Abundant menstruation with clots

The method of treatment of ample menstruation with clots is prescribed by the doctor in accordance with the age of the patient, the causes of the occurrence, the amount of blood lost and the duration of bleeding. But, in any case, the first stage is hemostasis - stopping bleeding, which can be done surgically or medically.

How to stop profuse menstruation?

The first thing to do is to calm down, as blood vessels dilate in the excitement and bleeding may intensify. If the bleeding has occurred in a pregnant woman, it is necessary to take a horizontal position with the raised leg of the bed, relax, call an ambulance. It is allowed to take the tablet form of ethamylate "Dicinon" 1- 2 tablets with water.

For other reasons for the occurrence of copious monthly bunches, the pre-medical measures should be as follows:

• Call an ambulance.
• Take the horizontal position with the raised leg of the bed raised.
• Put a heating pad, a bottle or any other vessel with cold water on the bottom of the stomach, which helps to narrow the blood vessels and reduce bleeding.
• Use a large amount of fluid to fill the volume of blood loss.
• The use of drugs that stop bleeding, such as: Dicycin 1-2 tablets, maximum 4 tablets per day for 0.25 mg., Tincture of water pepper 25 drops 3 times a day, extract of a shepherd's bag of 25 drops 3 times a day., Calcium gluconate 1-2 tablets 3 times a day.

Further treatment will be prescribed by a gynecologist in accordance with the indications.

1. Hemostatic therapy is aimed at stopping bleeding, for which fibrinolysis inhibitors - Aminocaproic acid and Tranexam - are used.

Aminocaproic acid is an effective antihemorrhagic drug whose action is directed to inhibition of fibrinolysis, which provides a blood-stopping effect. The effect of the drug occurs 15 minutes after intravenous administration. Assign the drug intravenously drip 100 ml of a 5% solution of not more than 8 grams per day or oral 30 ml 4 times a day. Contraindication to use is coagulopathy, a tendency to thrombosis, a history of cerebral circulation, ischemic heart disease. With caution appoint a drug with estragensoderzhaschimi contraceptives, which increases the risk of thromboembolism.

Traneksam is an antifibrinolytic drug with a local and systemic blood-restoring effect. The effect of the drug comes in 3 hours after ingestion and remains up to 17 hours. Apply 1 tablet 4 times a day for 4 days. Intravenously, the transex is administered a drop of 15 mg / kg every 6 hours no faster than 1ml / min. Contraindications for use are subarachnoidal hemorrhage, renal insufficiency. With caution appoint with thrombophlebitis deep veins, thromboembolic syndrome. Side effects occur with increasing recommended doses or with individual hypersensitivity to the active substance of the drug, and may manifest as nausea, vomiting, dizziness, thrombosis, tachycardia, skin rash, itching, urticaria.

2. Hormonal therapy is indicated for prescription based on age and survey results.

During puberty, hormones are prescribed if there is no effect on the haemostatic therapy. Preference is given to combined oral contraceptives: Microinone, Lindineth 20, Yarina 2-3 tablets per day with a gradual dose reduction to 1 tablet for 21 days.

Probably the appointment of gestagens: Dyufaston, Norkolut, Utrozhestan, 2 tablets per day with a subsequent dose reduction.

In the reproductive age, only nulliparous women should be given if, with ultrasound, the M-echo of the endometrium does not exceed 8 mm. The drugs of choice are: 17OPK 12.5% 2 ml IM once a day for 7 days, Dufaston 1 tablet 3-5 times a day, Norkolut 1 tablet 3-5 times a day, followed by a gradual decrease to 1 tablet per day .

17 OPC (oxyprogesterone capronate) - synthetic progesterone, of progestational progenesis in high doses depresses the secretion of gonadotropins, which helps to reduce bleeding and has a prolonged gestagenic effect. The drug is administered intramuscularly 2.0 ml of 12.5% solution every day until the relief of bleeding and 0.5-1.0 ml for 21 days to prevent the development of rebleeding. After intramuscular injection, the drug starts in 5 hours and lasts up to 14 days. Contraindications to the introduction of 17OPK is a violation of the liver, a tendency to thrombosis, malignant formations of the pelvic organs and mammary glands.

In the climacteric, women over 45 years of age are not recommended to carry out hormonal hemostasis. It is permissible to prescribe progestins, such as: 17OPK 250 mg on the 14th and 21st day of the menstrual cycle, Depot Provera 200 mg on days 14 and 21.

In the event of bleeding associated with impaired ovarian function, intramuscular progesterone administration is prescribed at 5-15 mg / day for 7 days, followed by a decrease in dose with positive dynamics.

Gonadotropin-releasing hormone agonists, such as Goserelin and Diferelin, are not often used to relieve exaggerated periods with clots, but are well established in regimens for further treatment of uterine bleeding. The fact is that with the constant administration of drugs, the synthesis of LH decreases and the concentration of estradiol in the blood decreases. This helps to reduce the growth and proliferation of the endometrium, which leads to minimizing the risk of bleeding until the development of menopause. Goserelin is injected subcutaneously into the anterior abdominal wall 1 time in 28 days, which ensures maintenance of the effective concentration of the drug in the body. The drug is contraindicated in pregnant, lactating and children. The drug is well tolerated. In rare cases, headaches, mood changes, dryness of the vaginal mucosa, cessation of menstruation, demineralization of bone tissue can occur.

3. Vitaminotherapy. Prolonged, abundant uterine bleeding, as a rule, leads to depletion of vitamins and microelements of the body. First and foremost, iron deficiency arises and as a result, iron deficiency anemia develops. For its elimination and replenishment of iron appoint:

• Vitamin B12 is 200 μg / day.
• Folic acid by 0.001g 2-3 r / day.
• Totem 1-5 ampoules per day orally.
• Globirone 1 tablet once a day.
• Sorbifer durules 1 tablet 1 p / day.
• Maltofer 1 tablet 1 p / day.
• Venofer intravenously drip.

