Lecture of premenopausal bleeding

2021-03-18 12:00 AM

All premenopausal disorders must be suspected of having a malignant cause. A thoughtful gynaecological examination is not to be missed

Often referred to as premenopausal. In fact, it may initially be menorrhagia, later bleeding is prolonged, bleeding no longer follows the mechanism of menstruation, but due to damage (inflammation) in the uterine lining and is hemorrhage.

Quite popular. Disorders of the amount of menstruation such as lack of period, menstruation, disorders of the menstrual cycle such as menstruation, menstruation can be encountered.

All premenopausal disorders must be suspected of having a malignant cause. Thoughtful gynecological examination (laparoscopy, tumor mapping, curettage of the uterine lining, cervical biopsy ...) is not to be missed. Cancer can originate from the cervix, from the lining of the quadrant, from the ovaries, from the sounds of the vagina. Only after eliminating the cause of the malignancy can symptomatic treatment be given.

In premenopausal menopause, a biopsy of the quadrilateral mucosa (up to 90%) has developed picture, only about 10% has a secretory image. Picture of follicular hyperplasia of the uterine lining is 10 times more common than the age of 20-45 years old.

In the postmenopausal period, often seeing images of uterine atrophy, the uterine lining is not working.

Benign and malignant tumors that cause bleeding disorders have different rates depending on age. In perimenopause, the rate of fibroids of the uterus, cervical polyps, and cancer of the lining of the uterus is 1-2%. Benign tumors are less common after menopause and increasingly turn to malignant tumors.

The best symptomatic treatment of menopausal menopause is the curettage of the uterine lining. There are 3 distinct benefits: rapid hemostasis, helping to prevent prolonged blood loss, having a piece of the uterine lining to try pathological anatomy, clearly identifying overproduction of the uterine lining to orient the use of honnon. next.

The date of curettage is considered the first day of the next menstrual cycle. If using hormones, take that day as a landmark. Usually, a progestin should be given from day 16, 10mg daily (Duphaston, Norcolut, Turinal ...), drink for 10 days. Drinking in 3 consecutive cycles like that, the result is always good, if there is no physical damage attached. After stopping the drug 2-3 days, the patient will menstruate in 3-4 days, the amount of menstruation is not much.

Note that progestin should never be given immediately after curettage as some physicians often do with the intention and hope to shrink the uterine lining immediately after curettage because there is a very high risk of bleeding. If the last progestin causes bleeding after curettage, the estrogen should be given immediately as 1-2 tablets of Mikrotollin or estradiol injected, which will stop the bleeding quickly.

There are a number of authors who give positive results after using testosterone treatment for premenopausal seaweed, helping to speed up menopause completely.

Besides the drugs and measures mentioned above, uterotonic drugs such as oxytocin, ergotamine should be used early and usually only beneficial. Medicines that help stop the bleeding like EAC, vitamin K, and calcium also help stop bleeding, such as iron, vitamins A, and B that also help.