Heavy first period

Heavy first periods are a problem not only for adult women, but also often for young girls, which makes them worry about their health and general well-being. Diagnosis of such a condition is not difficult, but establishing the cause is sometimes a difficult task, although 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. Heavy first periods are a problem for more than 78% of girls on the way to establishing a normal menstrual cycle. The reason for this in 90% of cases is precisely the physiological imbalance, which passes with time, and only 10% of cases of heavy first periods are caused by organic pathology requiring treatment.

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Causes heavy first period

The clinic of heavy first menstruation has a rapid development and serious consequences, therefore, an integral part of the treatment is identifying the cause. Among all possible causes, it is necessary to consider, first of all, the woman's age, and only then think about the range of all possible factors.

When a girl first gets her period, it is the beginning of the reproductive period. Then the girl becomes a young woman 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 hormone increases. It is the concentration of hormones that causes ovulation. In this case, the ovarian follicle ruptures and the egg comes out of it. In parallel with these processes, changes occur in the uterus under the influence of other hormones. The 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 endometrium of the uterus, and in the second phase, progesterones prevail. When the amount of luteinizing hormone and progesterone decreases towards the end of the second phase, the first menstruation occurs.

Often, the cause of heavy first periods in women of reproductive age can be a recent abortion or miscarriage. After such an abortion, the endometrium is restored with a large number of cells, which is a risk factor for further bleeding.

Among other possible causes of heavy periods in women, it is necessary to mention benign formations, such as myoma, which can give the clinical picture of heavy periods.

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

Heavy periods are very common in women of menopausal age. This is due to the fact that the woman's body gradually ages, the ovaries lose their function and the amount of estrogens decreases. When such phenomena occur in spurts, the excess of estrogens can give the clinical picture of heavy periods. It often happens that after several years of menopause, for example, if there has been no period for five years, there are such heavy bloody discharges as the first period. This is a very bad sign and the cause may be uterine cancer. This should be given special attention and this pathology should be excluded first of all.

When talking about the causes of heavy first periods, it is important to emphasize that there can be many of them. Therefore, it is necessary to limit ourselves not only to clinical manifestations, but also to the woman's age, which directly affects the cause of this pathology.

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Risk factors

When talking about the causes of heavy first periods in women, it is necessary to pay special attention to possible risk factors. Among the risk factors for such pathology, the following can be distinguished:

• 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 of less than three years;
• recent miscarriage or abortion.

Such risk factors increase the likelihood of complications and cycle disorders in the future. The reasons for the appearance of heavy first periods, for example, after childbirth, are associated with some hormonal imbalance. After the birth of a child, a woman's body secretes a huge amount of the hormone prolactin, which promotes lactation. Its second function is to delay the development of the next egg, so nursing mothers do not have periods for at least six months after childbirth. This condition works only when a woman actively breastfeeds the child and the interval between feedings is no more than three hours. Then prolactin is actively secreted and its constant amount delays the onset of menstruation. When the child is six months old, he breastfeeds less often and prolactin is secreted less - this leads to the fact that the first menstruation may occur. They should be established with the first cycle, but there are some problems. The reason for heavy first periods after childbirth may be a lack of prolactin or progesterone. If a woman did not have milk and did not breastfeed, then menstruation may begin some time after childbirth and it will be heavy. The reason for this is precisely the prolactin deficiency. Parts of the membranes and tissues of the fetus, as well as the functional layer of the endometrium, can be strongly expressed, which will be the reason for such heavy discharge. If childbirth was complicated by bleeding or retention of amniotic membranes, or after a cesarean section - then this can be the reason for heavy first periods, since in response to damage to the endometrium, the body protects itself and the functional layer of the uterine epithelium increases.

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Pathogenesis

The pathogenesis of the development of heavy first periods in girls is associated with the hormonal background. When all the complex hormonal processes in a girl have not yet been established, there is no balance of hormones that regulate the phases of the menstrual cycle. As a rule, girls have predominantly estrogens and there is a lack of luteinizing hormone. Therefore, during the first menstruation, excess estrogens stimulate the growth of a thick endometrium. The consequence of this is a long first menstruation. Under normal conditions, the duration of menstruation is from three to five days, this is in women with an established cycle. But in girls, heavy first periods are a common occurrence, which can be considered physiological for several cycles in a row. Therefore, the main reason for heavy first periods in girls can be considered hormonal imbalance.

