At the same time, it can be considered a normal phenomenon, when after a while after a miscarriage appears a menses of profuse nature. This indicates the protection of the body and the removal of all unnecessary. At the same time, a woman can feel slight malaise, a slight pain in the abdomen, typical for menstruation, and there are no other symptoms. The body temperature should be normal, and the cycle should be restored the next month.

If the abundant periods are accompanied by an increase in temperature and symptoms of intoxication, then it is possible to suspect an inflammatory disease of the uterus. Endometritis or parametritis often has a postnatal etiology, but nevertheless, it is accompanied by bloody discharge from the vagina that a woman can go in for with monthly. Such secretions have an unpleasant odor and can be mixed with pus.

Fibromioma of the uterus is a disease that is characterized by the formation of connective tissue among the muscular layer of the uterus. These cells grow very fast and can be located both inside the uterus and on the serous membrane. If the myoma is of a nodular nature, then such nodes are located inside the uterine canal and often the symptoms are bleeding, which is similar to copious periods. Therefore, it is important to conduct differential diagnosis with such symptoms.

Endometriosis is a pathology in which foci of the endometrium fall on the ovary, vagina or cervical canal, and these foci produce blood under the influence of hormones. This is manifested in the form of profuse menstruation, which in addition is accompanied by severe pain. Such menstruation lasts about a week or two and leads to anemization of the woman.

If a woman of menopausal age has strong bloody discharge, then the cause may be in endometrial cancer. Such spotting is often contact and may be accompanied by other symptoms - weight loss, pain or a feeling of heaviness in the abdomen, a digestive disorder, or a pain in the stomach. In any case, you must first exclude tumors, and only then look for a further reason.

[24], [25], [26],

Complications and consequences

The consequences of copious first months can be very serious. The most often occurs posthemoragic anemia, which disrupts the heart, vessels and other internal organs. This happens more often in young girls against a background of insufficient hormonal regulation. If the cause of profuse menses is inflammatory disease, there may be complications in the form of spreading the process to the small pelvis and the development of peritonitis. Complications that can occur against the background of endometriosis, this uterine bleeding and in the future may malignization of these foci.

Fibromyoma of the uterus, which is the cause of copious periods, may be a consequence of the development of necrosis of the myomatous node or its inflammation. If spotting is observed after an abortion or a miscarriage, then there is a possibility of developing hematomas or other complications that threaten in future with problems with conception of the child and bearing pregnancy. Such complications are far from all, but their importance for women's health emphasizes the need for timely diagnosis and treatment.

[27], [28], [29], [30], [31]

Diagnostics of the abundant first months

Diagnosis of abundant first months should begin already at the stage of collecting anamnesis. It is necessary to know exactly which woman has a cycle, how long the selection data continues, how it affects her health and whether there were any surgical interventions. It is necessary to estimate approximately the volume of possible blood loss and then proceed with external examination.

If the girl turned, you need to pay attention to the development of secondary sexual characteristics in her, because it characterizes the hormonal background of the girl. If there are no secondary sexual characteristics on the background of the onset of menstruation, then this may indicate a hormonal imbalance, then it is necessary to consult a pediatric endocrinologist. If there are symptoms of profuse menstruation against the background of a girl's well-being, then most likely this is a normal phenomenon and it is necessary to conduct tests to eliminate organic pathology.

Diagnosis of anemia can also be carried out by external signs - paleness of the skin and mucous membranes, blueness of the sclera, tachycardia and systolic murmur on the apex with auscultation of the heart are revealed. These diagnostic signs appear even with severe anemia, when plentiful monthly ones last several months. Sometimes, with huge blood loss, there may be symptoms of low blood pressure and fainting.

Adult woman must be examined on the chair. When vaginal examination and examination in the mirrors can identify many pathologies. Fibromyoma of the uterus gives a thickening of the uterine wall, its immobility or significant nodes in its cavity. Only with the help of a routine examination can already be ruled out myoma. Endometriosis can also be seen on the cervix in the form of brown dots that bleed.

