With the advice of Dr. Pietro Cignini, specialist in Gynecology and Obstetrics, Obstetric and Gynecological Diagnostic Service, Artemisia Main Center Rome and Milan, we will try to understand what are the steps to take when the menstrual cycle is abundant and painful.
The modification of the features of period (duration, quantity and rhythm) is certainly more frequent after one pregnancy, however possible changes they can and must always fall within the limits of normality, that is to maintain with a cadence of 24-30 days, lasting about 4-7 days.
In cases where there is a large quantity flow, it is possible to run the risk of aanemization, ie a reduction of ferro, fundamental component hemoglobin contained in red blood cells. On the other hand, the reduction of blood iron (anemia sideropenica) and backup (contained in liver) door around you to an accentuation blood loss, since iron is an element basic for good coagulation some blood.
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The advice is to first check i blood parameters, coagulants and, above all, iron reserves (ferritin) because very often one supplementation of iron is sufficient a restore a normal cycle. In general, the diagnostic hypotheses can be grouped into dysfunctional causes ovulation (ovulatory or anovulatory), injuries benign (myomas, endometrial polyps, adenomyosis), neoplasms malignant (cervical cancer, endometrial adenocarcinoma) e systemic pathologies (platelet disorders, coagulation factor abnormalities, hypothyroidism).
What can be the causes of menometrorrhagia?
The main ones cause organic determinants menometrorragie (bleeding) in women aged i 20 e i 50 years are to be sought in leiomyoma, benign smooth muscle tumors (36-68%), especially if submucosis, in polyps endometriali (6-20%) e nell’adenomiosi diffuse (20-25%), which occurs when the fabric endometrial than normally covers the uterus, grow up in the muscular walls of the uterus.
Generally speaking a menstrual cycle that increases of flow, in a woman in premenopause with maintained cyclicality, it suggests the presence of pathologies benign such as i miomi. While the irregularity of bleeding is a typical sign of the ovulation disorders. However one must never forget that losses irregular blood is also caused by neoplasms malicious, certainly infrequenti in the age group between 20 and 50 years, but always possible.
Investigations and treatments: never waste time
With simple ones test laboratory and diagnostic is possible frame the problem bleeding abnormal. You will have to contact your own gynecologist who will prescribe some exams to evaluate the coagulation structure and the possible presence of anemia sideropenica consequence and in turn cause of losses of blood abnormal.
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It will be important to perform aultrasound of the uterus and of ovaries to evaluate the presence of uterine myomas, endometrial polyps e cyst ovarian.
Finally, the execution of the pap test for the evaluation of the neck of the uterus and contextually its direct visualization.
The cure they will be instructed on the basis of findings exams, following which you can to establish a therapy doctor the surgical which will vary from case to case. For example, in the presence of polyps endometrial we will proceed to them removal endoscopically, through a small optic fiber vaginally, in day hospital. While in the presence of ovarian cysts of small and medium size, dysfunctional, a medical therapy hormonal it might be enough for them reabsorption spontaneous. In more cysts large sometimes their surgical removal is necessary with the laparoscopy.