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Symptoms heavy first period

The first signs of heavy first periods can be caused by the volume of blood loss. After all, under normal conditions, a woman's body is adapted to monthly blood loss and the number of formed elements and the liquid part of the blood is quickly restored. But with heavy first periods, especially in girls with an asthenic physique, the first symptom of blood loss can be loss of consciousness. This happens because the amount of circulating blood in the body decreases and blood pressure decreases. At the same time, there is a lack of oxygen for the brain, which is manifested by fainting.

Other symptoms that may occur are also related to blood loss. Dizziness, weakness, lethargy, headache, and palpitations appear. Sometimes these symptoms may be accompanied by nausea, loss of appetite, and paleness of the face. All this develops due to a lack of oxygen for all cells of the body, which eventually leads to internal organs suffering. If such heavy periods are repeated more than once, then anemia develops.

Heavy first menstruation after childbirth may be normal if it happens only once, and then the cycle should be restored. If such discharge has been going on for several months and leads to significant health problems, then you should pay attention to this. In this case, there may be symptoms not only of dizziness, paleness, exhaustion, but also an increase in temperature, pain in the mammary gland or lactation disorders. Then you should think about the possibility that there are remnants of the membranes in the uterus after childbirth and conduct an examination. If the first menstruation after childbirth first appeared after six months, and they are heavy for one or two times, then this phenomenon is considered a normal formation of the menstrual cycle.

Heavy first periods after a cesarean section are more common than after a normal birth, since there is interference with the integrity of the endometrium. After all, along with the fetal membranes, it is possible that a deeper layer of the endometrium is also removed, and its restoration takes longer.

The first heavy menstruation after a miscarriage or abortion is also associated with interference in the normal structure of the functional layer of the uterus. It can be considered normal when heavy menstruation appears some time after a miscarriage. This indicates the body is protecting itself and removing all unnecessary things. In this case, a woman may feel a slight malaise, minor abdominal pain, typical for menstruation, and there are no other symptoms. The body temperature should be normal, and the cycle should be restored the following month.

If heavy periods are accompanied by a rise in temperature and symptoms of intoxication, then one can suspect an inflammatory disease of the uterus. Endometritis or parametritis often has a postpartum etiology, but nevertheless, it is accompanied by bloody discharge from the vagina, which a woman can confuse with menstruation. Such discharge has an unpleasant odor and can be mixed with pus.

Uterine fibroids are a disease characterized by the formation of connective tissue among the muscular layer of the uterus. These cells grow very quickly and can be located both inside the uterus and on the serous membrane. If the fibroid is nodular, then such nodes are located inside the uterine canal and often the symptoms are bleeding, which is similar to heavy menstruation. Therefore, it is important to conduct differential diagnostics with such symptoms.

Endometriosis is a pathology in which foci of the endometrium get on the ovary, in the vagina or cervical canal, and at the same time these foci under the influence of hormones secrete blood. This manifests itself in the form of heavy menstruation, which is also accompanied by severe pain. Such menstruation lasts about a week or two and leads to anemia of the woman.

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

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Complications and consequences

The consequences of heavy first periods can be very serious. Most often, posthemorrhagic anemia occurs, which disrupts the functioning of the heart, blood vessels and other internal organs. This is more common in young girls due to insufficient hormonal regulation. If heavy periods are caused by inflammatory diseases, complications may occur in the form of the process spreading to the small pelvis and the development of peritonitis. Complications that can occur against the background of endometriosis are uterine bleeding and, in the future, malignancy of these foci is possible.

Uterine fibroids, which are the cause of heavy periods, may be a consequence of the development of necrosis of the myomatous node or its inflammation. If bloody discharge is observed after an abortion or miscarriage, then there is a possibility of developing hematometra or other complications that threaten problems with conceiving a child and carrying a pregnancy in the future. Such complications are far from all, but their importance for a woman's health emphasizes the need for timely diagnosis and treatment.