If the plentiful first months appear after an abortion or a miscarriage, this may occur due to delay in the amniotic membranes. This can be seen when vaginal examination, as well as in parallel to conduct a diagnostic scraping of the uterine cavity. This is an obligatory method of diagnosis precisely in case of suspected pathology. In case the symptoms of profuse menstruation appear in a woman of climacteric age, then necessarily the contents of the uterus is sent for histological examination to exclude the malignant process.

Analyzes that allow you to determine the degree of blood loss and possible medical measures - this is primarily an expanded blood test. Determination of the amount of hemoglobin, erythrocytes, color index - allow to determine the degree of anemia. The first degree is characterized by a decrease in hemoglobin level below 110 g / l, the second - below 90 g / l, the third - below 70 g / l, and the fourth - less than 50 g / l, which is a very dangerous condition.

If the first months are abundant in the girl, then for the purpose of differential diagnosis, analyzes are conducted to determine the sex hormones.

Instrumental diagnosis of abundant periods is very important for identifying the cause. The most informative diagnostic method in gynecology is transvaginal ultrasound. This method allows you to determine the presence of thickness of the endometrium, the state of the ovaries and follicles, the presence of additional structures in the uterine cavity, and can also accurately determine the fibromyom, its size or other phenomena in the form of foci of endometriosis. If an ultrasound is performed by a young girl, then it is often impossible to detect any pathology, then it is necessary to conduct hormonal screening.

[32], [33], [34], [35], [36], [37], [38], [39],

Differential diagnosis

Differential diagnosis in girls should be conducted primarily between physiological first menstruation and dysfunctional uterine bleeding. The latter pathology is often the cause of uterine bleeding in young girls, the cause of which is the insufficiency of the second luteal phase. In this case, the lack of luteinizing hormone leads to the fact that menstruation does not end and bleeding is significant. Therefore, in young girls, the definition of sex hormones must necessarily be in the diagnostic program to exclude such pathologies.

Also it is necessary to conduct differential diagnostics between copious monthly and miscarriage in the course. The main diagnostic point here is the presence of pregnancy or delay in menstruation, while with a plentiful monthly cycle is not violated. For the purpose of differential diagnosis of fibromioma or endometriosis, ultrasound should be performed, which allows one to exclude this or that pathology.

Thus, the diagnostic program should be as informative as possible, taking into account the age and condition of the patient.

Treatment of the abundant first months

Medicines that are used for this pathology can be divided into emergency drugs and funds for long-term therapy. If the volume of hemorrhage is such that the level of hemoglobin is less than 70, that is, the third degree of anemia, then this is an indication for blood transfusion. Such conditions often develop against the background of acute hemorrhage. But if the months are plentiful for several days, then this may correspond to the first or second degree of anemia, then use hemostatic agents. In the future, to maintain the hormonal background, which will normalize menstruation, for several months prescribe a substitute or additional hormone therapy with a gradual withdrawal of drugs.

1. Etamsylate is a drug from the group of systemic haemostatic agents that can be used to stop profuse menstruation. The drug has a predominant effect on platelet cells and capillaries, which contributes to the activation of the vascular-platelet link in stopping bleeding. The method of using the drug to stop bleeding intravenous, which accelerates the effect of the drug. Dosage of the drug - 10 milligrams per kilogram, on average use one ampoule three or four times a day. Side effects are possible in the form of jaundice, the appearance of a rash, itching of the skin, a sensation of fever in the face and a decrease in pressure. Precautions - use with caution in patients with asthma and varicose veins.
2. Aminocaproic acid is a remedy for systemic hemostasis, which acts by inhibiting fibrinolysis. The drug can be used to treat copious uterine discharge, especially for a quick stop of such bleeding. Method of application of the drug intravenous drip. Dosage of 100 milliliters of solution throughout the first hour, and then under the control of the condition and blood test. Side effects of aminocaproic acid - violation of the heart rhythm, headache, tinnitus, thrombosis, nasal congestion, dizziness, convulsions. Precautions - if there is blood in the urine, use the drug with caution, as this may cause further anuria.
3. The use of antibiotics in women with profuse menstrual periods is considered justified because the consequence of blood loss may be a decrease in local immunity and the development of complex infectious diseases. They prefer antibiotics of a wide spectrum of action.