The duration of iron supplementation depends on the degree of anemia and is controlled by blood counts.

Vitamin B6 and B1 with alternation for intramuscular injection are justified from vitamin preparations. Also recommended the appointment of vitamin E at 200 mg per day and routine at 200 mg 3 r / day.

4. Widespread use in the treatment of ample menstruation with clots found medicinal herbs and alternative medicine.

• Dry leaves of nettle pour half a liter of water and boil for 10 minutes, insist 30 minutes. Use inside for 1 tbsp. Spoon 5 times a day.
• Grass shepherd's bag 50g, herb mountaineer bird's 50g, grass mistletoe white 50g. A mixture of herbs pour 200 ml of water, boil for 5 minutes, cool. Drink 1 glass 2 times a day from the 3rd day of menstruation.
• Oak bark 30g, wild strawberry leaves 20g, raspberry leaves 20g, yarrow herb 30g. Brew in 200 ml of water and drink 200 ml. Morning and evening from the 1st day of the month.
• Bark buckthorn 30g and raspberry bark 30g. Collect the boiling water, insist and drink in the morning and in the evening for 1 glass.

In alternative medicine for the treatment of plentiful menstruation with clots, not only herbal preparations, but also other components for the preparation of medicinal potions are used.

• Decoction of orange peels has a good haemostatic property. Rind 5 oranges to boil in 1 liter of water for 1 hour on low heat. Add a little sugar and drink 1 tablespoon three times a day.
• Berries of fresh mountain ash and mint leaves are mixed 1: 1 and brewed in the form of tea. Such tea should be drunk 3 times a day before the end of the month.
• 30 g of dried and finely chopped herbs and parsley roots brew with boiling water in 400 ml of water and boil for 15 minutes, then strain. Take half a glass three times a day for 15 minutes before eating.

5. Physiotherapy.

In the treatment of copious uterine bleeding with clots, the following types of physiotherapy are widely used:

• Electrophoresis with copper sulfate provides a vasoconstrictor effect
• Cervico-facial galvanization increases the contractile function of the uterine myometrium
• Endonasal electrophoresis with vitamin B1 increases the muscle tone of the uterus
• Vibration massage of the paravertebral zones has a complex effect on the vessels of the uterus and muscle tone, which helps to reduce blood loss.

6. Homeopathy.

If the cause of abnormal periods with clots are functional disorders, the following drugs are used for treatment:

• Ovarium compositum. It is a complex homeopathic remedy, regulates the hormonal background. It has metabolic, sedative and anti-inflammatory functions. Assigned to 2.2 ml intramuscularly 2 times a week, from the third week 1 time in 5 days. The course of treatment is 10 injections. Contraindications - hypersensitivity to the components of the drug, children under 12 years. Precautions are given to pregnant and lactating women. Among the side effects noted increased salivation, in which case it is recommended to reduce the dose of the drug or to cancel it.
• Mulimen is a complex homeopathic drug whose action is aimed at regulating the balance of gonadotropic and steroid hormones, normalizing the autonomic nervous system and stabilizing the woman's mental state. Has hormone-regulating, spasmolytic, sedative and draining pharmacological properties. It is indicated for use in disorders of the menstrual cycle, mastopathy, treatment of side effects of hormonal contraception, premenstrual and climacteric syndrome. It is prescribed for 10-12 drops 2 times a day in the intermenstrual period and on menstruation days for 10-15 drops 3-5 times a day, depending on the degree of bleeding. Take before meals for 15-20 minutes, delaying briefly in the oral cavity. Contraindicated at the age of 12 years and with increased sensitivity to the components of the drug. Precautions are given to pregnant and lactating women. The drug is usually well tolerated, occasionally there may be allergic reactions.

With the development of abundant periods with clots against the background of the inflammatory process of the pelvic organs,

• Gynecochel is a basic anti-inflammatory drug that has vasotonic, anti-edematous and analgesic pharmacological properties. Promotes the completion of the inflammatory process, the restoration of microcirculation and the formation of a new tissue in the focus of inflammation. Reduces the risk of complications. Has a regulating effect on the menstrual cycle. It is prescribed for 10 drops 3 times a day daily, except for the days of menstruation. The course of treatment is 3 cycles. The drug is contraindicated in people who are allergic to the poison of bees, wasps and bumblebees. No adverse events were detected.
• Traumeel C is the first choice for any damage to body tissues. Has anti-inflammatory, antiexudative, regenerating and analgesic pharmacological properties. The drug is contraindicated in people with hypersensitivity to the components of the drug, suffering from tuberculosis, leukemia, AIDS. It is prescribed for 1 tablet 3 times a day. Possible adverse reactions in the form of redness and rash on the skin.

7. Operative treatment.

Surgical intervention in case of copious periods with clots, regardless of the cause, is performed with a haemostatic purpose to stop bleeding.

Treatment and diagnostic curettage of the walls of the uterine cavity is carried out under general anesthesia followed by the direction of the scrap obtained for pathohistological examination, which makes it possible to establish the cause of bleeding in 80%. After the operation, the patient is assigned hemostatic and antibacterial therapy.

Endometrial ablation is a surgical method for treating uterine bleeding, which is performed with a laser, or an electrode under the control of a hysteroscope, to remove the entire layer of the endometrium.

Hysterectomy is a radical surgery and is to remove the uterus. It is the last stage in the treatment of uterine bleeding, when the condition is not amenable to treatment by other methods.