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Diagnostics heavy first period

Diagnosis of heavy first menstruation should begin already at the stage of collecting anamnesis. It is necessary to know exactly what the woman's cycle is, how long this discharge lasts, how it affects her well-being and whether there were any surgical interventions. It is necessary to roughly estimate the volume of possible blood loss and then proceed to an external examination.

If a girl has come to us, then you need to pay attention to the development of secondary sexual characteristics in her, because this characterizes the girl's hormonal background. If there are no secondary sexual characteristics against the background of the onset of menstruation, then this may indicate a hormonal imbalance, then you need to consult a pediatric endocrinologist. If there are symptoms of heavy periods against the background of the girl's good health, then most likely this is a normal phenomenon and you need to conduct tests to exclude organic pathology.

Anemia can also be diagnosed by external signs - pale skin and mucous membranes, blue sclera, tachycardia and systolic murmur at the apex during auscultation of the heart. These diagnostic signs appear already with severe anemia, when heavy menstruation continues for several months. Sometimes, with huge blood loss, there may be symptoms of low blood pressure and fainting.

An adult woman must be examined on a chair. Many pathologies can be detected during a vaginal examination and examination in mirrors. Uterine fibroids cause thickening of the uterine wall, its immobility or significant nodes in its cavity. Only with the help of a regular examination can fibroids be excluded. Endometriosis can also be seen on the cervix in the form of brown spots that bleed.

If heavy first periods occur after an abortion or miscarriage, this may be due to the retention of amniotic membranes. This can be seen during a vaginal examination, and diagnostic curettage of the uterine cavity can be performed in parallel. This is a mandatory diagnostic method precisely when this pathology is suspected. If symptoms of heavy periods appear in a woman of climacteric age, then the contents of the uterus are necessarily sent for histological examination to exclude a malignant process.

Tests that allow you to determine the degree of blood loss and possible treatment measures are, first of all, a detailed blood test. Determining the amount of hemoglobin, red blood cells, and color index allow you to determine the degree of anemia. The first degree is characterized by a decrease in hemoglobin levels 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 a girl's first period is heavy, then for the purpose of differential diagnosis, tests are carried out to determine sex hormones.

Instrumental diagnostics of heavy periods is very important for identifying the cause. The most informative diagnostic method in gynecology is considered to be transvaginal ultrasound. This method allows you to establish the thickness of the endometrium, the condition of the ovaries and follicles, the presence of additional structures in the uterine cavity, and you can also accurately determine the fibroid, its size or other phenomena in the form of endometriosis foci. If the ultrasound is performed on a young girl, then often no pathology can be detected, then it is necessary to conduct hormonal screening.

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Differential diagnosis

Differential diagnostics in girls should be carried out 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 determination of sex hormones must be included in the diagnostic program to exclude such pathologies.

It is also necessary to conduct differential diagnostics between heavy periods and miscarriage in progress. The main diagnostic point here is the presence of pregnancy or delayed menstruation, whereas with heavy periods the cycle is not disrupted. For the purpose of differential diagnostics of fibroids or endometriosis, it is necessary to conduct ultrasound, which allows to exclude one or another pathology.

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

Treatment heavy first period

Medicines used for this pathology can be divided into emergency aid and long-term therapy. If the volume of blood loss is such that the hemoglobin level 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 blood loss. But if the menstruation is heavy for several days, then this may correspond to the first or second degree of anemia, then hemostatic agents are used. In the future, to maintain the hormonal background, which will allow normalization of menstruation, replacement or additional hormonal therapy is prescribed for several months with a gradual withdrawal of drugs.

