Sudden heavy menstruation with blood clots

If your menstrual flow suddenly becomes heavy and there are blood clots, the heavier the flow in the first two days of your period, the more normal it is. There was nothing unusual about the blood clot. The relationship between the degree of endometrial detachment. If the menstrual volume exceeds 80 ml, it is necessary to see what the cause is. Prolonged menstruation may be due to infection, endometriosis, uterine fibroids, blood disorders or dysfunction. Guide the examination of B-ultrasound and sex hormone test to find out the cause and then treat it symptomatically. Pay attention to warmth and rest during menstruation. After your period starts, you can prepare for pregnancy.

1. Caused by neuroendocrine dysfunction

The main problem is that the function of the hypothalamus-pituitary-ovarian axis is unstable or defective.

2. Caused by ovarian problems

Menstrual irregularities in women of childbearing age are generally due to poor ovarian corpus luteum function, which often manifests as heavy menstrual bleeding.

3. Caused by organic disease or drugs

Including local inflammation, tumors and developmental abnormalities, malnutrition of the reproductive organs; intracranial diseases; other endocrine dysfunctions, such as abnormal thyroid and adrenal cortex function, diabetes, Sheehan's disease, etc.; liver diseases; blood diseases, etc. Menorrhagia may occur in women who use psychiatric medications, endocrine preparations, or intrauterine devices for contraception.

Clinical manifestations

Patients with menorrhagia lose more than 80 ml of blood per menstrual cycle. Each patient's subjective judgment of bleeding volume varies greatly. It has been reported that among patients complaining of heavy menstrual flow, only 40% had objectively measured blood loss of more than 80 ml.

▍Inspection

1. Perform routine blood tests, hormone level tests, coagulation function tests, platelet adhesion and aggregation function tests, BBT tests, and perform endometrial or blood progesterone tests at an appropriate time.

2. Hysteroscopy, laparoscopy, B-ultrasound, and uterine artery angiography.

Diagnosis

Based on the clinical manifestations and the above-mentioned related examinations, measuring the blood progesterone concentration 5 to 9 days before menstruation can help determine whether it is ovulatory dysfunctional uterine bleeding.

Treatment

1. Medication

(1) For patients who do not require contraception or are unwilling to use hormone treatment, antifibrinolytic drugs such as tranexamic acid or anti-PG synthetic drugs such as flufenamic acid (flufenamic acid) and mefenamic acid (mefenamic acid) can be used. Adverse reactions may include nausea, dizziness, headache, etc.

(2) For patients who require contraception, endometrial atrophy treatment can be used.

(3) Others: Danazol is a derivative of 17a-ethynyltestosterone. It can inhibit the secretion of gonadotropin-releasing hormone, inhibit the peak of the gonadotropin cycle and the production of ovarian sex hormones, and reduce blood loss. However, attention should be paid to side effects such as rash, liver damage, and virilization. Gonadotropin-releasing hormone enhancers are effective in suppressing ovarian function, but due to side effects caused by low estrogen levels, they can only be used for a short period of time. Cottonpol has a strong effect in atrophying the endometrium and can also act directly on the ovaries. Potassium chloride (slow-release potassium) should be taken in addition to prevent the side effect of hypokalemia. Suitable for patients in the menopausal transition period who no longer desire fertility.