Many female friends around me asked me, “My period is only clean for more than a week, how come I suddenly come a little bit again? Excluding abnormal bleeding, a common clinical condition is: ovulatory bleeding.
What do you mean by ovulatory bleeding?
In the middle of two regular menstrual periods, that is, occurring during ovulation, the endometrium of some women loses the support of estrogen due to a brief decrease in estrogen levels caused by ovulation, and the endometrium is shed, causing regular vaginal bleeding, which is called ovulatory bleeding.
After ovulation, the estrogen level drops significantly, and some women cannot maintain the growth of the endometrium due to the lower estrogen level, causing the endometrium to shed locally, resulting in a small amount of breakthrough bleeding. repair and the bleeding stops.
Clinical symptoms.
It usually occurs on the 12th to 16th day of the regular menstrual cycle and usually lasts for a few hours or 2 to 3 days, not more than 7 days. The amount is significantly less than normal menstrual bleeding and the bleeding may stop on its own. It may be accompanied by mild lower abdominal discomfort or lumbar pain or no accompanying discomfort, sometimes occurring occasionally between this and the next menstrual cycle, or in some cases lasting longer, with ovulatory bleeding occurring in 4 to 5 menstrual cycles.
Clinical examination.
1. Gynecologic examination: pay attention to the presence of cervical erosion and bleeding, supplemented by TCT examination of the cervix if necessary, and the presence of pressure pain in the uterus and bilateral adnexa.
2. presence of thickening and masses (check if necessary, operation should be gentle.) .
Auxiliary examinations.
1.Signs of ovulation: basal body temperature is biphasic, normal ovulation is detected by ultrasound, ovulation changes are also seen by ovulation test paper, bleeding occurs during the conversion of body temperature from low to high and when the test paper changes from positive to negative, i.e. ovulation phase.
2. Ultrasound examination: to exclude other diseases causing abnormal bleeding, such as cervical lesions, endometrial polyps, submucosal fibroids, etc.
3.Hysteroscopy is feasible if necessary in order to exclude endocervical polyps, endometrial cancer and other organic lesions.
Differential diagnosis.
Exclude the following common causes of uterine bleeding.
1, cervical lesions cervical lesions can also present with a small amount of vaginal bleeding, but this bleeding mostly occurs after intercourse or gynecological examination without the regularity of accompanying menstrual cycle episodes, which can be identified by cervical TCT examination.
2. Vaginal bleeding in patients with endometrial polyps and submucosal fibroids often occurs during menstruation, leading to prolonged menstruation, dripping, and may be accompanied by abdominal pain, and pelvic ultrasound shows polyp-like changes in the endometrium or submucosal fibroids.
3, frequent menstruation short menstrual cycle, and ovulation bleeding is different from no bleeding once more once less, ovulation detection menstrual cycle shortening will appear early ovulation.
4, vaginitis, vulvodynia, trauma, etc.
5, exclude pregnancy-related diseases.
Treatment.
Small amounts of estrogen can be taken orally. For example, take Tegretol, starting from the 8th to 10th day of the menstrual cycle for 3 to 7 days. Small amounts of hemostatic drugs, such as Anilox, can also be taken.
Prevention.
1.Understand the physiology of ovulation, pay attention to keep a happy spirit during ovulation, avoid mental stimulation and emotional fluctuations, pay attention to keep warm, avoid cold stimulation and avoid overwork.
2, master the causes of ovulatory bleeding, pay attention to ovulatory hygiene, prevent infection, pay attention to the hygiene and cleanliness of the external genitalia, and never have sex during the bleeding period.
3, in the ovulation period to wear soft, cotton, ventilated and breathable underwear, to be washed and changed diligently, change of underwear should be put in the sun to dry.
4, ovulation should not eat cold, sour and spicy and other stimulating food, drink more water, keep the bowels unobstructed. The actual fact is that you should eat more fresh fruits and vegetables before your period, and avoid eating onions, garlic, leeks, ginger and other things that stimulate dryness and heat.