Abnormal Uterine Bleeding

Hello friends,

Main Dr. Surekha Jain hu. Aaj main aap ko batana chahti hoon AUB yani ki abnormal uterine bleeding kya hoti hai. Jaisa ki naam batata hai abnormal uterine bleeding ka matlab hai woh mahamari ya aurat ko vo bleeding jo samay par na ho aur normal flow se zada ho. Moti moti baat yahi hai ki waqt par nahi hoti, samay se irregular hoti hai aur jitna din ka flow hona chahiye usse zada hoti hai. Lekin is bleeding ko har umar mein alag alag kaaran aur alag alag tarah se treat kiya jata hai. Shuruvat hum karenge is baat se ki agar kisi ko zada ya excessive bleeding hoti hai, mahamari excessive hoti hai to usse kitni nuksan ho sakte hain. Kisi bhi umar mein zada bleeding hone se patient ko anaemia hoga khoon ki kami hogi usse usko thakan hogi, normal routine work karne mein mushkil hogi aur iss tarah se wo ek bimari ki stithi mein aa jayegi. Sabse pehle hum is baare mein baat karenge ki jo vayask avastha hoti hai jab ki ladki ko bleeding mensuration chalu hota hai ya jisko medically hum puberty kehte hain, puberty ke dauran ya puberty se ek saal, do saal ke aas paas agar hum ko abnormal uterine bleeding hoti hai to uske kaaran bilkul alag hote hain.

Uske zadatar kaaran hote hai usme sabse pehla kaaran hota hai ek saal tak ki bache ko paripakva awasthe mein nahi hota. Usme hypothalamus pituitary ovarian uterine axis jo ki puri ek axis hai jo ki patient ko bleed karati hai ya har mahine mahamari deti hai, woh paripakva vo mature nahi hoti. Immaturity ki wajah se immature signals aate hain aur har mahine anda nahi banta isliye patient ko kabhi kabhi jaldi aur kabhi kabhi late bleeding bhi hoti hai. Ek saal tak isilye pareshan hone ki zada zarurt nahi hai. Fir bhi agar ye hi awastha zada din tak rahe to hame kya karna chahiye? Sabse pehle complete haemogram patient ka pura hemoglobin dekha jaye, kitna hai kam hai zada, uska coagulation profile kya janmjaat koi coagulation ki bimari to patient ko nahi hai. Ek Von Willebrand factor bhi hota hai uski test bhi karayi jani chahiye. Thyroid ka bhi test karaya jana chahiye.

Ye common kaaran hai puberty ke around abnormal uterine bleeding ke. Uske alawa 1 ultrasound bhi zarur karana chahiye halaki ye kam bahut kam hota hai is awastha mein fir bhi kayi ovarian tumors aur abnormal development of the genital tract bhi iska kaaran ho sakta hai. Ab doosra hum aate hain vo awastha jo kareeb 25-40 saal tak ke beech mein jisko hum kehte hai childbearing age. Childbearing age mein abnormal uterine bleeding ke bohot sare causes ho sakte hain jis mein sabse pehla kaaran pregnancy se related hota hai. Pregnancy se related matlab patient pregnant hai, use pata nahi bleeding ho gayi aur usko tab pata chala vo doctor ke pass aayi jise hum threatened abortion kehte hain. Kayi bar patient pregnant hai, incomplete abortion ho gaya, patient bleed karti rahi, use maloom nahi hai, usko hum incomplete abortion kehte hain. Aur uske alawa missed abortion bhi hota hai, patient ne time pass kiya, andar hi bachcha kharab ho gaya aur thoda thoda karke bleeding hoti rahi. To pregnancy se related iske alawa ek aur stithi hoti hai jise kehte hai vesicular mole, jisme ki bachcha pura sa banta hi nahi hai aur vo khatarnak bimari hoti hai.

