Genital bleeding, outside of physiological norms, is a distinct symptom of a disorder in the woman’s genitourinary system. The main task in its presence is to find out where it originates from. Diseases that may be associated with genital bleeding are several groups: disorders in hormonal regulation, benign neoplasms and malignant diseases. 1. Disturbances in hormonal regulation The menstrual cycle in women is regulated by the hypothalamus-pituitary-ovary axis. In disorders that lead to changes in regulation, dysfunctional uterine bleeding is reached. Menstrual disorders in women are defined as follows: Dysmenorrhea – a condition of cyclic bleeding with pain (painful menstruation); Menorrhagia – the duration of cyclic bleeding (menstruation) is more than 7 days; Polymenorrhoea – bleeding less than 21 days apart; Oligomenorrhea – the interval between menstrual bleeding is more than 35 days. During the different periods of the woman, the causes of such bleeding may differ. Women in whom there is a prolonged period of menstruation and it is accompanied by pain, the presence of follicular cysts can be detected. Many of these cysts produce estrogens, which also leads to dysfunctional uterine bleeding. In women of reproductive age, dysfunctional uterine bleeding is observed in the presence of thyroid gland disorders. With hypothyroidism, prolonged menstruation can be observed. These disorders are also combined with anovulatory cycles – no ovulation occurred before the bleeding. In menopausal women, dysfunctional uterine bleeding is the result of reduced estrogen synthesis. This leads to atrophy of the endometrium and subsequent bleeding. In children between 2-8 years of age, it can be observed due to precocious puberty. The causes may be diseases that affect the central nervous system or those affecting the ovaries. Most often, these are tumors that lead to an increase in estrogen hormones and subsequent vaginal bleeding. NEWS_MORE_BOX In newborn girls, due to the increased hormonal levels of the mother, vaginal bleeding can be observed, it is called a hormonal crisis of the newborn. This condition is transient and does not require specific treatment. 2. Benign neoplasms Cervical polyps are the most common benign neoplasms in women. A very common symptom of them is bleeding after sexual intercourse or a gynecological examination. A uterine fibroid is a benign disease that originates in the myometrium, the muscle layer of the uterus. This disease can be asymptomatic or with genital bleeding. Very often, the bleeding begins a few days before a woman’s period begins. The symptoms of bleeding can be expressed in increased and abundant menstruation with increased blood loss. 3.Malignant diseases Cervical cancer is a neoplastic disease that develops from the squamous or cylindrical epithelium of the cervix. There are no early and characteristic symptoms that point to this disease. The appearance of bleeding on contact with the cervix is an important sign that requires diagnostic evaluation of the condition. Endometrial cancer is a neoplastic disease that originates in the lining of the uterus. Genital bleeding is an important symptom of this disease. In premenopausal women, the bleeding is irregular and unrelated to the monthly cycle. In postmenopausal women, genital bleeding is the most common symptom of endometrial cancer. When uterine bleeding occurs, it is necessary to stop it as quickly as possible and to determine the cause that led to it.
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