1. Etamzilat is a drug from the group of systemic hemostatic agents that can be used to stop heavy menstruation. The drug has a predominant effect on platelet cells and capillaries, which helps activate the vascular-platelet link to stop bleeding. The method of using the drug to stop bleeding is intravenous, which accelerates the effect of the drug. The dosage of the drug is 10 milligrams per kilogram, on average, one ampoule is used three or four times a day. Side effects are possible in the form of jaundice, rash, itching of the skin, a feeling of heat in the face and a decrease in pressure. Precautions - use with caution in patients with asthma and varicose veins.
2. Aminocaproic acid is a systemic hemostasis agent that acts by inhibiting fibrinolysis. The drug can be used to treat heavy uterine discharge, especially to quickly stop such bleeding. The method of administration of the drug is intravenous drip. Dosage of 100 milliliters of solution during the first hour, and then under the control of the condition and blood test. Side effects of aminocaproic acid are heart rhythm disturbances, 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 heavy periods is considered justified due to the fact that the consequence of blood loss can be a decrease in local immunity and the development of complex infectious diseases. Broad-spectrum antibiotics are preferred.

Ceftriaxone is a third-generation beta-lactam antibiotic, especially effective against gram-positive and gram-negative flora. The drug has a bactericidal effect on possible anaerobic pathogens, so it can be used for prophylactic purposes in gynecology. The dosage of the drug is 200 milligrams twice a day, taking into account prophylactic administration, for at least five days. Side effects are possible when affecting the stomach - colitis or dysbacteriosis develops, which is manifested by bloating, stool disorders. Precautions - the drug cannot be used if you are allergic to penicillin antibiotics, as well as with congenital enzyme deficiencies.

1. Femoston is a combined hormonal drug that includes estradiol (an analogue of natural estrogen) and dydrogesterone (an analogue of progesterone). This drug allows you to control the level of hormones, and in case of bleeding caused by their deficiency, it 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 rejection of the epithelium to begin in a timely manner. The method of using the drug in tablets throughout the cycle. The dosage of the drug is one tablet daily under the control of uterine discharge, the dosage of hormones can change. Side effects are dizziness, drowsiness, pain in the mammary gland, itching of the skin, 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. Lindinet is a complex hormonal agent, 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 normalization of hormone levels. The method of administration of the drug is in tablet form with a dosage of 20 or 30 milligrams. Treatment for 21 days with individual selection of the dose. Side effects - pain in the lower abdomen, bloody discharge from the vagina, swelling of the breast, allergic reactions 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 posthemorrhagic anemia, which is caused by heavy periods, it is often necessary to use iron preparations to correct the condition - Ferritin, Transferrin, Maltofer. For treatment, you need to use a dose for a month, and then a prophylactic dose for three months.

Physiotherapy treatment can only be used during the period of remission.

Folk remedies for heavy first periods

Traditional methods of treatment are very effective in stopping uterine bleeding, and many herbs have a tonic effect and normalize hormonal balance.

1. Beet juice is a very good remedy for correcting anemia, it tones the uterine vessels and improves blood circulation. Beet infusion can be used even during severe bleeding. To do this, squeeze out a liter of beet juice and add one hundred grams of honey. Then add twenty grams of dry yeast and let this solution stand for three to five days. Dosage - take half a glass of juice in the morning and evening.
2. A good hemostatic agent is an infusion of sea pepper. For a medicinal infusion, you need to take the root of sea pepper, insist for twenty minutes in hot water and make a tampon from such an infusion. You need to insert it carefully into the vagina for fifteen minutes, only if there is no pronounced bleeding, better after such heavy periods.
3. Cold and compress on the lower abdomen relieves pain, spasm and reduces bleeding. To do this, take an infusion of blueberry leaves, wet a bandage folded in several layers, and put it on the lower abdomen. After a few minutes, remove the compress and apply cold.
4. Tea made from viburnum, gooseberry and lemon is very good for restoring the volume of lost blood and stimulating the formation of formed elements of the blood.