Ceftriaxone, a beta-lactam antibiotic of the third generation, is especially effective when acting on gram-positive and gram-negative flora. The drug has a bactericidal effect on possible anaerobic pathogens of infection, so it can be used for preventive purposes in gynecology. Dosage of the drug - 200 milligrams twice a day, taking into account the preventive reception, at least five days. Side effects are possible with the influence on the stomach - develops colitis or dysbiosis, which manifests itself by bloating, a violation of the stool. Precautions - do not use the drug for allergies to antibiotics-penicillins, as well as for congenital fermentopathies.

1. Femoston is a combined hormonal drug that contains estradiol (an analog of natural estrogen) and dydrogesterone (an analog of progesterone). This tool allows you to monitor the level of hormones, and when bleeding caused by their deficiency allows you to establish a normal cycle. Estrogens contribute to the formation of a normal layer of the endometrium, and the action of progesterones allows the timely start of rejection of the epithelium. Method of application of the drug in tablets throughout the cycle. Dosage of the drug - one tablet daily under the control of uterine secretions, the dosage of hormones can vary. Side effects - dizziness, drowsiness, pain in the mammary gland, skin itching, vomiting, fluid retention with the formation of edema. Precautions - it is important to monitor the dosage of the drug and the effect of this dose.
2. Lindineth is a complex hormone, which includes ethinyl estradiol and gestodene - analogues of estrogen and progesterone. The action of the drug is associated with the regulation of the cycle and the normalization of the level of hormones. The method of application of the preparation is in a tablet form with a dosage of 20 or 30 milligrams. Treatment for 21 days with individual dose selection. Side effects - pain in the lower abdomen, spotting from the vagina, swelling of the chest, allergic manifestations on the skin.

Vitamins can be used in complex treatment for faster recovery of the body. Preference is given to preparations containing vitamin C, P, A, as well as combined vitamin products. In chronic posthemoragic anemia, which is caused by profuse menstruation, it is often necessary to use iron preparations - Ferritin, Transferrin, Maltofer for correction of the condition. For treatment, you need to use the dose for a month, and then for three months - a preventive dose.  

Physiotherapy can be used only during remission.

Alternative treatment of copious first monthly

Alternative therapies are very effective in stopping uterine bleeding, as well as many herbs have a tonic effect and normalize the balance of hormones.

1. Beet juice is a very good remedy for correction of anemia, it tones the tone of the vessels of the uterus and improves blood circulation. Infusion of beet can be used even during severe bleeding. To do this, squeeze a liter of beet juice and add to it a hundred grams of honey. Then you need to add twenty grams of dry yeast and give this solution to stand for three to five days. Dosage - half the glass of juice is taken in the morning and in the evening.
2. A good hemostatic is the infusion of pepper sea. For medical infusion it is necessary to take the root of peppercorn, insist twenty minutes in hot water and make a tampon from such infusion. Enter need to gently in the vagina for fifteen minutes, only if there is no pronounced bleeding, better after such plentiful monthly.
3. Cold and compress on the lower abdomen relieves pain, spasm and reduces bleeding. To do this, take the infusion from the leaves of blueberries, soak the bandage folded in several layers, and put it on the bottom of the stomach. After a few minutes, you need to remove the compress and put the cold.
4. Tea made from viburnum, gooseberry and lemon is very good for recovering the volume of lost blood and stimulating the formation of blood cells.

The use of herbs is very useful not only in terms of stopping bleeding, but also for restoring the tone of blood vessels, the nervous system and the circulatory system.

1. For the preparation of therapeutic tea, which has a hemostatic property, it is necessary to take 50 grams of dioecious nettle and the same amount of milk thistle, it must be cooked on low heat for five to ten minutes and then filtered. To drink such tea you need five times a day for half a cup, in an acute period, you can and more.
2. Especially effective in the treatment of uterine bleeding and further hormonal disorders infusion from the roots of arnica, alternating and bark of oak. To make medicinal tea you need to take ten grams of bark and arnica root, pour water in the amount of half a liter, and then after he has fed twenty minutes, strain and drink. Dosage - about a liter of tea you need to drink a day, controlling the general condition.
3. Pasternak is a plant that normalizes the hormonal background and improves blood circulation in the uterus, regulating nerve conduction. To make medicinal tea, you need to take 50 grams of parsnip root, it should be boiled over a slow fire for five to ten minutes and then filtered. Drink this tea three times a day for a teaspoon after the end of bloody discharge.
4. Powder from the fruit of anise very well helps from dysfunctional uterine bleeding due to action on the ovaries. For medical infusion it is necessary to take 100 grams of anise fruit, make a powder from them, add a glass of liquid honey and take a teaspoon three times a day.