Isiliye doctor se jab bhi aap ko pregnancy mein bhi bleeding ho turant doctor se consult karna chahiye. Ectopic pregnancy matlab jabki pregnancy uterus mein na ho kar tubes mein hoti hai jo jaanleva bhi ho sakti hai tab bhi thodi thodi bleeding ho sakti hai. Kehne ka tatpariye ye raha ki agar aap pregnant hai, aap ko pata hai aur thodi bhi bleeding hoti hai to doctor se zarur consult karna chahiye. Iske alawa ye childbearing age mein aur bohot sari problems aisi hai jo aap ko is tarah ki bleeding de sakti hai. Jaise agar patient PCOD hai, to har mahine uska anda nahi banta aur uski growth andar jo bachchedani mein endometrium layer endometrial layer vo zada grow kar jati hai, itna grow karti hai ki vo fir hold nahi kar sakti aur fir zada bleed karti hai. To matlab kehne ka yahi hua ki aap ko jab bhi aniyamit bleeding ho ya normal se zada khoon jaye to aap ko doctor se zaroor consult karna chahiye. Childbearing age mein teesra ek kaaran jo sadharantya hota hai vo hai fibroid uterus matlab thodi thodi gathein, rasolia uterus mein ban jati hai jo is tarah ki problem de sakti hai.

Aur adenomyosis chota chota wall mein gathein banjati hai bachedani ki, vo bhi is tarah ki problem de sakti hai ya pelvic inflammation ya pelvic infection. Koi bhi infection, bohot tarah ke infections hote hain jo soojan de sakte hai pelvis mein, pelvic area mein aur bleeding zada ho sakti hai ya fir doctor dwara jaise apne koi copper-T lagvaya hai, multiload lagvaya hai ya mirana lagvaya hai vo bhi kabhi kabhi mahine ke beech mein bhi thodi thodi spotting ho sakti hai ya mahine ke time mein bohot zada bleeding ho sakti hai. Ye aur agar aap ko bachchedani ke muh pe koi jhakham hai vo bhi aap ko bleeding zada de sakta hai. Childbearing age mein hame kya kya investigation karni chahiye? Isme aur investigation ke alawa sabse important ye hai agar aap ko post-coital bleeding hai matlab aap ko husband se contact karne ke baad bleeding hoti hai to that can be woh ek nishani ho sakti hai ki aap bachchedani ke muh yani cervix ka cancer develop kar sakte hain, aisi condition main PAP smear ya HPV DNA aaj kal test hota hai jo ye doctor ko badi aasani se bohot jaldi bata deta hai ki haan aap ke saath ye problem hai aur usko badi aasani se treat kiya ja sakta hai. Iske alawa investigation mein sab aate hain hemogram, blood sugar, thyroid aur urine ka koi infection yeh saree routine test aap ko doctor se milke jarur karne chahiye. Ab aate hain hum vo awastha jo bhudapa kehlati hai ya menopause kehlati hai, pre-menopause and menopause both.

Pre-menopause mein agar aap ko irregular bleeding hoti hai to dubara se woh kaaran ho sakta hai ki aap ka physiologically anda theek se nahi ban raha kyunki ab aap ka vanning period hai dhere dhere aap ki hormones kam hoti ja rahi hai isiliye aap bleed kar rahi hai. Lekin agar aap ka menopause aa gaya hai ek saal tak aap ko koi bleeding nahi hue hai uske bad achanak koi bleeding hoti hai to vo khatre ki nishani ho sakti hai. Aise mein zarur aap ko doctor ko dikhana chahiye jo aap ke upar bohot sare test karke aap ko bata sakti hai ki koi early cancer to nahi hai. Early cancer ke liye aaj kal PAP smear aur HPV DNA jaise maine bataya vo to karte hi hai, ek aur acha test hai jo humari doorbeen hoti hai jisse hum puri bachchedani dekh sakte hai aur bata sakte hai ki andar kya kharabi hai. In sab test karane se aap khatarnak bimariyo se aasani se bach sakte hai, ultrasound, MRI ye sab hamare ko sehyog dete hai diagnosis banane mein. To mai friends aap ko yahi kehna chahti hu koi bhi abnormal uterine bleeding ko aap neglect mat kariye, usko seriously lijiye aur ek bar doctor ki raye zarur lijiye.

Dhanyavad.