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

1. To prepare a medicinal tea that has a hemostatic property, you need to take 50 grams of stinging nettle and the same amount of milk thistle, boil it over low heat for five to ten minutes and then strain. You need to drink this tea five times a day, half a cup at a time, in the acute period you can drink more.
2. Particularly effective in the treatment of uterine bleeding and further hormonal disorders is an infusion of arnica root, string and oak bark. To prepare a medicinal tea, take ten grams of arnica bark and root, pour half a liter of water, and then after it has been infused for twenty minutes, strain and drink. Dosage - about a liter of tea should be drunk per day, monitoring the general condition.
3. Parsnip is a plant that normalizes hormonal levels and improves blood circulation in the uterus, regulating nerve conduction. To prepare a medicinal tea, you need to take 50 grams of parsnip root, boil it over low heat for five to ten minutes and then strain it. You need to drink this tea three times a day, one teaspoon after the end of bloody discharge.
4. Powder from anise fruits helps very well with dysfunctional uterine bleeding due to its effect on the ovaries. For a medicinal infusion, take 100 grams of anise fruits, make a powder out of 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 long-term use and minimal harm. In addition, homeopathic remedies can be used selectively in relation to the main symptoms.

1. Lachesis compositum is a homeopathic medicine used for heavy first periods in girls, accompanied by abdominal pain of a pulling nature, especially when it radiates to the lumbar region. The dosage for primary cases is four drops in the morning and evening, and if this is not the first pathology, then the same dose can be taken three times. The course of treatment can be started already during menstruation with a dose of three drops, and then during the first month take eight drops. Precautions - it is not recommended to use the drug in obese women with arterial hypertension. Side effects are rare, allergic skin reactions are possible.
2. Plumbum is an inorganic homeopathic preparation. It is used to treat uterine bleeding with severe headache and dizziness. The method of using the preparation depends on the form. The dosage for drops is one drop per ten kilograms of body weight, and for capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of the hands and feet, as well as a feeling 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 effect on nerve endings. Method of application of the drug - two drops should be taken every morning, under the control of the heartbeat - if tachycardia occurs, the dose can be reduced. No side effects have been identified. Precautions - do not take if you are allergic to plant pollen.
4. Echinacea is a homeopathic remedy of natural plant origin. This plant is primarily a systemic remedy for improving blood circulation, since the plant stimulates the nervous system and blood vessels, which increases blood pressure. Therefore, the use of the drug is recommended for girls and women of asthenic physique, who are prone to fainting and low blood pressure. The method of using the drug is to use a homeopathic solution in ampoules, dissolving them in clean water. Dosage is five drops per glass of water. Side effects can be in the form of increased pressure, tachycardia, insomnia. Stool disorders in the form of diarrhea are often observed. Precautions - in the presence of arterial hypertension, take with caution, under the control of blood pressure - if it rises, you need to reduce the dose or stop taking the drug. Reception can be in the acute period of heavy menstruation, and during the period of remission, constant use is not recommended.

Surgical treatment of heavy first menstruation can be used only if the cause is an acute pathology that threatens the health and life of the woman, and also if this is the only way to stop the bleeding. If the cause of such heavy menstruation is a myomatous node, then surgical intervention is performed to remove the nodular myoma. The scope of the operation depends on the size of the tumor and can be transvaginal or intra-abdominal. If the cause of such heavy discharge is the remains of the placenta after an incomplete abortion or miscarriage, then surgical treatment is mandatory - curettage of the uterine cavity. In young girls, with such bleeding, a waiting tactic is used; diagnostic curettage is carried out extremely rarely.

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Prevention

Prevention of the appearance of heavy first periods after childbirth consists of proper care of the reproductive system, which consists not only in hygiene, but also in mandatory breastfeeding. After all, normal breastfeeding helps to normalize the hormonal background and prevents the development of such problems in the future. As for other reasons for heavy periods, you need to carefully monitor your cycle, and consult a doctor if there are any irregularities. You should not self-medicate and carry out all invasive procedures or termination of pregnancy only in special institutions. Mothers should monitor the development of their daughters and control the formation of their menstrual function.

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Forecast

The prognosis for a favorable resolution of heavy menstrual flow is favorable for recovery and prevention of complications only if the necessary amount of medical care is provided in a timely manner.

Heavy first menstruation is a pathology more frequent than diagnosed and treated correctly, which is dangerous for the health of a woman and her reproductive function. The consequence of such discharge can be not only anemia, but also problems in the future with the entire cycle, so you should not miss any such violations. If something bothers you in nature or general condition, it is always better to consult a doctor.