Homeopathic treatment is widely used to treat such pathologies due to the possibility of prolonged use and minimal harm. In addition, homeopathic remedies can be used with selectivity in relation to the main symptoms.

1. Lahiesis compositum is a homeopathic remedy, which is used for copious first months in girls, which are accompanied by pain in the abdomen of the pulling character, especially when they are irradiated into the lumbar region. Dosage in the initial cases is four drops in the morning and evening, and if this pathology is not the first, then you can take the same dose three times. The course of treatment can begin already at monthly with a dose of three drops, and then during the first month to take eight drops. Precautions - it is not recommended to use the drug in full women with hypertension. Side effects are rare, allergic skin reactions are possible.
2. Plumbum is an inorganic homeopathic preparation. Used to treat uterine spotting with severe headache and dizziness. The way of using the drug depends on the form. Dosage in case of taking drops - one drop per ten kilograms of body weight, and when taking capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of hands and feet, as well as sensation of heat. Precautions - do not use simultaneously with antispasmodics.
3. Adonis vernalis is a homeopathic remedy of organic origin. The drug has a regenerating effect, improves local blood circulation in the uterus and normalizes the tone of the ovaries due to the action on nerve endings. The way of using the drug - two drops should be taken every morning, under the control of the heartbeat - with the appearance of tachycardia, the dose can be reduced. There were no side effects. Precautions - do not take with allergies to pollen from plants.
4. Echinacea is a homeopathic remedy of natural plant origin. This plant is mainly a systemic tool for improving blood circulation, as the plant stimulates the nervous system and blood vessels, which increases blood pressure. Therefore, the use of the drug is recommended in girls and women with asthenic constitution, which are prone to fainting and lowering blood pressure. The method of using the drug is the use of a homeopathic solution in ampoules, dissolving them in pure water. Dosage - five drops per glass of water. Side effects can be in the form of increased pressure, tachycardia, insomnia. Often there are disorders of stool in the form of diarrhea. Precautions - if you have arterial hypertension take with caution, under the control of blood pressure - when lifting it, you need to reduce the dose or stop taking the drug. Admission can be in the acute period of profuse menstrual periods, and during the remission period a constant reception is not recommended.

Surgical treatment of copious first months can be used only if the cause is acute pathology that threatens the health and life of women, and if this is the only way to stop bleeding. If the cause of such a plentiful monthly is the myomatous node, then surgery is performed to remove the nodal fibroids. The volume of the operation depends on the size of the tumor and can be either transvaginal or intra-abdominal. If the cause of such abundant discharge is the placenta remnants after incomplete abortion or miscarriage, then surgical treatment of the uterine cavity is necessary. At young girls at such bleedings the tactic of expectation is applied, diagnostic curettage are spent extremely seldom.

[40]

Prevention

Prevention of the appearance of abundant first months after birth is the proper care of the reproductive system, which is not only in hygiene, but also in mandatory breastfeeding. After all, normal breastfeeding helps to normalize the hormonal background and further prevents the development of such problems. As for other causes of profuse menstruation, you need to carefully monitor your cycle, with any violation of it, consult a doctor. Do not self-medicate and conduct all procedures for invasive intervention or abortion only in special settings. Moms should monitor the development of their daughters and control their development of menstrual function.

[41], [42], [43], [44],

Forecast

The prognosis of favorable resolution of copious menstrual flow is favorable for recovery and prevention of complications, only if the required volume of medical care is provided in a timely manner.

Abundant first months - pathology more frequent than diagnosed and properly treated, which is dangerous for the health of a woman and her reproductive function. The consequence of such secretions can be not only anemia, but also problems in the future with the whole cycle, so do not miss any such violations. If anything is bothering about the nature or the general condition, it is always better to see a doctor.